May 2019 Clinical Review Criteria
Posted on May 28, 2019
Health New England’s Clinicial Policies have been updated and can be found on the Provider Resources page at healthnewengland.org/Providers/Resources.
Most recently, the following policies have been released and/or reviewed:
Medical:
Spinal Cord Stimulation (UM300POL)
Preimplantation Genetic Testing (PGT) / Preimplantation Genetic Diagnosis (PGD) (UM481POL)
Therapeutic Shoe and Orthotic Coverage (UM340POL)
Speech Therapy for Autism Disorders (UM623POL)
Formula and Enteral Nutrition (MH-UM029POL)
Photochemotherapy (PUVA), Phototherapy, Laser Treatments (UM460POL)
Female Reduction Mammoplasty and Breast Reconstruction (UM001POL)
Behavioral Health:
Access to Behavior Health Care (BH259POL)
Behavioral Health Day Treatment (UM369POL)
Admission and Concurrent Review Criteria for Inpatient Rehabilitation for Substance Use Disorder (BH629POL)
Transcranial Magnetic Stimulation (BH368POL)
Applied Behavior Analysis for Autism Spectrum Disorders (UM391POL)
Neuropsychological Testing (UM060POL)
Guidelines for ADHD
Guidelines for Substance Use Disorders
