| Ambetter Health Indiana Clinical | Concert Genetic Testing: Prenatal and Preconception Carrier Screening (V1.2025) | 2024-11-01 |
| Ambetter Health Indiana Clinical | Concert Genetic Testing: Prenatal Diagnosis (via Amniocentesis, CVS, or PUBS) and Pregnancy Loss (V1.2025) | 2024-11-01 |
| Ambetter Health Indiana Clinical | Concert Genetic Testing: Skeletal Dysplasia and Rare Bone Disorders (V1.2025) | 2024-11-01 |
| Ambetter Health Indiana Clinical | DME and O&P Criteria | 2024-11-01 |
| Ambetter Health Indiana Clinical | Implantable Intrathecal or Epidural Pain Pump | 2024-11-01 |
| Ambetter Health Indiana Clinical | Implantable Loop Recorder | 2024-11-01 |
| Ambetter Health Indiana Clinical | Obstetrical Home Care Programs | 2024-11-01 |
| Ambetter Health Indiana Clinical | Proton and Neutron Beam Therapies | 2024-11-01 |
| Ambetter Health Indiana Clinical | Selective Dorsal Rhizotomy in CP | 2024-11-01 |
| Ambetter Health Indiana Clinical | Spinal Cord, Peripheral Nerve, and Percutaneous Electrical Nerve Stimulation | 2024-11-01 |