Our Coverage Determination Guidelines are intended to standardize the interpretation and application of terms of the Member's Benefit Plan including terms of coverage, Benefit Plan exclusions and limitations.
Custodial Care and Inpatient & Residential Services
Depressive Disorders (MDD, PDD, PMDD)
Disruptive, Impulse and Conduct Disorder
Dissociative Identity Disorders (DID)
Health & Behavior Assessment and Intervention
Home-Based Outpatient Treatment
Judicial or Administrative Proceedings or Orders (aka Court Ordered Treatment)
Neurocognitive Disorders (Dementia)
Obsessive Compulsive Disorder (OCD)
Other and Unspecified Disorders
Other Conditions That May Be a Focus of Clinical Attention (V-Codes)
Psychological and Neuropsychological Testing
Schizophrenia and Schizoaffective Disorder
School-Based Services for Children and Adolescents