On August 17, 2018, October 9, 2018, and November 16, 2018, the pharmacy and therapeutic (P&T) committee approved Clinical Criteria applicable to the medical drug benefit for Anthem Blue Cross and Blue Shield (Anthem). These policies were developed, revised or reviewed to support clinical coding edits.


The Clinical Criteria is publicly available on the Anthem provider website, and the effective dates are reflected in the Clinical Criteria updates notification. Visit the Clinical Criteria website to search for specific policies.


Email for questions or additional information.


Featured In:
May 2019 Anthem Provider Newsletter - Wisconsin