Care Guidelines
Presbyterian Health Plan utilizes the Care Guidelines to determine medical necessity for the plans that we manage. The Guidelines are the protected intellectual property of MCG. Presbyterian Health Plan is not able to distribute them without the permission of MCG. MCG has provided a tool that allows Presbyterian Health Plan members and prospective members to view relevant MCG guidelines, however you will not be able to print them.
Follow the instructions below to access the MCG Guidelines:
Access guidelines, read the disclaimer, and accept the terms and conditions.
Complete the User information form.
Complete the verification process to continue.
Click on the arrow icon.
Click on the guidelines you wish to view.
Access Care Guidelines