Clinical Care Guidelines Overview
Our member's health benefit plan may make decisions using criteria from the clinical care guidelines provided by MCG Health.
Access Appropriate Clinical Care
At Anthem, our clinical care guidelines serve as an educational resource for healthcare providers and patients, detailing the evidence-based criteria used to determine the medical necessity of healthcare services.
To access the correct coverage guideline tool for the member in question, please:
- Locate the appropriate state from our list of options
- Select the state with the member’s correct health benefit plan to ensure the correct data can be accessed.
- Follow the steps in the selected Coverage Guidelines tool to access correct criteria.
Medicare providers: Access the MCG Medicare Coverage Guidelines tool