This paper describes the efforts of a committee of child psychiatrists to evaluate the problems and complexities of meeting PSRO requirements. A retrospective review of charts was done, using PSRO model criteria sets on children and adolescents on inpatient units at five hospitals. Problems were noted in the use of diagnoses, the care given, and the length of stay. Many charts would not have passed the initial nonphysician screening and would have required a physician review. It is anticipated that once PSRO criteria are introduced, a concurrent review might be less difficult. The results of this review suggest that to meet PSRO criteria, costs would have to go up.