Clinical Practice Guidelines

We adopt and develop our clinical practice guidelines from national organizations and/or in cooperation with specialty organizations and collaborative groups. We periodically update our clinical practice guidelines to include new information about treatments, medications, and technology that reflect best practices.

The guidelines below are applicable for both Harvard Pilgrim Health Care and Tufts Health Plan products. These clinical guidelines are not intended to replace a provider’s clinical judgement, but serve as a resource to support it.

Please note that these clinical practice guidelines are separate and independent from coverage criteria, which vary by product and may differ from these guidelines. In order to determine whether a treatment or service is covered under a particular plan, please review the coverage criteria specific to that plan.