Community Health Plan of Washington uses guidelines for chronic diseases (including medical and behavioral health conditions) and for preventative services. Reference is made to the pertinent, evidence-based, peer-reviewed guidelines from nationally recognized agencies.
The guidelines are intended to help guide providers in their care of our members including Medicare, Apple Health, Cascade Select, and Behavioral Health Services Only members. The guidelines also ensure that the Clinical Coverage Criteria used for utilization management decisions are aligned with the current evidence-based guidelines.
The following new and previously approved guidelines have been reviewed and re-approved by the Clinical Quality Improvement Committee (CQIC) on February 10, 2026.
New:
| Topic | Guideline Link |
| Immunizations Adults | AAFP Adults 19 and Older Immunization Schedule |
| Immunization | WCHA 2025-2026 Respiratory Virus Season Immunization Recommendations |
Reviewed with no changes:
| Topic | Guideline Link |
| ADHD | ADHD in Children and Adolescents |
| ADHD | ADHD: Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents |
| Adult Sinusitis | AAFP Guideline for Sinusitis in Adults |
| Alcohol Use Disorder | Pharmacotherapy for Adults With Alcohol Use Disorder in Outpatient Settings: Systematic Review |
| Allergic Rhinitis | Allergic Rhinitis |
Reviewed with updates:
Retired:
| Topic | Guideline Link |
| Immunization Adults | ACIP Vaccine Recommendations and Guidelines |
The complete list of Clinical Practice Guidelines is located here.
(Guidelines last updated: February 16, 2026)
