Clinical criteria updates

Medicare Advantage

 

On March 29, 2019, April 12, 2019 and May 1, 2019, the Pharmacy and Therapeutic (P&T) Committee approved clinical criteria applicable to the medical drug benefit for Anthem Blue Cross and Blue Shield. These policies were developed, revised or reviewed to support clinical coding edits.

 

The clinical criteria is publicly available on our anthem.com/medicareprovider website, and the effective dates will be reflected in the Clinical Criteria Q2 update. Visit clinical criteria to search for specific policies.

 

For questions or additional information, send us an email.