Clinical Practice Guidelines | Texas Children's Health Plan
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Clinical Practice Guidelines

Below you will find all of the Clinical Practice Guidelines. If you wish to open the following forms, you must have Adobe Acrobat Reader installed on your computer. To download a form, right click on one of the links below and select "Save Target As."

To download a free copy of Adobe Acrobat Reader, click here.

Availability of Criteria

The criteria which is used to make an authorization decision is available to the practitioner over the phone or made available in our office for proprietary criteria. Criteria used from the public domain is facilitated through a URL link or a mailed copy.

Providers requesting the criteria by phone should call Provider Relations at 832-828-1004 and request the Utilization Review manager.

Allergy Guidelines

Allergy Diagnostic Testing
Allergen Immunotherapy

Asthma Guidelines

Global Initiative for Asthma (GINA) Guide for Management and Prevention 
Management of acute loss of asthma control in the yellow zone
Adult and Pediatric Asthma Care Guidelines

Behavioral Health Guidelines

American Academy of Child and Adolescent Psychiatry Practice Parameters
AACAP Practice Parameter - Depressive Disorders 
American Academy of Pediatrics Guidelines  
AAP Clinical Practice Guidelines - ADHD
American Society of Addiction Medicine 
American Psychiatric Association Practice Guidelines
APA - Practice Guideline Major Depressive Disorder 
Institute for Clinical Systems Improvement, Health Care Guideline: Major Depression in Adults in Primary Care 
Texas Health and Human Services - Substance Abuse Outpatient Care
AACAP Clinical Practice Guideline - Anxiety

State guidelines

Texas Health and Human Services Child and Adolescent Needs and Strength Assessment (CANS) 
Texas Health and Human Services Adult Needs and Strength Assessment (ANSA)
Texas Health and Human Services Psychiatric Drug Formulary 

Diabetes Guidelines

Diabetes Standards of Care
Diabetes Standards of Care Change Summary 
Diabetes Care for Transition to Adult Diabetes Care Systems

Neuropsychology Guidelines

Neuropsychological Testing Guidelines

Otitis Guidelines

AAP Otitis Media with Effusion

Obesity Guidelines

National Heart, Lung, and Blood Institute (NHLBI) Obesity Guidelines for Adults
American Academy of Pediatrics
Endocrine Society
NIH Pediatric Obesity Algorithm

Pharyngitis Guidelines 

Pharyngitis Practice Guidelines

Preventative Guidelines

Texas Health Steps Periodicity Schedule 
Recommended Immunization Schedule Age 0-18 
Catch-up Immunization Schedule Age 0-18 
AAP Bright Futures Periodicity Schedule 
Adult Immunization Schedule Narrative 
Adult Immunization Schedule
Adult Preventative Services 
Developmental Screening - Texas Children's Health Plan 

Tonsillectomy

Tonsillectomy in Children