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Medical coverage policies

We provide medical coverage policies - referral guidelines as a reference for health care professionals within the Kaiser Permanente Medical Care Program. The Kaiser Permanente Mid-Atlantic States medical coverage policies may provide details about referring patients for treatment, including the following:

  • diagnosis
  • indications
  • contraindications
  • measures prior to referral
  • clinical indications for referral
  • optional approaches

If you would like to receive a hard copy of the Medical Coverage Policy, UM criteria/protocol or Affirmation Statement, please contact the Utilization Management Operations Center at 1-800-810-4766 and follow the prompts.

Kaiser Permanente Revised Milliman Guidelines NICU Levels

Please download and view the revised Milliman guidelines for additional details.

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