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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


Asthma


Coronary Artery Disease


COPD


Diabetes


Heart Failure


Immunizations and Preventive Services


Obesity


Pain


Prenatal Care



Behavioral Health Guidelines


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


Attention-deficit / hyperactivity disorder (ADHD) Adults


Anxiety


Autism Spectrum Disorder


Depression


Eating Disorders


Gender Affirming Care


Bipolar Disorder


Psychotic Disorders


Trauma Informed Care


Substance Use Disorders



Oral Health Guidelines