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Provider : Cpgs

Clinical Practice Guidelines 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. Click on the links below to view each Clinical Practice Guideline.

Guidelines listed as IN REVIEW are currently in the approval process; the date listed is the most current copy of the guideline. 

Guidelines listed as REVISED have been reviewed and are current as of the date listed.


Here are our most current lines of business (LOBS):
Please note: LOBs are subject to change without notice.


  • WellCare (Arkansas, Connecticut, Florida, Georgia, Illinois, Kentucky, Louisiana, Mississippi, New Jersey, New York, South Carolina, Tennessee, Texas)
  • ‘Ohana Health Plan
  • Easy Choice Health Plan
  • WellCare Prescription Drug Plans


  • Harmony Health Plan of Illinois
  • Missouri Care
  • ‘Ohana Health Plan
  • Staywell of Florida
  • WellCare (Georgia, Kentucky, New Jersey, New York, Ohio, South Carolina)


Medicare-Medicaid Plan (MMP)

  • New York WellCare Advocate Complete FIDA

General Clinical Practice Guidelines

Apply to all markets and LOBs unless otherwise noted.


Behavioral Health


Legal Disclaimer:  Clinical practice guidelines made available by WellCare are informational in nature and are not a substitute for the professional medical judgment of treating physicians or other health care practitioners.  These guidelines are based on information available at the time and may not be updated with the most current information available at subsequent times. Individuals should consult with their physician(s) regarding the appropriateness of care or treatment options to meet their specific needs or medical condition.  Disclosure of clinical practice guidelines is not a guarantee of coverage. Members of WellCare health plans should consult their individual coverage documents for information regarding covered benefits.  WellCare does not offer medical advice or provide medical care, and therefore cannot guarantee any results or outcomes.  WellCare does not warrant or guarantee, and shall not be liable for any deficiencies in the information contained herein or for any inaccuracies or recommendations made by independent third parties from whom any of the information contained herein was obtained.

All links associated in the section above require the ability to open .pdf files. If for any reason you are not able to view these links, please download the reader software.
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Last modified: 07/27/2015

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