Horizon NJ Health uses the care guidelines fromMCG Healthto make behavioral health care utilization management determinations for members enrolled in:

• Horizon Medicare Advantage plans
• Horizon NJ Health Medicaid plans - including Division of Developmental Disabilities (DDD), NJ FamilyCare and Managed Long Term Services & Supports (MLTSS) plans
• Horizon NJ TotalCare (HMO D-SNP)

We use American Society of Addiction Medicine (ASAM) criteria when making coverage determinations for services related to Substance Use Disorders.

For more information, review our常见Questions.