| Cigna | Biofeedback - (CPG294) | 2025-11-15 |
| Cigna | Breast Reduction - (0152) | 2025-11-15 |
| Cigna | Chromoendoscopy - (0148) | 2025-11-15 |
| Cigna | Cochlear Implants - (0190) | 2025-11-15 |
| Cigna | Corneal Remodeling for Refractive Errors - (0141) | 2025-11-15 |
| Cigna | Deep Brain, Motor Cortex and Responsive Cortical Stimulation - (0184) | 2025-11-15 |
| Cigna | Extracorporeal Shock Wave Therapy (ESWT) for Musculoskeletal Conditions - (0004) | 2025-11-15 |
| BCBS Texas Medical Policies | Balloon Dilation of the Eustachian Tube | 2025-11-15 |
| BCBS Texas Medical Policies | Closure Devices for Patent Foramen Ovale and Atrial Septal | 2025-11-15 |
| BCBS Texas Medical Policies | Composite Tissue Allotransplantation of the Hand and Face | 2025-11-15 |