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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.

Asthma

Coronary Artery Disease

COPD

Diabetes

Heart Failure

Immunizations and Preventative Services

Obesity

Pain

Prenatal Care

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