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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

Allergen Immunotherapy

Asthma Guidelines

Global Initiative for Asthma (GINA) Guide for Management and Prevention

2020 Focused Updates to the Asthma Management Guidelines: A Report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group | NHLBI, NIH

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

Clinical Practice Guideline: Diagnosis and Evaluation of the Child With Attention-Deficit/Hyperactivity Disorder | Pediatrics | American Academy of Pediatrics (aap.org)

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

Group A Pharyngitis, IDSA

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 

Tonsillectomy

Tonsillectomy in Children