Current | Carelon Clinical Guidelines and Pathways

Carelon Medical Benefits Management clinical appropriateness guidelines and cancer treatment pathways

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Current

Lymphoma (Hodgkin)

Lymphoma (Mantle Cell)

Myeloma

Nuclear Medicine Imaging 2023-09-10

Oncologic Imaging 2025-11-15 [for Amerigroup Georgia Medicaid]

Oncologic Imaging 2026-04-04

Percutaneous Coronary Intervention 2024-10-20 updated 2026-01-01

Perirectal Hydrogel Spacer for Prostate Radiotherapy 2026-04-04

Permanent Implantable Pacemakers 2024-10-20

Pharmacogenetic Testing 2026-06-14

Physical Therapy, Occupational Therapy, and Speech Therapy 2024-04-14

Predictive and Prognostic Polygenic Testing 2026-06-14

Prenatal Screening using Cell-free DNA 2025-09-20

Proton Beam Therapy 2025-03-23

Radiation Therapy (excludes Proton) 2026-04-04

Radiation Therapy for Non-Malignant Disease 2026-04-04

Sacroiliac Joint Fusion 2024-10-20 updated 2025-01-01 [for Anthem BCBS Ohio Medicaid]

Sacroiliac Joint Fusion 2025-11-15 updated 2026-01-01

Site of Care for Advanced Imaging 2024-11-17

Site of Care for Physical, Occupational, and Speech Therapies 2023-12-30

Site of Care for Surgical Procedures 2024-11-17

Skilled Nursing Facility Level of Care 2024-09-01

Sleep Disorder Management 2024-10-20 updated 2025-07-01 [for Anthem BCBS Ohio Medicaid]

Sleep Disorder Management 2025-11-15 updated 2026-03-21

Small Joint Surgery 2025-11-15

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