| BCBS Louisiana | Radiofrequency Coblation Tenotomy and Percutaneous Ultrasonic Tenotomy for Musculoskeletal Conditions | 2025-07-01 |
| BCBS Louisiana | Balloon Spacers for Treatment of Irreparable Rotator Cuffs of the Shoulder | 2025-07-01 |
| BCBS Louisiana | Journavx™ (suzetrigine) | 2025-07-01 |
| BCBS Louisiana | remestemcel-L-rknd (Ryoncil®) | 2025-07-01 |
| Ambetter Health Nevada Silver Summit Clinical | Intradiscal Steroid Injections for Pain Management | 2025-07-01 |
| Ambetter Health Nevada Silver Summit Clinical | Sacroiliac Joint Interventions for Pain Management | 2025-07-01 |
| Ambetter Health Iowa Clinical | Trigger Point Injections for Pain Management | 2025-07-01 |
| UHC Medicaid Medical & Drug | Surgery of the Hand or Wrist – Community Plan Medical Policy | 2025-07-01 |
| BCBS Louisiana Avalon | F2019: Flow Cytometry | 2025-07-01 |
| BCBS Louisiana Avalon | G2031: Allergen Testing | 2025-07-01 |