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Practice Guidelines

Quick links: Medical Guidelines | Behavioral Health Guidelines | Oral Health Guidelines

Practice Guideline Adoption and Recommended Use

PacificSource Community Solutions, PacificSource Medicare, and PacificSource Health Plans support the use of practice guidelines based on nationally recognized, valid, and reliable evidence-based clinical literature or a consensus of professionals in a particular field.

PacificSource adopts medical, behavioral, and oral health guidelines to assist providers and members in making decisions about appropriate healthcare choices. PacificSource practice guidelines are not meant to replace the clinical judgment of a treating provider. Guidelines are reviewed and updated as needed on an annual basis.

In all cases, benefit determinations should be based on the applicable contract coverage. Should there be any discrepancy between these guidelines and the contract language, the contract language will take precedence.

Medical Guidelines


Coronary Artery Disease



Heart Failure

Immunizations and Preventive Services



Prenatal Care

Behavioral Health Guidelines

Attention-deficit / hyperactivity disorder (ADHD) Children and Adolescents

Attention-deficit / hyperactivity disorder (ADHD) Adults


Autism Spectrum Disorder


Eating Disorders

Gender Affirming Care

Bipolar Disorder

Psychotic Disorders

Trauma Informed Care

Substance Use Disorders

Oral Health Guidelines