| Ambetter Health Georgia Clinical | Caudal or Interlaminar Epidural Steroid Injections | 2025-05-01 |
| Ambetter Health Georgia Clinical | Cochlear Implant Replacements | 2025-05-01 |
| Ambetter Health Georgia Clinical | Facet Joint Interventions | 2025-05-01 |
| Ambetter Health Georgia Clinical | Fecal Incontinence Treatments | 2025-05-01 |
| Ambetter Health Georgia Clinical | Fetal Surgery in Utero for Prenatally Diagnosed Malformations | 2025-05-01 |
| Ambetter Health Georgia Clinical | Neuromuscular Electrical Stimulation (NMES) | 2025-05-01 |
| Ambetter Health Georgia Clinical | Pediatric Liver Transplant | 2025-05-01 |
| Ambetter Health Georgia Clinical | Reduction Mammoplasty and Gynecomastia Surgery | 2025-05-01 |
| Ambetter Health Georgia Clinical | Total Artificial Heart | 2025-05-01 |
| Ambetter Health Illinois Clinical | Caudal or Interlaminar Epidural Steroid Injections | 2025-05-01 |