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
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