Current | Carelon Clinical Guidelines and Pathways

Carelon Medical Benefits Management clinical appropriateness guidelines and cancer treatment pathways

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Current

Ambulatory Cardiac Rhythm Monitoring 2024-07-01

Bladder Cancer

Breast Cancer (Endocrine)

Breast Cancer (Metastatic)

Breast Cancer (Neoadjuvant & Adjuvant)

Cancer Treatment Pathways

Cardiac Resynchronization Therapy 2024-10-20

Carrier Screening in the Reproductive Setting 2025-09-20

Catheter-Based Closure of Patent Foramen Ovale 2024-11-01

Chromosomal Microarray Analysis 2026-06-14 updated 2026-07-01

Diagnostic Coronary Angiography 2023-04-01 updated 2024-11-17 [for Anthem BCBS Ohio Medicaid]

Diagnostic Coronary Angiography 2025-11-15

Dialysis Access Evaluations 2024-11-01

Electrophysiological Studies 2024-07-01

Endovascular Revascularization 2025-11-15 updated 2026-01-01

Febrile Neutropenia Risk 2025-11-15

For Medicare beneficiaries enrolled in a Medicare Advantage plan

Gastroesophageal Cancer

Genetic Liquid Biopsy in the Management of Cancer and Cancer Surveillance 2026-06-14 updated 2026-07-01

Genetic Testing for Inherited Conditions 2025-09-20 updated 2026-07-01

Head and Neck Cancer

Hereditary Cancer Testing 2026-04-04 updated 2026-07-01

Imaging of the Abdomen and Pelvis 2025-03-23 [for Amerigroup Georgia Medicaid]

Imaging of the Abdomen and Pelvis 2026-04-04

Imaging of the Brain 2024-10-20 [for Anthem BCBS Ohio Medicaid]

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