MCG care guidelines

In addition to the Corporate Medical Policies that Blue Cross NC maintains for coverage decisions, we also adopt criteria developed and maintained by other organizations. Note that where we have developed a commercial or a Medicare medical policy that addresses a service also described in one of these other sets of criteria, Blue Cross NC medical policy takes precedence. MCG guidelines are proprietary and Blue Cross NC is not able to distribute them without MCG’s permission. MCG has provided a tool that allows members to view the relevant MCG guidelines.

If you have questions about these guidelines, please call the phone number on your member ID card.

Follow these instructions for access to MCG care guidelines.

1. Select either the Commercial or Medicare MCG care guidelines, read the disclaimer, and accept the terms and conditions.
2. Complete the user information form.
3. Complete the verification process to continue.
4. Expand the list of guidelines in the content group to access the specific guidelines.
5. Select the guideline you’re searching for.