State & FederalMedicare AdvantageAugust 31, 2019

Customizations to the 23rd edition of the MCG Care Guidelines

Beginning January 1, 2024, Empire became Anthem. This article, published under the former brand, now applies to Anthem.

Category: Medicare

Effective November 1, 2019, customizations will be implemented for Chemotherapy and Inpatient & Surgical Care (W0162) for adult patients. The customizations provide specific criteria and guidance on the following:

  • Clinical indications for admission; examples will also be added for:
    • Aggressive hydration needs that cannot be managed in an infusion center.
    • Prolonged marrow suppression.
  • Regimens that cannot be managed outpatient; examples will also be added.

 

Providers can view a summary of the 23rd edition of the MCG Care Guidelines customizations online by selecting Customizations to MCG Care Guidelines 23rd Edition.

 

EBSCRNU-0040-19 July 2019

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