| BCBS Highmark Delaware | Trastuzumab (Herceptin), Trastuzumab Biosimilars, and Trastuzumab and Hyaluronidase-oysk (Herceptin Hylecta) | 2025-11-03 |
| BCBS Highmark West Virginia | Diabetic Services, Continuous Glucose Monitoring, and Supplies | 2025-11-03 |
| BCBS Highmark West Virginia | Durable Medical Equipment | 2025-11-03 |
| BCBS Highmark West Virginia | Negative Pressure Wound Therapy Pumps/Vacuum Assisted Closure of Chronic Wounds | 2025-11-03 |
| BCBS Highmark West Virginia | Outpatient Pulmonary Rehabilitation | 2025-11-03 |
| BCBS Highmark West Virginia | Interspinous and Interlaminar Stabilization/Distraction Devices (Spacers) | 2025-11-03 |
| Humana Medicare Advantage | Brain Stimulation Treatments - Medicare Advantage | 2025-11-03 |
| Humana Medicare Advantage | Cold and Heat Therapy Devices - Medicare Advantage | 2025-11-03 |
| Humana Medicare Advantage | Immersion Therapy Mattress-Bed - Medicare Advantage | 2025-11-03 |
| Humana Medicare Advantage | Inpatient and Long Term Acute Care Hospital Services - Medicare Advantage | 2025-11-03 |