Medicare Advantage

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:

          o Aggressive hydration needs that cannot be managed in an infusion center

          o 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.



Featured In:
September 2019 Anthem Provider News - Virginia