Medical policies are based on Select Health determination of whether services or devices are standard medical practice, experimental/investigational, cosmetic, or within coding standards. These conclusions reflect our review of currently available clinical information including
- Research in peer-reviewed published medical literature
- Regulatory status of the technology
- Evidence-based guidelines of public health and health research agencies
- Evidence-based guidelines and positions of leading national health professional organizations
- Views of physicians practicing in relevant clinical areas
- Other relevant factors
Laboratory utilization policies reflect a partnership between Select Health and Avalon Healthcare. NOTE: Post-service automated policy adherence applies to outpatient laboratory services regardless of place of service. Learn more by accessing:
Select Health may use additional coverage criteria where a medical policy is not available: InterQual Criteria
For Select Health Medicare Nevada: MCG Criteria