2025 Clinical Practice Guidelines Form
Please answer all questions to determine coverage (0 of 2)
Anthem Blue Cross and Blue Shield Healthcare Solutions is the trade name of Community Care Health Plan of Nevada, Inc. Anthem Blue Cross and Blue Shield is the trade name of Community Care Health Plan of Nevada, Inc. and Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. Independent licensee(s) of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc. NV-BCBS-CDCRCM-010325-26-GRP2410 | May 2026 Clinical Practice Guidelines
Nevada | Anthem Blue Cross and Blue Shield Healthcare Solutions | Medicaid Managed
Care
Nevada | Anthem Blue Cross and Blue Shield and HMO Colorado, Inc. (Anthem) |
Medicare Advantage • Commercial
Table of Contents:
Adult Health Note: Multiple documents also discuss the management of the referenced condition in the pediatric population.
Infectious Disease
Pediatric/Adolescent Health
Substance Use
Women’s Health
Other Technology
Condition/Disease Guideline Title Recognized Source(s) URL ADULT HEALTH Return to Table of Contents Adjustment Disorder Adjustment Disorder (Updated: September 22, 2025) John Hopkins Medicine Adjustment Disorder | Johns Hopkins Psychiatry Guide
Clinical Practice Guidelines Page 2 of 32
Condition/Disease Guideline Title Recognized Source(s) URL Alzheimer’s Disease/Dementia Health Systems and Medical Professionals Resource Site Alzheimer’s Association https://www.alz.org/professionals/health- systems-medical-professionals
American Psychiatric Association Practice Guideline on the Use of Antipsychotics to Treat Agitation or Psychosis in Patients with Dementia (May 2016)
American Psychiatric Association
https://psychiatryonline.org/doi/pdf/10.117
6/appi.books.9780890426807
Anxiety
Anxiety Disorders
(Last Reviewed
December 2024)
National Institute of Mental Health (NIMH)
http://www.nimh.nih.gov/health/publicatio ns/anxiety-disorders/treatment-of-anxiety- disorders.shtml
Appendicitis
Diagnosis and Treatment of Acute Appendicitis: 2020 Update of the WSES Jerusalem Guidelines
World Society of Emergency Surgery (WSES)
https://www.wses.org.uk/wp-
content/uploads/2020/04/acute-
appendicitis-update.pdf
Asthma
Guidelines for the
Diagnosis and
Management of
Asthma (EPR-3)
(September 2012)
2020 Focused Updates to the National Heart, Lung and Blood Institute (NHLBI) https://www.nhlbi.nih.gov/health- topics/guidelines-for-diagnosis- management-of-asthma
Clinical Practice Guidelines Page 3 of 32
Condition/Disease Guideline Title Recognized Source(s) URL Asthma Management Guidelines: A Report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group (Updated February 04, 2021)
https://www.nhlbi.nih.gov/health- topics/all-publications-and- resources/2020-focused-updates-asthma- management-guidelines
Global Strategy for Asthma Management and Prevention (Updated November 2025)
Global Initiative for Asthma (GINA)
https://ginasthma.org/wp- content/uploads/2025/11/GINA-2025- Update-251108-WMS.pdf Atopic Dermatitis
Atopic Dermatitis Clinical Guideline (Updated September 2025)
American Academy of Dermatology
https://www.aad.org/member/clinical-
quality/guidelines/atopic-dermatitis
Behavioral Health
Screening,
Assessment and
Treatment
The American
Psychiatric
Association Practice
Guidelines for the
Psychiatric
Evaluation of Adults
3rd edition
(August 2015)
American Psychiatric Association
(APA)
https://psychiatryonline.org/doi/full/10.117
6/appi.books.9780890426760.pe02
Clinical Practice Guidelines Page 4 of 32
Condition/Disease Guideline Title Recognized Source(s) URL
National Guidelines for Behavioral Health Crisis Care Best Practice Toolkit (January 2025)
Substance Abuse and Mental Health Services Administration (SAMHSA)
https://bja.ojp.gov/sites/g/files/xyckuh186/ files/media/document/samsha-national- guidelines.pdf
2025 National
Guidelines for a
Behavioral Health
Coordinated
System
of Crisis Care
Substance Abuse and Mental Health
Services Administration (SAMHSA)
https://988crisissystemshelp.samhsa.gov/
sites/default/files/2025-04/national-
guidelines-crisis-care-pep24-01-037.pdf
Bipolar Disorder*
addresses diagnosis and treatment of bipolar disorder in special populations such as children and adolescents
CANMAT and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder
Canadian Network for Mood and Anxiety Treatments (CANMAT)
Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder
Borderline PersonalityPractice Guideline for the Treatment of Patients with Borderline Personality Disorder (November 2024)
American Psychiatric Association
https://psychiatryonline.org/doi/book/10.1 176/appi.books.9780890428009
Clinical Practice Guidelines Page 5 of 32
Condition/Disease Guideline Title Recognized Source(s) URL Coronary Artery Disease (CAD)
AHA/ACCF
Secondary
Prevention and Risk
Reduction Therapy
for Patients With
Coronary and Other
Atherosclerotic
Vascular Disease
(November 2011
Update)
American Heart Association/ American College of Cardiology Foundation (AHA/ACCF)
https://www.ahajournals.org/doi/pdf/10.11 61/CIR.0b013e318235eb4d
Treatment of
Hypertension in
Patients With
Coronary Artery
Disease
(Updated
September 2016)
American Heart Association, American College of Cardiology, and American Society of Hypertension https://www.ahajournals.org/doi/pdf/10.11 61/CIR.0000000000000207
Effectiveness- Based Guidelines for the Prevention of Cardiovascular Disease in Women- 2011 Update (February 2011)
American Heart Association (AHA)
https://www.ahajournals.org/doi/pdf/10.11 61/CIR.0b013e31820faaf8
ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease (2019)
American College of Cardiology/American Heart Association (ACC/AHA) https://www.jacc.org/doi/pdf/10.1016/j.jacc .2019.03.010
Clinical Practice Guidelines Page 6 of 32
Condition/Disease Guideline Title Recognized Source(s) URL
2021 AHA/ACC/ASE/CH EST/SAEM/ SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain American College of Cardiology/ American Heart Association/ Society of Cardiovascular Computed Tomography/Society for Academic Emergency Medicine/Society for Cardiovascular Magnetic Resonance/American College of Chest Physicians/American Society of Echocardiography/American Heart
https://www.jacc.org/doi/pdf/10.1016/j.jacc
.2021.07.053
2021
ACC/AHA/SCAI
Guideline for
Coronary Artery
Revascularization
American College of Cardiology
/American Heart Association /Society
for Cardiovascular Angiography and
Interventions
https://www.jacc.org/doi/10.1016/j.jacc.202
1.09.006?_ga=2.60669549.1356655696.164
1505900-317854238.1639608139
Celiac Disease
ACG Clinical Guidelines: Diagnosis and Management of Celiac Disease (January 2023)
American College of Gastroenterology https://journals.lww.com/ajg/fulltext/2023/0 1000/%20mericancollegeofgastroenter ologyguidelines.17.aspx
Chronic Kidney Disease (CKD) The National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF KDOQI)™ evidence-based clinical practice guidelines for all stages of chronic kidney disease (CKD) and related complications National Kidney Foundation
https://www.kidney.org/professionals/guid elines/guidelines_commentaries
Clinical Practice Guidelines Page 7 of 32
Condition/Disease Guideline Title Recognized Source(s) URL
Chronic Kidney Disease: Detection and Evaluation (2017)
American Academy of Family Physicians (AAFP) https://www.aafp.org/afp/2017/1215/p776.h tml
KDIGO (Kidney Disease Improving Global Outcomes) 2024 CKD evaluation and Management
International Society of Nephrology https://kdigo.org/guidelines/ckd- evaluation-and-management/ Chronic Obstructive Pulmonary Disease (COPD) Global Strategy for the Prevention, Diagnosis, and Management of COPD
Global Initiative for Chronic Obstructive Lung Disease (GOLD) https://goldcopd.org/2025-gold-report/
Delirium Prevention and Treatment of Delirium (2025)
American Psychiatric Association
(APA)
https://www.psychiatry.org/psychiatrists/p
ractice/clinical-practice-
guidelines/delirium
Depression
Canadian Network
for Mood and
Anxiety Treatments
(CANMAT) 2023
Update on Clinical
Guidelines for
Management of
Major Depressive
Disorder in Adults
(Updated August
2025)
Canadian Network for Mood and
Anxiety Treatments (CANMAT)
https://journals.sagepub.com/doi/epub/10.
1177/07067437241245384
Clinical Practice Guidelines Page 8 of 32
Condition/Disease Guideline Title Recognized Source(s) URL
Depression in
Adults: Screening
(June 2023)
U.S. Preventive Services Task Force (USPSTF) https://www.uspreventiveservicestaskforc e.org/uspstf/recommendation/screening- depression-suicide-risk-adults
VA/DoD Clinical
Practice
Guideline for the
Management of
Major Depressive
Disorder (2022)
Department of Veterans Affairs Department of Defense https://www.healthquality.va.gov/guideline s/MH/mdd/
APA Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts (February 2019)
American Psychological Association (APA)
https://www.apa.org/depression- guideline/guideline.pdf
Diabetes
Standards of Medical Care in Diabetes (2026)
American Diabetes Association (ADA)
https://diabetesjournals.org/care/issue/49/
Supplement_1
Eating Disorders
Practice Guideline
for the Treatment of
Patients with Eating
Disorders
Fourth Edition
(2023)
American Psychiatric Association
(APA)
https://ajp.psychiatryonline.org/doi/pdf/10.
1176%2Fappi.ajp.23180001
Eosinophilic
Esophagitis
AGA Institute and
the Joint Task
American Gastroenterological
Association (AGA)
https://www.gastrojournal.org/action/show
Pdf?pii=S0016-5085%2820%2930265-1
Clinical Practice Guidelines Page 9 of 32
Condition/Disease Guideline Title Recognized Source(s) URL Force on Allergy- Immunology Practice Parameters Clinical Guidelines for the Management of Eosinophilic Esophagitis (2020)
Gender-Dysphoria/
Incongruence
Endocrine
Treatment of
Gender-
Dysphoric/Gender-
Incongruent
Persons: An
Endocrine Society
Clinical Practice
Guideline
(September 2017)
Correction to Clinical Practice Guideline (February 2018)
Correction to
Clinical Practice
Guideline
(July 2018)
The Endocrine Society https://academic.oup.com/jcem/article/102 /11/3869/4157558?login=true
https://academic.oup.com/jcem/article/103 /2/699/4675081
https://academic.oup.com/jcem/article/103 /7/2758/5036711
Standards of Care for the Health of Transgender and Gender Diverse People, Version 8 World Professional Association for Transgender Health (WPATH) https://www.wpath.org/publications/soc
Clinical Practice Guidelines Page 10 of 32
Condition/Disease Guideline Title Recognized Source(s) URL
Fall Risk
Falls Prevention in Community- Dwelling Older Adults: Interventions (June 2024)
U.S. Preventive Services Task Force
(USPSTF)
https://www.uspreventiveservicestaskforc
e.org/uspstf/recommendation/falls-
prevention-community-dwelling-older-
adults-interventions
Evidence–Based
Falls Prevention
Programs:
Resources for
Professionals and
Advocates
National Council on Aging https://www.ncoa.org/article/evidence- based-falls-prevention-programs/
Hearing Loss
Age-Related
Hearing Loss (April
2024)
American Academy of Otolaryngology
— Head and Neck Surgery
https://www.entnet.org/quality-
practice/quality-products/clinical-practice-
guidelines/cpg-age-related-hearing-loss/
Heart Failure (HF) 2022 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/America n Heart Association Task Force on Practice Guidelines
ACCF/AHA/HFSA Guideline for the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines/ Heart Failure Society of America (ACCF/ AHA/HFSA) https://www.ahajournals.org/doi/epub/10.1 161/CIR.0000000000001142
http://www.onlinejacc.org/content/70/6/776 ?_ga=2.23313085.667318568.1514996759- 679389624.1511900706
Clinical Practice Guidelines Page 11 of 32
Condition/Disease
Guideline Title
Recognized Source(s)
URL
Management of
Heart Failure
(Focused Update
2017)
Hyperlipidemia 2026 ACC/AHA/AACVPR /ABC/ACPM/ADA/A GS/APhA/ASPC/NL A/PCNA Guideline on the Management of Dyslipidemia: A Report of the American College of Cardiology/America n Heart Association Joint Committee on Clinical Practice Guidelines
American College of Cardiology/American Heart Association/ American Association of Cardiovascular and Pulmonary Rehabilitation/American Academy of Physician Assistants/Association of Back Cardiologists/American College of Preventive Medicine/American Diabetes Association/American Geriatrics Society/American Pharmacists Association/ American Society of Preventive Cardiology/National Lipid Association/Preventive Cardiovascular Nurses Association (ACC/AHA/AACVPR/AAPA/ABC/ACP M/ADA/AGS/APhA/ASPC/NLA/PCNA)
https://www.jacc.org/doi/10.1016/j.jacc.202
5.11.016
Hypertension
ACC/AHA/AAPA/AB
C/ACPM/AGS/APh
A/ASH/ASPC/NMA/
PCNA Guideline for
the Prevention,
Detection,
Evaluation, and
Management of
High Blood
Pressure in Adults
(2025)
American College of Cardiology (ACC)/ American Heart Association (AHA)/ American Academy of Physician Assistants (AAPA)/ Association of Black Cardiologists (ABC)/ American College of Preventive Medicine (ACPM)/ American Geriatrics Society (AGS)/ American Pharmacists Association (APhA)/ American Society of Hypertension (ASH)/ American Society for Preventive Cardiology (ASPC)/ National Medical Association (NMA)/ https://www.jacc.org/doi/abs/10.1016/j.jacc .2025.10.006
Clinical Practice Guidelines Page 12 of 32
Condition/Disease Guideline Title Recognized Source(s) URL Preventive Cardiovascular Nurses Association (PCNA) Low Back Pain
Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline from the American College of Physicians (2017)
American College of Physicians (ACP)
https://www.acpjournals.org/doi/10.7326/M
16-2367
Obesity
Weight Loss to
Prevent Obesity-
Related Morbidity
and Mortality in
Adults: Behavioral
Interventions
(September 2018)
U.S. Preventive Services Task Force
(USPSTF)
https://www.uspreventiveservicestaskforc
e.org/uspstf/recommendation/obesity-in-
adults-interventions
2013 AHA /ACC /TOS Guideline for the Management of Overweight and Obesity in Adults (Updated June 2014)
American College of Cardiology
(ACC)/ American Heart Association
(AHA) Task Force on Practice
Guidelines and The Obesity Society
(TOS)
https://www.ahajournals.org/doi/10.1161/0
1.cir.0000437739.71477.ee
Oppositional
Defiant Disorder
(ODD)
Common Questions
About Oppositional
Defiant Disorder
(April 2016)
American Academy of Family
Physicians (AAFP)
https://www.aafp.org/dam/brand/aafp/pubs /afp/issues/2016/0401/p586.pdf
Clinical Practice Guidelines Page 13 of 32
Condition/Disease
Guideline Title
Recognized Source(s)
URL
ODD: A Guide for
Families by the
American Academy
of Child and
Adolescent
Psychiatry
American Academy of Child &
Adolescent Psychiatry (AACAP)
https://www.aacap.org/App_Themes/AAC
AP/docs/resourcecenters/odd/oddresou
rcecenterodd_guide.pdf
Pain (Chronic)
APA CLINICAL
PRACTICE
GUIDELINE
for Psychological
and Other
Nonpharmacologica
l Treatment
of Chronic
Musculoskeletal
Pain in Adults
(2024)
American Psychological Association
(APA)
https://www.apa.org/practice/guidelines/n
onpharmacological-treatment-chronic-
musculoskeletal-pain.pdf
Posttraumatic
Stress Disorder
APA Clinical
Practice Guideline
for the Treatment of
Posttraumatic
Stress Disorder
(PTSD) in Adults
(2025)
VA/DOD Clinical Practice Guideline for the Management of Posttraumatic Stress Disorder and Acute Stress Disorder (2024)
American Psychological Association (APA)
Department of Veterans Affairs Department of Defense: The Management of Posttraumatic Stress Disorder Work Group
https://www.apa.org/ptsd- guideline/ptsd.pdf
https://www.healthquality.va.gov/guideline s/MH/ptsd/PTSD-in-Annals-2024.pdf
VA/DoD Clinical Practice Guideline for Management of Posttraumatic Stress Disorder and Acute Stress Disorder
Clinical Practice Guidelines Page 14 of 32
Condition/Disease Guideline Title Recognized Source(s) URL PTSD Screening Instruments
Department of Veterans Affairs: PTSD: National Center for PTSD https://www.ptsd.va.gov/professional/asse ssment/screens/index.asp
Rheumatoid
Arthritis
2021 American
College of
Rheumatology
Guideline for the
Treatment of
Rheumatoid
Arthritis
American College of Rheumatology
(ACR)
https://assets.contentstack.io/v3/assets/bl tee37abb6b278ab2c/blt9e44ccb701e1918c/ 63360f6775c0be225b8d943a/ra-guideline- 2021.pdf
Rhinitis
Rhinitis 2020: A
practice parameter
update
American Academy of Allergy,
Asthma, and Immunology (AAAAI)
https://www.jacionline.org/action/showPdf
?pii=S0091-6749%2820%2931023-X
Schizophrenia
Practice Guideline
for the Treatment of
Patients with
Schizophrenia 3rd
edition (2021)
VA/DoD Clinical
Practice
Guideline for the
Management of
First-Episode
Psychosis and
Schizophrenia
(2023)
American Psychiatric Association (APA)
Veterans Administration/Department of Defense (VA/DoD) https://s21151.pcdn.co/wp- content/uploads/APA-Practice-Guideline- for-the-Trmt-of-Patients-with- Schizophrenia-3rd-Edition-SRC-1-8-21- CMMC-1.pdf
https://www.mirecc.va.gov/visn22/VA_DoD
2023GuidelinefortheManagementof
FirstEpisodePsychosisand_Schizoph
renia.asp
Sickle Cell Anemia
American Society of
Hematology 2020
guidelines for sickle
cell disease:
management of
American Society of Hematology
https://ashpublications.org/bloodadvance s/article/4/12/2656/460974/
Clinical Practice Guidelines Page 15 of 32
Condition/Disease Guideline Title Recognized Source(s) URL acute and chronic pain Stroke 2024 Guideline for the Primary Prevention of Stroke: A Guideline From the American Heart Association/Americ an Stroke Association (Updated February 2025)
American Heart Association/American
Stroke Association
https://www.ahajournals.org/doi/epub/10.1
161/STR.0000000000000475
Suicide Risk SAFE-T: Suicide Assessment Five- Step Evaluation and Triage for Clinicians (Last updated 2/21/2025)
Suicide Prevention Resource Center (SPRC)
https://www.samhsa.gov/resource/dbhis/s afe-t-pocket-card-suicide-assessment- five-step-evaluation-triage-safe-t- clinicians
VA/DoD Clinical
Practice
Guideline for
Assessment and
Management of
Patients at Risk for
Suicide (2024)
Veterans Administration/Department of Defense (VA/DoD) https://healthquality.va.gov/HEALTHQUAL ITY/guidelines/MH/srb/VADoD-CPG- Suicide-Risk-Full-CPG-2024Final508.pdf
Surgery Surgical technical evidence review for Agency for Healthcare Research and Quality (AHRQ)
https://www.ajog.org/article/S0002- 9378(18)30583-0/pdf
Clinical Practice Guidelines Page 16 of 32
Condition/Disease Guideline Title Recognized Source(s) URL gynecologic surgery conducted for the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery (December 2018)
Surgical Technical Evidence Review for Colorectal Surgery Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery (October 2017)
Surgical Technical Evidence Review for Elective Total Joint Replacement Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery (February 2018)
AHRQ
AHRQ
https://www.ncbi.nlm.nih.gov/pubmed/287 97562
https://journals.sagepub.com/doi/pdf/10.1 177/2151458518754451
Clinical Practice Guidelines Page 17 of 32
Condition/Disease
Guideline Title
Recognized Source(s)
URL
Trauma Care
Trauma-Informed
Care in Behavioral
Health Services
(October 2015)
Trauma-Informed Care in Behavioral Health Services: Treatment Improvement Protocol (TIP) Series
Substance Abuse and Mental Health Services Administration (SAMHSA) https://store.samhsa.gov/product/Trauma- Informed-Care-in-Behavioral-Health- Services/SMA15-4420
Trauma-Informed Care in Behavioral
Health Services | SAMHSA Library
Urinary Tract
Infections
Clinical Practice
Guideline by
Infectious Diseases
Society of America
(IDSA): 2025
Guideline on
Management and
Treatment of
Complicated
Urinary Tract
Infections:
Introduction and
Methods (2025)
Infectious Diseases Society of
America (IDSA)
https://www.idsociety.org/globalassets/ids
a/practice-guidelines/cuti/introduction-
and-methods-manuscript.pdf
INFECTIOUS DISEASE Return to Table of Contents
Chlamydia/ Human
Papillomavirus
(HPV)
Sexually
Transmitted
Diseases Treatment
Guidelines
(2021)
Center for Disease Control and
Prevention (CDC)
https://www.cdc.gov/std/treatment-
guidelines/default.htm
Clinical Practice Guidelines Page 18 of 32
Condition/Disease
Guideline Title
Recognized Source(s)
URL
Hepatitis B
AASLD Guidelines
for Treatment of
Chronic Hepatitis B
(August 2015)
Update on Prevention, Diagnosis, and Treatment of Chronic Hepatitis B: AASLD 2018 Hepatitis B Guidance (Jan 2018)
American Association for the Study of Liver Diseases (AASLD) https://aasldpubs.onlinelibrary.wiley.com/ doi/epdf/10.1002/hep.28156
https://www.ncbi.nlm.nih.gov/pmc/articles/
PMC5975958/pdf/nihms957253.pdf
Hepatitis C
HCV Guidance:
Recommendations
for Testing,
Managing and
Treating Hepatitis C
(Updated March
2025)
Infectious Diseases Society of America (IDSA)/ American Association for the Study of Liver Disease (AASLD) http://www.hcvguidelines.org/ Guidelines for the Screening, Care and Treatment of Persons with Chronic Hepatitis C Infection (2016)
World Health Organization (WHO) http://apps.who.int/iris/bitstream/handle/1 0665/205035/9789241549615_eng.pdf;jses sionid=569946A6B8399B8CED0D09D7F7A 9BD3C?sequence=1%20%20%20
HIV/AIDS HIVMA/IDSA 2024 Primary Care Guidance Update for Providers Who HIV Medicine Association of the Infectious Diseases Society of America (IDSA) https://www.idsociety.org/practice- guideline/primary-care-management-of- people-with-hiv/
Clinical Practice Guidelines Page 19 of 32
Condition/Disease Guideline Title Recognized Source(s) URL Care for Persons with Human Immunodeficiency Virus
HIV Guidelines and Recommendations
Centers of Disease Control and Prevention (CDC)
https://www.cdc.gov/hivnexus/hcp/guideli
nes/index.html
2017 HIVMA of
IDSA Clinical
Practice Guideline
for the Management
of Chronic Pain in
Patients Living With
HIV
Infectious Diseases Society of America https://www.idsociety.org/globalassets/ids a/practice-guidelines/2017-hivma-of-idsa- clinical-practice-guideline-for-the- management-of-chronic-pain-in-patients- living-with-hiv.pdf
HIV and Adolescents: Guidance for HIV testing and counselling and care for adolescents living with HIV (2013)
World Health Organization (WHO)
https://www.who.int/publications/i/item/97
89241506168
Lyme Disease
AAN/ACR/IDSA
2020 Guidelines for
the Prevention,
Diagnosis and
Treatment of Lyme
Disease
American Academy of Neurology (AAN), American College of Rheumatology (ACR), and Infectious Diseases Society of America (IDSA) https://www.idsociety.org/practice- guideline/lyme-disease/#null
Clinical Practice Guidelines Page 20 of 32
Condition/Disease Guideline Title Recognized Source(s) URL Upper Respiratory Infections Treatment of the Common Cold (2019) American Academy of Family Physicians (AAFP)
https://www.aafp.org/pubs/afp/issues/2019 /0901/p281.html
Outpatient Clinical Care for Adults (Last reviewed April 16, 2024)
Centers for Disease Control and
Prevention (CDC)
https://www.cdc.gov/antibiotic-
use/hcp/clinical-care/adult-
outpatient.html?CDCAArefVal=https://w
ww.cdc.gov/antibiotic-use/clinicians/adult-
treatment-rec.html
Outpatient Clinical
Care for Pediatric
Populations (Last
reviewed April 22,
2024)
Centers for Disease Control and
Prevention (CDC)
https://www.cdc.gov/antibiotic-
use/hcp/clinical-care/pediatric-
outpatient.html?CDCAArefVal=https://w
ww.cdc.gov/antibiotic-
use/clinicians/pediatric-treatment-rec.html
IDSA Guidelines on
the Treatment and
Management of
Patients with
COVID-19
(Document updated
on a regular basis)
Infectious Diseases Society of
America
https://www.idsociety.org/practice-
guideline/covid-19-guideline-treatment-
and-management/
Tuberculosis
ATS/CDC/ERS/IDS
A Clinical Practice
Guidelines on the
Treatment of Drug-
Resistant
Tuberculosis (2019)
American Thoracic Society (ATS), the
Centers for Disease Control and
Prevention (CDC), the European
Respiratory Society, and Infectious
Diseases Society of American (IDSA)
https://www.idsociety.org/practice-
guideline/treatment-of-drug-resistant-
tb/#null
PEDIATRIC/ADOLESCENT HEALTH Return to Table of Contents
Adjustment
Disorder
Adjustment Disorder: Collection of Evidence-Based Virginia Commission on Youth
https://vcoy.virginia.gov/documents/collec tion/Adjustment%20Disorder%20- %2010th.pdf
Clinical Practice Guidelines Page 21 of 32
Condition/Disease Guideline Title Recognized Source(s) URL Practices, 10th Edition
Anxiety Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents with Anxiety Disorders (2020)
American Academy of Adolescent
Psychiatry
https://www.jaacap.org/article/S0890-
8567(20)30280-X/fulltext#secsectitle0095
Attention Deficit
Hyperactivity
Disorder (ADHD)
Clinical Practice
Guideline for the
Diagnosis,
Evaluation, and
Treatment of
Attention-
Deficit/Hyperactivity
Disorder in Children
and Adolescents
(October 2019)
American Academy of Pediatrics (AAP) https://publications.aap.org/pediatrics/arti cle/144/4/e20192528/81590/Clinical- Practice-Guideline-for-the-Diagnosis
ADHD Diagnosis
and Treatment in
Children and
Adolescents (2024)
Agency for Healthcare Research and
Quality (AHRQ)
https://effectivehealthcare.ahrq.gov/produ
cts/attention-deficit-hyperactivity-
disorder/research
Autism
Identification
Evaluation, and
Management of
Children with
Autism Spectrum
American Academy of Pediatrics
(AAP)
https://pediatrics.aappublications.org/cont
ent/pediatrics/early/2019/12/15/peds.2019-
3447.full.pdf
Clinical Practice Guidelines Page 22 of 32
Condition/Disease Guideline Title Recognized Source(s) URL Disorder (January 2020)
Celiac Disease / Gluten Disorders Guideline for the Diagnosis and Treatment of Celiac Disease in Children: Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (January 2005)
North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) http://www.naspghan.org/files/documents/ pdfs/position- papers/celiacguideline2004_jpgn.pdf
NASPGHAN
Clinical
Report on the
Diagnosis and
Treatment of
Gluten-related
Disorders (2016)
NASPGHAN / European Society for
Paediatric Gastroenterology,
Hepatology and Nutrition (ESPGHAN)
https://naspghan.org/files/documents/pdfs
/position-
papers/NASPGHANClinicalReportont
heDiagnosisand.28.pdf
Depression
Depression and
Suicide Risk in
Children and
Adolescents:
Screening
(October 2022)
U.S. Preventive Services Task Force (USPSTF) https://www.uspreventiveservicestaskforc e.org/uspstf/recommendation/screening- depression-suicide-risk-children- adolescents
APA Clinical Practice Guideline for the Treatment of Depression American Psychological Association (APA)
https://www.apa.org/depression- guideline/guideline.pdf
Clinical Practice Guidelines Page 23 of 32
Condition/Disease Guideline Title Recognized Source(s) URL Across Three Age Cohorts (February 2019)
Hypertension in
Children and
Adolescents
Clinical Practice
Guideline for
Screening and
Management of
High Blood
Pressure in
Children and
Adolescents
(September 2017)
American Academy of Pediatrics (AAP) https://publications.aap.org/pediatrics/arti cle/140/3/e20171904/38358/Clinical- Practice-Guideline-for-Screening-and
Obesity Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents with Obesity (2023)
American Academy of Pediatrics (AAP) https://publications.aap.org/pediatrics/arti cle/151/2/e2022060640/190443/Clinical- Practice-Guideline-for-the-Evaluation-and
Clinical Report: The
Role of the
Pediatrician in the
Promotion of
Healthy, Active
Living
(March 2024)
American Academy of Pediatrics
(AAP)
https://publications.aap.org/pediatrics/arti
cle/153/3/e2023065480/196676/The-Role-
of-the-Pediatrician-in-the-Promotion-of
Oppositional
Defiant Disorder
(ODD)
Fifty years of
preventing and
treating childhood
behaviour
National Institute of Health (NIH)
PubMed
https://www.ncbi.nlm.nih.gov/pmc/articles/
PMC5950520/
Clinical Practice Guidelines Page 24 of 32
Condition/Disease Guideline Title Recognized Source(s) URL disorders: a systematic review to inform policy and practice (April 2018)
Pharmacologic Monitoring of Antipsychotics
Evidence-Based Recommendations for Monitoring Safety of Second Generation Antipsychotics in Children and Youth (2011)
Canadian Alliance for Monitoring
Effectiveness and Safety of
Antipsychotics in Children
https://www.ncbi.nlm.nih.gov/pmc/articles/
PMC3143700/pdf/ccap20_3p218.pdf
Preventive Care
AAP Bright Futures
American Academy of Pediatrics
(AAP)
https://www.aap.org/en/practice-
management/bright-futures/
Learn the Signs. Act
Early.
Centers for Disease Control (CDC)
https://www.cdc.gov/act-early/index.html
SUBSTANCE USE Return to Table of Contents
Substance use
The ASAM Criteria:
Treatment Criteria
for Addictive,
Substance-Related,
and Co-occurring
Conditions, Volume
1: Adults. 4th ed
American Society of Addiction Medicine https://www.asam.org/asam-criteria
Document requires purchase Medication-Assisted Treatment of Adolescents with American Academy of Pediatrics (AAP)
https://publications.aap.org/pediatrics/arti cle/138/3/e20161893/52715/Medication- Assisted-Treatment-of-Adolescents-With
Clinical Practice Guidelines Page 25 of 32
Condition/Disease Guideline Title Recognized Source(s) URL Opioid Use Disorders (September 2016)
-Appropriate Use of Drug Testing in Clinical Addiction Medicine (Reviewed December 2019)
American Society of Addiction Medicine https://www.asam.org/quality-care/clinical- guidelines/drug-testing
Unhealthy Alcohol
Use in Adolescents
and Adults:
Screening and
Behavioral
Counseling
Interventions
(November 2018)
U.S. Preventive Services Task Force
(USPSTF)
https://www.uspreventiveservicestaskforc
e.org/Page/Document/UpdateSummaryFin
al/unhealthy-alcohol-use-in-adolescents-
and-adults-screening-and-behavioral-
counseling-interventions
CDC Clinical
Practice Guideline
for Prescribing
Opioids for Pain —
United States, 2022
Centers for Disease Control and Prevention (CDC) https://www.cdc.gov/mmwr/volumes/71/rr/ rr7103a1.htm?scid=rr7103a1.htmw
American Society of Addiction Medicine Clinical Practice Guideline on Alcohol Withdrawal Management (2020)
American Society of Addiction Medicine https://www.asam.org/docs/default- source/quality- science/theasamclinicalpracticeguide lineonalcohol-1.pdf?sfvrsn=ba255c2_2
American Psychiatric American Psychiatric Association https://psychiatryonline.org/doi/pdf/10.117 6/appi.books.9781615371969
Clinical Practice Guidelines Page 26 of 32
Condition/Disease Guideline Title Recognized Source(s) URL Association Practice Guideline for the Pharmacological Treatment of Patients with Alcohol Use Disorder
The National Practice Guideline for the Treatment of Opioid Use Disorder – 2020 Focused Update
American Society of Addiction
Medicine
https://www.asam.org/quality-care/clinical-
guidelines/national-practice-guideline
Treatment Options
for Substance Use
Disorder (Updated
August 2025)
Substance Abuse Mental Health
Services Administration (SAMHSA)
https://www.samhsa.gov/medication-
assisted-treatment
Cigarette
Cessation
The Go-To Guide
on Your Quitting
Journey
Truth Initiative with Mayo Clinic
https://www.becomeanex.org/
Identifying and
Treating Patients
Who Use Tobacco
(July 2017)
U.S. Department of Health and Human
Services
https://millionhearts.hhs.gov/files/Tobacc
o-Cessation-Action-Guide.pdf
2018 ACC Expert
Consensus
Decision Pathway
on Tobacco
American College of Cardiology (ACC) https://www.jacc.org/doi/pdf/10.1016/j.jacc
.2018.10.027
Clinical Practice Guidelines Page 27 of 32
Condition/Disease Guideline Title Recognized Source(s) URL Cessation Treatment
Electronic
Cigarettes
E-Cigarettes
(Vapes)
Centers for Disease Control and
Prevention (CDC)
https://www.cdc.gov/tobacco/e-
cigarettes/?CDCAArefVal=https://www.c
dc.gov/tobacco/basic_information/e-
cigarettes/index.htm
American Academy of Pediatrics Policy Statement E- Cigarettes and Similar Devices (Reaffirmed August 2025)
American Academy of Pediatrics
(AAP)
https://publications.aap.org/pediatrics/arti
cle/143/2/e20183652/37305/E-Cigarettes-
and-Similar-Devices
All states offer smoking cessation telephone quitline services at no cost to you. Dialing 1-800-QUIT-NOW will connect the
caller to their state quitline.
WOMEN’S HEALTH Return to table of contents
Perinatal
Depression
Perinatal
Depression: AAP
Policy Statement
on Recognition and
Management (2019)
American Academy of Pediatrics
(AAP)
https://www.aafp.org/pubs/afp/issues/2019
/1001/p443.pdf
Routine
Antepartum Care
American Academy
of Pediatrics,
Guidelines for
Perinatal Care,
Eighth Edition
(September 2017)
American Academy of Pediatrics
(AAP)
& American Congress of Obstetrics
and Gynecology (ACOG)
https://publications.aap.org/aapbooks/boo
k/522/Guidelines-for-Perinatal-
Care?autologincheck=redirected
Preventive Care
Women's
Preventive Services
Health Resources and Services
Administration (HRSA)
https://www.hrsa.gov/womens-guidelines-
2016/index.html
Clinical Practice Guidelines Page 28 of 32
Condition/Disease Guideline Title Recognized Source(s) URL Guidelines (Last Reviewed 2022)
Cancer Screening Updated Cervical Cancer Screening Guidelines (Reaffirmed April 2025)
American Congress of Obstetrics and Gynecology (ACOG) https://www.acog.org/clinical/clinical- guidance/practice- advisory/articles/2021/04/updated- cervical-cancer-screening-guidelines
Cervical Cancer:
Screening
(August 2018)
U.S. Preventive Services Task Force
(USPSTF)
https://www.uspreventiveservicestaskforc
e.org/uspstf/recommendation/cervical-
cancer-screening
Diabetes and
Pregnancy
Management of
Diabetes in
Pregnancy
(2026)
American Diabetes Association (ADA)
https://diabetesjournals.org/care/article/49 /Supplement_1/S321/163918/15- Management-of-Diabetes-in-Pregnancy- Standards
Gestational Diabetes Mellitus, Screening (August 2021)
United States Preventive Services Task Force (USPSTF)
https://www.uspreventiveservicestaskforc
e.org/uspstf/recommendation/gestational-
diabetes-mellitus-
screening?ds=1&s=gestational%20diabete
s
WHO
recommendations
for Prevention and
treatment of pre-
eclampsia and
eclampsia (2011)
Updates in 2018,
2020 2021
World Health Organization (WHO) https://www.who.int/publications/i/item/97 89241548335
Clinical Practice Guidelines Page 29 of 32
Condition/Disease Guideline Title Recognized Source(s) URL Committee Opinion
Magnesium Sulfate Before Anticipated Preterm Birth for Neuroprotection (Reaffirmed 2020)
American Congress of Obstetrics and Gynecology (ACOG)/ Society for Maternal Fetal Health (SMFH) https://www.acog.org/- /media/project/acog/acogorg/clinical/files/ committee- opinion/articles/2010/03/magnesium- sulfate-before-anticipated-preterm-birth- for-neuroprotection.pdf
Pregnancy Tailored Prenatal Care Delivery for Pregnant Individuals (2025)
American Congress of Obstetrics and Gynecology (ACOG) https://www.acog.org/- /media/project/acog/acogorg/clinical/files/ clinical- consensus/articles/2025/04/tailored- prenatal-care-delivery-for-pregnant- individuals.pdf?rev=5090db51445e4f7eacc fd4b5c9de7983&hash=9A628D8A3AC996A 84CE0EEE00624BD56
Substance use Specific to Women Alcohol Abuse and Other Substance Use Disorders: Ethical Issues in Obstetric and Gynecologic Practice. Number 633 (Reaffirmed 2021)
American Congress of Obstetricians and Gynecologists (ACOG) https://www.acog.org/clinical/clinical- guidance/committee- opinion/articles/2015/06/alcohol-abuse- and-other-substance-use-disorders- ethical-issues-in-obstetric-and- gynecologic-practice
Guidelines for the identification and management of substance use and substance use disorders in pregnancy (2014)
World Health Organization (WHO) https://www.who.int/publications/i/item/97 89241548731
Clinical Practice Guidelines Page 30 of 32
Condition/Disease Guideline Title Recognized Source(s) URL Substance Abuse and Mental Health Services Association Clinical Guidance for Treating Pregnant and Parenting Women with Opioid Use Disorder and Their Infants (May 2018)
Substance Abuse and Mental Health
Services Association
https://store.samhsa.gov/sites/default/files
/d7/priv/sma18-5054.pdf
Equity in Health
Care
Importance of Social Determinants of Health and Cultural Awareness in the Delivery of Reproductive Health Care (Reaffirmed 2018)
American Congress of Obstetrics and
Gynecology (ACOG)
https://www.acog.org/-
/media/project/acog/acogorg/clinical/files/
committee-
opinion/articles/2018/01/importance-of-
social-determinants-of-health-and-
cultural-awareness-in-the-delivery-of-
reproductive-health-care.pdf
Committee Opinion
749 Marriage and
Family Building
Equality for
Lesbian, Gay,
Bisexual,
Transgender,
Queer, Intersex,
Asexual, and
Gender
Nonconforming
Individuals
(Reaffirmed 2021)
American Congress of Obstetrics and Gynecology (ACOG) https://www.acog.org/- /media/project/acog/acogorg/clinical/files/ committee- opinion/articles/2018/08/marriage-and- family-building.pdf
Clinical Practice Guidelines Page 31 of 32
Condition/Disease Guideline Title Recognized Source(s) URL Committee Opinion 586: Health Disparities in Rural Women (Reaffirmed 2021)
American Congress of Obstetrics and Gynecology (ACOG) https://www.acog.org/- /media/project/acog/acogorg/clinical/files/ committee-opinion/articles/2014/02/health- disparities-in-rural-women.pdf
Smoking Cessation during Pregnancy Tobacco and Nicotine Cessation During Pregnancy ACOG. Number 807 (Reaffirmed 2023)
American Congress of Obstetrics and Gynecology (ACOG) https://www.acog.org/clinical/clinical- guidance/committee- opinion/articles/2020/05/tobacco-and- nicotine-cessation-during-pregnancy
Need Help Putting Out That Cigarette?
American Congress of Obstetrics and Gynecology (ACOG) http://www.tobacco- cessation.org/PDFs/NeedHelpBooklet.pdf
Smoking Cessation for Pregnancy and Beyond: A Virtual Clinic,” an Innovative Web- Based Training for Healthcare Professionals
Dartmouth Medical School https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC4394722/
OTHER TECHNOLOGY Return to Table of Contents Other Technology Guidelines for the Practice of Telepsychology (Updated August 2024)
American Psychological Association (APA) https://www.apa.org/about/policy/telepsyc hology-revisions
Best Practices in Videoconferencing- American Psychiatric Association (APA) and American Telemedicine Association (ATA) https://s21151.pcdn.co/wp- content/uploads/APA-ATA-Best-Practices-
Clinical Practice Guidelines Page 32 of 32
Condition/Disease Guideline Title Recognized Source(s) URL Based Telemental Health (April 2018)
in-Videoconferencing-Based-Telemental-
Health.pdf
AACAP's
Telepsychiatry
Toolkit
American Academy of Child &
Adolescent Psychiatry (AACAP)
https://www.aacap.org/AACAP/Clinical_Pr
acticeCenter/BusinessofPractice/Telep
sychiatry/toolkitvideos.aspx
Telehealth in
Oncology: ASCO
Standards and
Practice
Recommendations
(September 2021)
American Society of Clinical Oncology
(ASCO)
https://ascopubs.org/doi/full/10.1200/OP.2
1.00438
Telehealth and
Telemedicine
American Academy of Family Physicians (AAFP) https://www.aafp.org/family- physician/practice-and-career/managing- your-practice/telehealth-and- telemedicine.html
Standards for
Technology in
Social Work
Practice
National Association of Social Workers
(NASW), Association of Social Work
Boards (ASWB), Council on Social
Work Education (CSWE) & Clinical
Social Work Affiliation (CSWA)
https://www.socialworkers.org/Practice/N ASW-Practice-Standards- Guidelines/Standards-for-Technology-in- Social-Work-Practice
Walk through this policy with us
Review how this policy can be converted into cited criteria, prior authorization checks, and operational automation.