Appeals Process

NQTL

A Non-Quantitative Treatment Limitation is any restriction on the scope or duration of mental health benefits that is not expressed as a number — including prior authorization requirements, medical necessity criteria, step therapy requirements, and network adequacy standards. Under MHPAEA, NQTLs applied to MH/SUD benefits must be no more restrictive than those applied to comparable medical/surgical benefits, both in terms of the written standards and as applied in practice.

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