| Ambetter Health Indiana Clinical | Implantable Intrathecal or Epidural Pain Pump | 2025-11-01 |
| Ambetter Health Indiana Clinical | Implantable Loop Recorder | 2025-11-01 |
| Ambetter Health Indiana Clinical | Obstetrical Home Care Programs | 2025-11-01 |
| Ambetter Health Indiana Clinical | Orthognathic Surgery | 2025-11-01 |
| Ambetter Health Indiana Clinical | Proton and Neutron Beam Therapies | 2025-11-01 |
| Ambetter Health Indiana Clinical | Selective Dorsal Rhizotomy in CP | 2025-11-01 |
| Ambetter Health Indiana Clinical | Spinal Cord, Peripheral Nerve, and Percutaneous Electrical Nerve Stimulation | 2025-11-01 |
| Ambetter Health Kansas Sunflower Clinical | Biofeedback | 2025-11-01 |
| Ambetter Health Kansas Sunflower Clinical | Selective Dorsal Rhizotomy in CP | 2025-11-01 |
| Ambetter Health Kansas Sunflower Clinical | Concert Genetic Testing: General Approach to Genetic and Molecular Testing | 2025-11-01 |