Clinical guidelines and pathways
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Carelon Medical Benefits Management clinical appropriateness guidelines and cancer treatment pathways
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Permanent Implantable Pacemakers 2024-03-17 [for Healthy Blue Louisiana Medicaid]
Permanent Implantable Pacemakers 2024-10-20
Pharmacogenetic Testing 2025-11-15 updated 2026-01-01
Pharmacogenomic Testing 2025-07-26 [for Anthem BCBS Ohio Medicaid]
Physical Therapy, Occupational Therapy, and Speech Therapy 2024-04-14
Predictive and Prognostic Polygenic Testing 2024-10-20 updated 2025-04-01
Predictive and Prognostic Polygenic Testing 2024-10-20 updated 2026-01-01
Prenatal Screening using Cell-free DNA 2025-09-20
Proton Beam Therapy 2022-03-13 [for Healthy Blue Louisiana Medicaid]
Proton Beam Therapy 2025-03-23
Radiation Therapy (excludes Proton) 2023-04-09 [for Healthy Blue Louisiana Medicaid]
Radiation Therapy (excludes Proton) 2025-03-23
Sacroiliac Joint Fusion 2024-01-01 [for Healthy Blue Louisiana Medicaid]
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 [updated 2026-01-01]
Skilled Nursing Facility Level of Care 2024-09-01
Sleep Disorder Management 2023-09-10 [for Healthy Blue Louisiana Medicaid]
Sleep Disorder Management 2024-10-20 updated 2025-07-01 [for Anthem BCBS Ohio Medicaid]
Sleep Disorder Management 2025-11-15
Small Joint Surgery 2025-11-15
Somatic Tumor Testing 2024-11-17 updated 2025-01-01 [for Anthem BCBS Ohio Medicaid]
Somatic Tumor Testing 2025-11-15 updated 2026-01-01
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