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NEDA TOOLKIT for Parents Level of Care Guidelines for Patients Medical necessity criteria continue to change over time and can differ between insurance companies. This American Psychiatric Association chart will give you a good sense of the levels of care, but consumers should be aware that weight, co-occurring conditions, and motivation for change are all considered when clinical programs and insurance consider level of care. These guidelines are intended for use by treatment professionals in determining appropriate level of care. Please feel free to print and distribute to clinicians, insurance officials, and others involved in these decisions with your loved one. American Psychiatric Association Level of Care Guidelines for Patients with Eating Disorders Level One: Outpatient Medical Status Level Two: Intensive Outpatient Level Three: Level Four: Partial Residential Hospitalization Treatment (Full-day Outpatient Care) Medically stable to the extent that more extensive medical monitoring, as defined in levels 4 and 5, is not required Medically stable to the extent that intravenous fluids, nasogastric tube feedings, or multiple daily laboratory tests are not needed Level Five: Inpatient Treatment For adults: Heart rate <40 bpm; blood pressure <90/60 mmHg; glucose <60 mg/dl; potassium <3 mEq/L; electrolyte imbalance; temperature <97.0°F; dehydration; liver, kidney, or cardiac compromise requiring acute treatment; poorly controlled diabetes For children and adolescents: Heart rate near 40 bpm; orthostatic blood pressure changes (>20 bpm increase in heart rate or >10 mmHg to 20 mmHg drop); blood pressure <80/50 mmHg; low potassium, phosphate, or magnesium levels Page  | 27