Medical policies 

Select a PDF or Word doc below to see medical necessity criteria for a specific treatment or service. 

Medical policy listings

Clinical criteria do not certify coverage availability.

Please refer to the current Mass General Brigham Health Plan provider manual for a definition of “medical necessity.” Criteria may be amended or rescinded at any time by Mass General Brigham Health Plan and Mass General Brigham Health Plan shall have the exclusive right to interpret and enforce its terms.

Elbow Bump Greeting. Teen Girl In Medical Mask Bumping Elbows Meeting Nurse Doctor In Hospital Indoor. Social Distancing And Keeping Safe Distance For Covid-19 Protection Concept

 

Confirming coverage is easy

To verify services under a specific plan or to ask about guidelines not listed here, simply contact Provider Services at 800-462-5449.