Behavioral Health Clinical Practice Guidelines 2023-2024

Blue Cross and Blue Shield of Illinois adopts Clinical Practice Guidelines as the foundation for our Behavioral Health Care Management Program. We review and adopt updates to guidelines at least every two years. 

The evidence-based clinical guidelines from nationally recognized sources are designed to provide a framework for BCBSIL contracted providers for evaluating and treating our members. They’re not intended to substitute for a provider’s judgment or establish a protocol for all members with a particular condition. Providers are encouraged to make decisions based on their own judgment and most current evidence-based information available. Guidelines for the use of psychotropic medication management are included within each guideline. If you have questions, email our Behavioral Health Quality Improvement team.

The guidelines apply to services provided to our members who have behavioral health benefits through our individual and family, and group plans, including Blue Cross and Blue Shield Federal Employee Program® (FEP®) members. The guidelines also apply to our government plans, including Blue Cross Community Health PlansSM (BCCHP)SM and Blue Cross Community MMAI (Medicare-Medicaid Plan)SM. Learn more about our behavioral health program.

Acute Stress Disorder and Posttraumatic Stress Disorder (PTSD)

Alzheimer’s and Other Dementias

Attention-Deficit/Hyperactivity Disorder (ADHD)




Eating Disorders


Generalized Anxiety and Panic Disorders

Obsessive Compulsive Disorder


Substance Abuse Disorders




-Suicidal Behaviors


-Gender Diversity

-Multicultural Counseling

-Electroconvulsive Therapy

-Reproductive, Prenatal and Postpartum Mental Health

-Trauma-Informed Care

The above material is for informational purposes only and is not intended to be a substitute for the independent medical judgment of a physician. Physicians and other health care providers are encouraged to use their own best medical judgment based upon all available information and the condition of the patient in determining the best course of treatment. References to other third-party sources or organizations are not a representation, warranty, or endorsement of such organization. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations, and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.