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Clinical Guidelines

Clinical Coverage Guidelines
The Clinical Coverage Guidelines (CCG) are evidence-based documents detailing the medical necessity of given procedures or technologies. The guidelines set consistent criteria for the coverage of a procedure or technology, leading to greater consistency and efficiency in clinical decision making. This consistency and efficiency results in better provider/company interactions and increases the quality of our members' health.

Clinical Practice Guidelines
Clinical Practice Guidelines (CPG) are best-practice recommendations based on available clinical outcome and scientific evidence. WellCare Clinical Practice Guidelines reference expert professional and clinical society recommendations, ensuring that the guidelines contain the highest level of evidence-based content. Clinical Practice Guidelines are also used to guide efforts to improvement the quality of care in our membership.

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Last Updated On: 3/29/2022
Medicare Members: Protect yourself against Medicare fraud and Identify theft! The U.S. Department of Health and Human Services Office of Inspector General is alerting the public about a fraud scheme involving genetic testing. Learn how to protect yourself.
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