| BCBS South Dakota Medical Policies | Amniotic Membrane and Amniotic Fluid Grafts | 2025-04-01 |
| BCBS South Dakota Medical Policies | Bio-Engineered Skin and Soft Tissue Substitutes | 2025-04-01 |
| BCBS South Dakota Medical Policies | Hematopoietic Stem Cell Transplantation Autologous and Allogeneic* | 2025-04-01 |
| BCBS South Dakota Medical Policies | Vagus Nerve Stimulation (VNS) and Vagal Nerve Blocking Therapy | 2025-04-01 |
| Ambetter Health Arizona Clinical | Sacroiliac Joint Fusion | 2025-04-01 |
| Ambetter Health Arizona Clinical | Transcranial Magnetic Stimulation | 2025-04-01 |
| BCBS California | Ambulatory Surgery Center | 2025-04-01 |
| BCBS California | Hysterectomy Surgery for Benign Conditions | 2025-04-01 |
| BCBS California | Ingestible pH and Pressure Capsule | 2025-04-01 |
| BCBS California | Occupational Therapy | 2025-04-01 |