| BCBS California | Viscocanalostomy and Canaloplasty | 2025-05-01 |
| Health Net Comm & Medi-Cal Plan | Biofeedback for Behavioral Health Disorders | 2025-05-01 |
| Health Net Comm & Medi-Cal Plan | Caudal or Interlaminar Epidural Steroid Injections | 2025-05-01 |
| Health Net Comm & Medi-Cal Plan | Cochlear Implant Replacements | 2025-05-01 |
| Health Net Comm & Medi-Cal Plan | Facet Joint Interventions | 2025-05-01 |
| Health Net Comm & Medi-Cal Plan | Fecal Incontinence Treatments | 2025-05-01 |
| Health Net Comm & Medi-Cal Plan | Fetal Surgery in Utero for Prenatally Diagnosed Malformations | 2025-05-01 |
| Health Net Comm & Medi-Cal Plan | Neuromuscular Electrical Stimulation (NMES) | 2025-05-01 |
| Health Net Comm & Medi-Cal Plan | Pediatric Liver Transplant | 2025-05-01 |
| Health Net Comm & Medi-Cal Plan | Reduction Mammoplasty and Gynecomastia Surgery | 2025-05-01 |