InterQual® Level of Care Criteria

Assess the safest and most efficient care level based on severity of illness, comorbidities, complications, and the intensity of services being delivered.

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Evaluate the Appropriateness of Patient Care Across the Continuum

InterQual® Level of Care Criteria help healthcare organizations assess the safest and most clinically appropriate care level for more than 95% of reasons for admission. The condition-specific format presents evidence-based interventions that are specific to the condition and help to cost-effectively improve outcomes. The unique episode-day structure helps evaluate whether a patient is responding as expected and recommends interventions in the event of complications or a slower-than-expected response to treatment, as well as next steps for early responders.

Our novel approach involves evaluating Severity of Illness along with Intensity of Service to provide a clinically specific methodology for stay determinations. Additionally, only InterQual has incorporated management of comorbid conditions upon admission, along with continued stay.

InterQual Level of Care Criteria are available for:

  • Acute Adult
  • Acute Pediatric
  • Acute Rehabilitation
  • Long-Term Acute Care
  • Subacute and Skilled Nursing Facility
  • Home Care
  • Outpatient Rehabilitation and Chiropractic

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