Medicare AdvantageApril 26, 2024
MCG Care Guidelines 28th edition
Effective September 1, 2024, Anthem will upgrade to the 28th edition of MCG Care Guidelines for the following modules. Below is high level summary of the updates and is not intended to be all inclusive:
- Behavioral Health Care (BHG)
- The goal length of stay (GLOS) has been changed in 2 guidelines in the 28th edition of Behavioral Health Care.
- Inpatient & Surgical Care (ISC)
- The goal length of stay (GLOS) has been changed in a total of 72 Optimal Recovery Guidelines in the 28th edition of Inpatient & Surgical Care. In medical Optimal Recovery Guidelines, the GLOS has been changed in 37 guidelines and the GLOS has been changed in 35 surgical Optimal Recovery Guidelines, in the 28th edition of Inpatient & Surgical Care.
- General Recovery Care (GRG)
- The benchmark length of stay (BLOS) has been refined in the 28th edition of General Recovery Care.
- Chronic Care (CCG)
- A total of 10 guidelines have been moved in the 28th edition of Chronic Care.
For questions, please contact the provider service number on the back of the member's ID card.
Anthem BC Health Insurance Company is the trade name of Anthem Insurance Companies, Inc. Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross, Anthem Blue Cross Life and Health Insurance Company, and Anthem BC Health Insurance Company are independent licensees of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.
CABC-CR-056690-24-CPN55820
PUBLICATIONS: June 2024 Provider Newsletter
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