Pharmacy Clinical Guidelines
- Cook County Healthcare and Hospitals Systems Prior Authorization Guidelines
- Managed Medicaid Prior Authorization Guidelines
- Standard Non-Self-Administered (NSA) Prior Authorization Guidelines
- Standard Commercial Prior Authorization Guidelines
- New Century Health Drug Policies
Clinical Policies and Procedures
- PA.252.CC – Determination of Medical Necessity
- PA.237.CC – Human Donor Milk
- PA.007.CC – Transplant: Lung and Lobar Lung
- PA.251.CC – Fertility Preservation for Iatrogenic Infertility
- PA.078 – Clinical Trials Policy & Procedure Manual
- PA.018 – Gene Expression Testing for Breast Cancer Policy
- See Diagnosis and Procedure Codes for Elective Delivery
- PA.248.CC Site of Service Policy
- PA.227.CC Authorization for Observation vs. Inpatient Admission Level of Care
- Medical Drug (Non-Oncology) Policy
- Clinical Policy and Procedure: Outpatient Major Joint Arthroplasty (Hips and Knees)
- Clinical Policy and Procedure: Car-T Therapy
- Noninvasive Genetic Testing During Pregnancy
- Post-Acute Level of Care (PAC)
- Nutritional Support Medical Policy
- Cognitive Performance Testing
- Community Support Services
- Crisis Intervention
- Definitive (Quantitative) Urine Drug Testing
- Medication Training
- Neurobehavioral Status Exam
- Psychosocial Rehabilitation
- Step Therapy for Anti-VEGF Agents
- Surgical Management of Gender Dysphoria
- Targeted Case Management
Medical Drug Policies for Prior Authorization