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Guidelines
Respected professional and public health organizations create clinical practice guidelines that document best practices and recommendations for care. We’ve chosen certain clinical guidelines to help our providers give members high-quality, consistent care with effective use of services and resources. These include treatment protocols for specific conditions, as well as preventive health measures.
The intention of these guidelines is to clarify standards and expectations. They should not:
- Take precedence over your responsibility to provide treatment based on the member’s needs
- Substitute as orders for treatment of a member
- Guarantee coverage or payment for the type or level of care proposed or provided
Clinical practice guidelines
Congestive heart failure (CHF)
Contraceptive use recommendations (PDF)
Global Initiative for Chronic Obstructive Lung Disease 2023 Report
Global Initiative for Chronic Obstructive Lung Disease 2024 Actionable Digital Format
Immunizations for adults and children
Pediatric health care recommendations (PDF)
Prenatal care
American Academy of Family Physicians (AAFP) prenatal care topics
American College of Obstetricians and Gynecologists (ACOG) practice guidelines
Preterm birth
Progesterone and preterm birth prevention (PDF)
Sickle cell disease
Sickle cell disease expert panel report
Sickle cell disease management (PDF)
Vaccine recommendations for pregnant women
Tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine
Attention-deficit/hyperactivity disorder (ADHD)
Children and families in the aftermath of disasters and crises (PDF)
Disruptive behavior disorders in children and adolescents
Generalized anxiety disorder (PDF)
Major depressive disorder
American Psychiatric Association (APA) practice guidelines
Veterans Affairs/Department of Defense (VA/DoD) practice guidelines
Acute stress disorder and posttraumatic stress disorder
Eating disorders
Nicotine use
Health equity in tobacco prevention and control (PDF)
Personalized quit plan form (PDF)
Tobacco-related disparities (PDF)
Treating tobacco use and dependence
Obsessive-compulsive disorder
Opioid addiction
American Society of Addiction Medicine (ASAM) national practice guideline (PDF)
ASAM national practice guideline synopsis (PDF)
Schizophrenia
Substance use disorder
Suicidal behaviors
Clinical policy bulletins
These bulletins state our policy about the medical necessity or investigational status of medical technologies and other services to help with coverage decisions. A national review team creates the bulletins and bases them on:
- Published medical literature
- Formal technology assessments
- Structured evidence reviews
- Evidence-based consensus statements
- Expert opinions
- Evidence-based guidelines from professional and public health entities
Aetna® clinical policy bulletins