| BCBS Louisiana | Total Artificial Hearts and Implantable Ventricular Assist Devices | 2025-05-01 |
| BCBS Louisiana | Manipulation Under Anesthesia | 2025-05-01 |
| BCBS Louisiana | Bevacizumab Products | 2025-05-01 |
| Ambetter Health Nevada Silver Summit Clinical | Fetal Surgery in Utero for Prenatally Diagnosed Malformations | 2025-05-01 |
| UHC Medicaid Medical & Drug | Beds and Mattresses – Community Plan Medical Policy | 2025-05-01 |
| BCBS Federal Medical & Drug | 2.04.82 Genetic Testing for Inherited Thrombophilia | 2025-05-01 |
| Ambetter Health Louisiana Clinical | Biofeedback for Behavioral Health Disorders | 2025-05-01 |
| Ambetter Health Louisiana Clinical | Caudal or Interlaminar Epidural Steroid Injections | 2025-05-01 |
| Ambetter Health Louisiana Clinical | Facet Joint Interventions | 2025-05-01 |
| Ambetter Health Louisiana Clinical | Fecal Incontinence Treatments | 2025-05-01 |