| BCBS Massachusetts | Sensory Integration Therapy | 2025-05-01 |
| BCBS Massachusetts | Surgery for Groin Pain in Athletes | 2025-05-01 |
| BCBS Massachusetts | Viscocanalostomy and Canaloplasty | 2025-05-01 |
| BCBS South Dakota Medical Policies | Enteral Nutrition Therapy and Oral Formula | 2025-05-01 |
| BCBS South Dakota Medical Policies | Facet Arthroplasty | 2025-05-01 |
| BCBS South Dakota Medical Policies | Transurethral Water Vapor Thermal Therapy (Rezum) and Transurethral Waterjet Ablation (Aquablation) for Benign Prostatic Hypertrophy | 2025-05-01 |
| Ambetter Health Arizona Clinical | Biofeedback for Behavioral Health Disorders | 2025-05-01 |
| Ambetter Health Arizona Clinical | Caudal or Interlaminar Epidural Steroid Injections | 2025-05-01 |
| Ambetter Health Arizona Clinical | Cochlear Implant Replacements | 2025-05-01 |
| Ambetter Health Arizona Clinical | Facet Joint Interventions | 2025-05-01 |