Update to InterQual Criteria

Date: 07/16/25

Effective August 18, 2025, Iowa Total Care will implement criteria updates to InterQual® 2025. InterQual criteria updates are ongoing on an annual basis. These changes are applicable to all Medicaid products.

Iowa Total Care is committed to delivering cost-effective, quality care to our members. Updates to InterQual criteria will ensure members receive appropriate and consistent application of clinical criteria in decision making that is based on current medical criteria, expert clinical practices and healthcare technology.

For additional information regarding the InterQual changes impacted by this update, please refer to Introducing InterQual 2025 webpage.

For questions or concerns, contact your provider engagement account manager in your area or call Provider Services at 1-833-404-1061, Monday – Friday 7:30 a.m. to 6 p.m. CT.

Thank you for your partnership in serving Iowa Total Care members.