Clinical Practice Guidelines
2018-2019

Behavioral Health Guidelines

Clinical Practice Guidelines (CPGs) adopted by Blue Cross and Blue Shield of Texas (BCBSTX) are the foundation for the Behavioral Health Care Management Programs. Updates to CPGs are reviewed and adopted every two years.

If you have any questions about the CPGs adopted by BCBSTX,contact us via: Email BHQualityImprovement@bcbstx.com

The Behavioral Health Care Management Programs offered by BCBS serve members suffering from Depression, Alcohol/Substance Abuse Disorders, Anxiety/Panic Disorders, Attention Deficit/Hyperactivity Disorder, Bipolar Disorder, Eating Disorders, Schizophrenia and other Psychotic Disorders. If a professional provider has a patient who may benefit from participating in one of the above mentioned programs, please call Behavioral Health Member Services using the number on the back of the Member’s ID card to have the patient screened and considered for enrollment in a Case Management Program.

The Behavioral Health Clinical Practice Guidelines are applicable to all HCSC BH (product lines). These guidelines are designed to assist clinicians by providing a framework for evaluation, and treatment of patients and is not intended to either replace a clinician’s judgment or establish a protocol for all patients with a particular condition. Guidelines for the use of Psychotropic Medication Management are included within each Behavioral Health Clinical Practice Guideline.

Clinical Practice Guidelines for Behavioral Health Conditions

Select from the links listed below to view CPG’s for Behavioral health conditions:

Acute Stress Disorder and Post Traumatic Stress Disorder (PTSD)

• Practice Guideline for the Treatment of Patients with Acute Stress Disorder and Posttraumatic Stress Disorder
  American Psychiatric Association, 2004
• Guideline Watch: Practice Guideline for the Treatment of Patients with Acute Stress Disorder and Posttraumatic Stress Disorder
  American Psychiatric Association, 2009
• VA/DOD Clinical Practice Guideline for the Management of Post Traumatic Stress Disorder and Acute Stress Disorder (2017) Department of Veterans Affairs/Department of Defense
• Clinical Practice Guideline for the Treatment of PTSD (2017) American Psychological Association

Alzheimer's and Other Dementias

• Treatment of Patients with Alzheimer's Disease and Other Dementias 2nd edition
  American Psychiatric Association, 2007
• Guideline Watch: Practice Guideline for the Treatment of Patients with Alzheimer’s Disease and Other Dementias (2014)
• The American Psychiatric Association Practice Guideline on the Use of Antipsychotics to Treat Agitation or Psychosis in Patients with Dementia (2016) American Psychiatric Association 

Attention-Deficit/Hyperactivity Disorder (ADHD)

• ADHD: Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents” (2011) American Academy of Pediatrics 

Autism

• Practice Parameter for the Assessment and Treatment of Children and Adolescents with Autism Spectrum Disorder (2014) American Academy of Child and Adolescent Psychiatry
  American Psychiatric Association, 2007
• Autism Spectrum Disorder in Adults: Diagnosis and Management (2012) National Institute for Health and Care Excellence 
• Practice Parameter: Screening and Diagnosis of Autism (2000) American Academy of Neurology 

Bipolar

• Practice Guideline for the Treatment of Patients with Bipolar Disorder, Second Edition
  American Psychiatric Association, 2002
• Guideline Watch: Practice Guideline for the Treatment of Patients with Bipolar Disorder, Second Edition
  American Psychiatric Association, 2005
• Bipolar Disorder: Assessment and Management Clinical Guideline (2014) National Institute for Health and Care Excellence 

Depression

• Practice Guideline for the Treatment of Patients with Major Depressive Disorder, Third Edition
  American Psychiatric Association, 2010
• Practice Parameter for the Assessment and Treatment of Children and Adolescents with Depressive Disorders 
  American Academy of Child and Adolescent Psychiatry, 2007
• Screening for Depression in Children and Adolescents: US Preventive Services Task Force Recommendation Statement (2016) American Academy of Pediatrics
• Clinical Practice Review for Major Depressive Disorder (2016) Anxiety and Depression Association of America 

Eating Disorders

• Practice Guideline for the Treatment of Patients with Eating Disorders, Third Edition
  American Psychiatric Association, 2006
• Guideline Watch: Practice Guideline for the Treatment of Patients with Eating Disorders, Third Edition
  American Psychiatric Association, 2012
• Practice Parameter for the Assessment and Treatment of Children and Adolescents with Eating Disorders (2015) American Academy of Child and Adolescent Psychiatry

General

• Practice Guidelines for the Psychiatric Evaluation of Adults" (2015) American Psychiatric Association 

Generalized Anxiety and Panic Disorder

• Practice Guideline for the Treatment of Patients with Panic Disorder, Second Edition
  American Psychiatric Association, 2009
• Generalised Anxiety Disorder and Panic Disorder in Adults: Management Clinical Guideline (2011) National Institute for Health and Care Excellence 

Obsessive Compulsive Disorder

• Practice Guideline for the Treatment of Patients with Obsessive-Compulsive Disorder
  American Psychiatric Association, 2007
• Guideline Watch: Practice Guideline for the Treatment of Patients with Obsessive-Compulsive Disorder (2013) American Psychiatric Association

Schizophrenia

• Practice Guideline for the Treatment of Patients with Schizophrenia, Second Edition
  American Psychiatric Association, 2004
• Guideline Watch (September 2009): Practice Guideline for the Treatment of Patients with Schizophrenia
  American Psychiatric Association, 2009
• Treating Schizophrenia: A Quick Reference Guide (2004) American Psychiatric Association
• Practice Parameter for the Assessment and Treatment of Children and Adolescents with Schizophrenia (2013) American Academy of Child and Adolescent Psychiatry 

Substance Use Disorders

- General:

• Practice Guideline for the Treatment of Patients with Substance Use Disorders, Second Edition
  American Psychiatric Association, 2006
• Guideline Watch (April 2007): Practice Guideline for the Treatment of Patients with Substance Use Disorders, Second Edition
  American Psychiatric Association, 2007
• VA/DoD Clinical Practice Guideline for the Management of Substance Use Disorders (2015) Department of Veterans Affairs/Department of Defense Medication-Assisted Treatment for Opioid Addiction in Opioid Treatment Programs: A Treatment Improvement Protocol (TIP) 43 (2005) Substance Abuse and Mental Health Services Administration

- Opiod:

• Treatment of Opioid Use Disorders (2016) The New England Journal of Medicine 
• Interagency Guideline on Prescribing Opioids for Pain (2015) Agency Medical Directors' Group

- Suboxone:

• Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction: A Treatment Improvement Protocol (TIP) 40 (2004) Substance Abuse and Mental Health Services Administration

Suicidal Behaviors

• Practice Guideline for the Treatment of Patients with Bipolar Disorder 2nd Edition (2002) American Psychiatric Association
• APA Practice Guidelines (2016) Recommendations Regarding Assessment of Suicide as Part of the Initial Psychiatric Assessment (2016) American Psychiatric Association
• VA/DoD Clinical Practice Guideline for Assessment and Management of Patients at Risk for Suicide (2013) Department of Veterans Affairs/Department of Defense

Telehealth

• Practice Guidelines for Video-Based Online Mental Health Services (2009) American Telemedicine Association
• Practice Guidelines for Video-Based Online Mental Health Services (companion document) (2013) American Telemedicine Association
• Core Operational Guidelines for Telehealth Services Involving Provider-Patient Interaction (2014) American Telemedicine Association
• Guidelines for the Practice of Telepsychology (2013) American Psychological Association
• Practice Parameter for Telepsychiatry with Children and Adolescents (2008) American Academy of Child and Adolescent Psychiatry