Coverage Criteria, Medical Policies and Clinical Guidelines

Johns Hopkins Health Plans wants to ensure that you are always in control of your health care decisions. We make our Medicare Advantage Clinical Guidelines, Medical Policies and Coverage Criteria available and accessible to all our members as well as the public. To explore these, simply select the guideline, policy or coverage criteria that you wish to review.

• Clinical Practice Guidelines
• InterQual® Criteria
  • Registration is required to view the guidelines. Accounts are free and available to the public.
• Medical Policies
• Part B Drugs (Medical Injectable) Criteria
• eviCore healthcare
  • Member Information
  • Clinical Guidelines
    • Click on a program and search for the provider Johns Hopkins Healthcare to review the guidelines. Advantage MD only participates in select programs.
  • Participating Programs
    • Clinical Information for Medical Necessity Review
    • Cardiovascular and Radiology
    • Laboratory Management
    • Musculoskeletal Advanced Procedures 
    • Musculoskeletal Therapies
    • Post-Acute Care
      • Individual Guidelines