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Guidelines
Respected professional and public health organizations create clinical practice guidelines that document best practices and recommendations for care. We’ve chosen certain clinical guidelines to help our providers give members high-quality, consistent care with effective use of services and resources. These include treatment protocols for specific conditions, as well as preventive health measures.
The intention of these guidelines is to clarify standards and expectations. They should not:
- Take precedence over your responsibility to provide treatment based on the member’s needs
- Substitute as orders for treatment of a member
- Guarantee coverage or payment for the type or level of care proposed or provided
Clinical practice guidelines
Asthma
Asthma Management Guidelines: Focused Updates 2020
2020 Focused Updates to the Asthma Management Guidelines
Chronic obstructive lung disease (COPD)
Chronic Obstructive Pulmonary Disease (COPD) Guidelines, Reports, and References
Congestive heart failure (CHF)
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure
Coronary artery disease (CAD)
Primary Prevention of CVD Guideline Hub
Diabetes
American Diabetes Association Practice Guidelines Resources
Hepatitis C
HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C
HIV/AIDS
Clinical Care Guidelines and Resources
Hypertension (HTN)
Immunizations (CDC/ACIP guidelines)
COVID-19 Vaccination Clinical & Professional Resources
Low back pain
Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain
Diagnosis and Treatment of Low Back Pain (LBP) (2022)
Obesity
Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity
Obesity in adults: a clinical practice guideline
Opioids for chronic pain (CDC guideline)
Use of Opioids in the Management of Chronic Pain (2022)
Pediatric preventive health care
American Academy of Pediatrics Periodicity Schedule (PDF)
Prenatal services
Ambulatory Adult Prenatal Care Guideline
Preventive screenings counseling and preventive medication
U.S. Preventive Services Task Force (USPSTF)
Sickle Cell Anemia
Alcohol use disorder
The ASAM Clinical Practice Guideline on Alcohol Withdrawal Management (PDF)
APA Guideline for Treatment of Patients with Alcohol Use Disorder
Attention-deficit/hyperactivity disorder (ADHD)
Attention-Deficit/Hyperactivity Disorder (ADHD)
Eating disorders
Identification and Management of Eating Disorders in Children and Adolescents
The APA Guideline for the Treatment of Patients With Eating Disorders
Generalized anxiety disorder
AACAP Guideline for Assessment and Treatment of Children and Adolescents With Anxiety Disorders
Major depressive disorder (APA guidelines)
APA Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts (PDF)
Schizophrenia
Substance use disorder
Appropriate Use of Drug Testing in Clinical Addiction Medicine Consensus Document
The ASAM National Practice Guideline for the Treatment of Opioid Use Disorder
Suicide prevention
VA/DoD Clinical Practice Guidelines
Blueprint for Youth Suicide Prevention
Tobacco cessation
Cessation Materials for State Tobacco Control Programs
Tobacco and Nicotine Cessation During Pregnancy
U.S. Public Health Service Guideline for Treating Tobacco Use and Dependence
Trauma-informed care
Clinical policy bulletins
These bulletins state our policy about the medical necessity or investigational status of medical technologies and other services to help with coverage decisions. A national review team creates the bulletins and bases them on:
- Published medical literature
- Formal technology assessments
- Structured evidence reviews
- Evidence-based consensus statements
- Expert opinions
- Evidence-based guidelines from professional and public health entities
Aetna® clinical policy bulletins