| Ambetter Health North Carolina Clinical | Fetal Surgery in Utero for Prenatally Diagnosed Malformations | 2025-05-01 |
| Ambetter Health North Carolina Clinical | Neuromuscular Electrical Stimulation (NMES) | 2025-05-01 |
| Ambetter Health North Carolina Clinical | Pediatric Liver Transplant | 2025-05-01 |
| Ambetter Health North Carolina Clinical | Reduction Mammoplasty and Gynecomastia Surgery | 2025-05-01 |
| Wellcare Florida Medicare Clinical | Allogeneic Hematopoietic Progenitor Cell Therapy | 2025-05-01 |
| Wellcare Kentucky Medicare Clinical | Allogeneic Hematopoietic Progenitor Cell Therapy | 2025-05-01 |
| Wellcare Kentucky Medicaid Clinical | Biofeedback for Behavioral Health Disorders | 2025-05-01 |
| Wellcare Georgia Medicare Clinical | Allogeneic Hematopoietic Progenitor Cell Therapy | 2025-05-01 |
| Wellcare Alabama Medicare Clinical | Allogeneic Hematopoietic Progenitor Cell Therapy | 2025-05-01 |
| Wellcare North Carolina Medicaid Clinical | Allergy Immunotherapy | 2025-05-01 |