Improve Quality and Efficiency with Clinical Decision Support

McKesson's InterQual® Criteria products support better patient outcomes through integrated, streamlined care management processes and appropriateness of care support. Today, more organizations - payers and providers, public and private - rely on InterQual® than on any other evidence-based clinical decision support criteria. Wide adoption of InterQual fosters alignment between payers and providers and focuses all stakeholders on ensuring consistent, clinically appropriate care decisions.


InterQual helps to:

  • Reduce over- and under-utilization
    • Drive appropriate care with rule-based, patient-specific decision support using evidence-based medicine (EBM)
    • Appropriately reduce re-admissions, lengths of stay (LOS) and services with integrated tools for complex and co-morbid cases
  • Increase the defensibility of decisions and reduce risk
    • Facilitate care review communications and standardize terminology among staff and between health plans and providers with CareEnhance® Review Manager Enterprise, our interactive, browser-based access to InterQual Criteria that helps improve workflow and enhance data collection
    • Validate appropriate care with quality indicators, checklists and reporting
    • Drive cost efficiencies through Clear Coverage™, a clinical and financial decision support software-as-a-service solution
  • Align stakeholders
    • Support consistency with the same rule-based, customizable EBM decision support
    • Align with CMS guidelines
    • Reduce administrative expense with fewer denials and appeals
    • Improve quality with more time available for patient care
  • Support stakeholder performance management
    • Facilitate medical and payment policy decisions with rule-based EBM
    • Identify practice trends and areas for quality improvement
    • Identify high-quality, high-performing providers to support tailored networks


The expertise and intense rigor we apply in the InterQual development process results in unparalleled content integrity, so you can have greater confidence in your clinical decision-making. In addition, by sharing the underlying logic you can create greater transparency and alignment between you and your stakeholders.

Point-of-Care Decision Support

Ease of use is a key component of InterQual's success. We offer an array of options for accessing and sharing InterQual content and related information from within your unique care management workflows, as well as the ability to tailor the criteria and even add your own to meet your specific organizational needs.

Services for Your Success

When questions arise, our toll-free customer support hotline, email help and customer Web site offer paths to needed information. Our support team earned and maintains the prestigious Support Center Practices (SCP) Certification and a 96 percent customer satisfaction rating.

McKesson also offers a comprehensive portfolio of standard and customized education, training, technical services and professional consulting to help you get the greatest value from your decision.

  • Products

    • InterQual Level of Care Criteria

      InterQual Level of Care Criteria

      InterQual Level of Care Criteria help guide the reviewer toward the safest and most efficient care level

    • Doctor talking to oncology patient

      InterQual Care Planning Criteria

      InterQual Care Planning Criteria supports your organization in promoting clinical quality and cost-effective allocation of medical resources

    • InterQual Behavioral Health Criteria

      InterQual Behavioral Health Criteria

      Helping behavioral healthcare organizations deliver higher quality care at lower cost, and enabling you to build evidence-based medicine into your processes

    • InterQual Development Process

      InterQual Development Process

      The InterQual development process combines systematic, critical assessment of medical literature by our highly trained clinical team with peer review from over 750 national experts.