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Clinical Practice Guidelines
Below you will find all of the Clinical Practice Guidelines. If you wish to open the following forms, you must have Adobe Acrobat Reader installed on your computer. To download a form, right click on one of the links below and select "Save Target As."
To download a free copy of Adobe Acrobat Reader, click here.
Availability of Criteria
The criteria which is used to make an authorization decision is available to the practitioner over the phone or made available in our office for proprietary criteria. Criteria used from the public domain is facilitated through a URL link or a mailed copy.
Providers requesting the criteria by phone should call Provider Relations at 832-828-1004 and request the Utilization Review manager.
Allergy Guidelines
Asthma Guidelines
Global Initiative for Asthma (GINA) Guide for Management and Prevention
2020 Focused Updates to the Asthma Management Guidelines: Clinician's Guide | NHLBI, NIH
2020 Focused Updates to the Asthma Management Guidelines | NHLBI, NIH
Behavioral Health Guidelines
ADHD
Addiction Medicine
Clinical Guidelines (asam.org)
Texas Health and Human Services - Substance Abuse Outpatient Care
Depression
American Psychiatric Association Practice Guidelines
APA - Practice Guideline Major Depressive Disorder
Institute for Clinical Systems Improvement, Health Care Guideline: Major Depression in Adults in Primary Care
Anxiety
AACAP Clinical Practice Guideline - Anxiety
State Guidelines – Screening and Drug Formulary
Texas Health and Human Services Child and Adolescent Needs and Strength Assessment (CANS)
Texas Health and Human Services Adult Needs and Strength Assessment (ANSA)
Texas Health and Human Services Psychiatric Drug Formulary
Diabetes Guidelines
Professional Practice Committee: Standards of Medical Care in Diabetes—2021 | Diabetes Care | American Diabetes Association (diabetesjournals.org)
Diabetes Standards of Care Change Summary
Diabetes Care for Transition to Adult Diabetes Care Systems
Neuropsychology Guidelines
Neuropsychological Testing Guidelines
Otitis Guidelines
AAP Otitis Media with Effusion
Obesity Guidelines
National Heart, Lung, and Blood Institute (NHLBI) Obesity Guidelines for Adults
American Academy of Pediatrics
Endocrine Society
NIH Pediatric Obesity Algorithm
Pharyngitis Guidelines
Preventative Guidelines
Texas Health Steps Periodicity Schedule
Recommended Immunization Schedule Age 0-18
Catch-up Immunization Schedule Age 0-18
AAP Bright Futures Periodicity Schedule
Advisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older - United States, 2022 - PubMed (nih.gov)
Adult Preventative Services
Developmental Screening - Texas Children's Health Plan