| Ambetter Health Louisiana Clinical | Outpatient Oxygen Use | 2025-11-01 |
| Ambetter Health Louisiana Clinical | Proton and Neutron Beam Therapies | 2025-11-01 |
| Ambetter Health Louisiana Clinical | Selective Dorsal Rhizotomy in CP | 2025-11-01 |
| Ambetter Health Louisiana Clinical | Spinal Cord, Peripheral Nerve, and Percutaneous Electrical Nerve Stimulation | 2025-11-01 |
| Ambetter Health Louisiana Clinical | Urinary Incontinence Devices and Treatments | 2025-11-01 |
| Ambetter Health Louisiana Clinical | Ventricular Assist Devices | 2025-11-01 |
| Ambetter Health Alabama Clinical | Urinary Incontinence Devices and Treatments | 2025-11-01 |
| Ambetter Health Iowa Clinical | Concert Genetic Testing: Cardiovascular | 2025-11-01 |
| Ambetter Health Iowa Clinical | Concert Genetic Testing: Dermatology | 2025-11-01 |
| Ambetter Health Iowa Clinical | Concert Genetic Testing: Endocrinology | 2025-11-01 |