MCG Cite Guideline Transparency Tool Upgrade Effective April 26, 2025
4/21/2025
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Posted by Provider Relations
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Provider News
Fidelis Care would like to notify providers that the MCG Cite Guideline Transparency Tool is scheduled to be upgraded to the 29th edition effective Saturday, April 26, 2025. Providers can access this tool through the Fidelis Care Provider Portal.
Highlights of the changes in the 29th edition of the MCG care guidelines include:
- Five new observation care guidelines in MCG Inpatient & Surgical Care to support the use of observation care for specific diagnoses. In addition, a new calculator for mean arterial pressure (MAP) was added to the content (where applicable).
- A new “Gene and Cellular Therapy” section containing guidelines for cutting-edge treatments was added to MCG Ambulatory Care. These therapies represent a significant leap forward in managing rare genetic disorders. In addition, a new guideline was added for specialty medication related to Alzheimer’s disease.
- For MCG Behavioral Health Care, selected guidelines now include both rationale and information on related CMS coverage guidance in alignment with the 2024 Medicare Advantage and Part D Final Rule (CMS-4201-F).
- In order to address a wider population of patients who may be appropriate for hospital-at-home (HaH) level of care, a new guideline was developed for MCG General Recovery Care.
- For MCG Chronic Care, three new pediatric guidelines were added for anxiety, depression, and substance-related disorders. In addition, a new survey has been incorporated to assist organizations with meeting quality standards related to health equity.
- Additional changes were made to the latest versions of MCG Cite and Indicia software to support compliance with the 2024 Medicare Advantage and Part D Final Rule (CMS-4201-F) as well as for related reporting and transparency requirements.
As a reminder, with the MCG Cite Guideline Transparency Tool, Fidelis Care can share clinical indications with providers. The tool is a secure resource that helps meet regulations around transparency for care delivery. Benefits include:
• Transparency: Delivers industry-leading medical determination transparency.
• Access: Allows the review of MCG clinical evidence used by payers to support member care decisions.
• Security: Ensures easy and flexible access via secure web access.
This Quick Reference Guide details how to access the MCG tool.
To learn more about MCG or the MCG tool, visit MCG's website or call 888-464-4746.
If you have any questions, please contact your Fidelis Care Provider Engagement Account Manager. To find your designated representative, please visit Contact Your Designated Provider Relations Specialist.