Policy Updates Medical Policy & Clinical GuidelinesMedicaidFebruary 17, 2025

MCG Care Guidelines 29th edition

Effective June 1, 2025, Anthem will upgrade to the 29th 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 guidelines for substance‑related disorders have been updated to allow users to identify ASAM citations more easily within MCG content. Benchmarks have been added to the guidelines for Applied Behavioral Analysis, Neuropsychological Testing, Psychological Testing, and Urine Toxicology Testing.
  • Inpatient & Surgical Care (ISC):
    • Five new observation care guidelines have been added. Also, a new mean arterial pressure (MAP) calculator has been added.
  • General Recovery Care (GRG):
    • A new Hospital‑at-Home General Recovery Guideline has been added.
  • Recovery Facility Care (RFC):
    • The discharge planning section for Inpatient Rehabilitation Facility guidelines was expanded.
  • Chronic Care (CCG):
    • New guidelines have been added to self‑management and low‑intensity disease management pediatric guidelines.

If you have questions, please contact our Medi‑Cal Customer Care Center at 800‑407-4627 (TTY 711) outside L.A. County or 888‑285-7801 (TTY 711) inside L.A. County.

Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Blue Cross of California Partnership Plan, Inc. are independent licensees of the Blue Cross Association. Blue Cross of California is contracted with L.A. Care Health Plan to provide Medi-Cal Managed Care services in Los Angeles County. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

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PUBLICATIONS: March 2025 Provider Newsletter