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
Allergy Diagnostic Testing
Allergen Immunotherapy
Asthma Guidelines
Global Initiative for Asthma (GINA) Guide for Management and Prevention
Management of acute loss of asthma control in the yellow zone
Adult and Pediatric Asthma Care Guidelines
Behavioral Health Guidelines
American Academy of Child and Adolescent Psychiatry Practice Parameters
AACAP Practice Parameter - Depressive Disorders
American Academy of Pediatrics Guidelines
AAP Clinical Practice Guidelines - ADHD
American Society of Addiction Medicine
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
Texas Health and Human Services - Substance Abuse Outpatient Care
AACAP Clinical Practice Guideline - Anxiety
State guidelines
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
Diabetes Standards of Care
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
Pharyngitis Practice 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
Adult Immunization Schedule Narrative
Adult Immunization Schedule
Adult Preventative Services
Developmental Screening - Texas Children's Health Plan