| Ambetter Health Texas Superior Marketplace Clinical | Neuromuscular Electrical Stimulation (NMES) | 2025-05-01 |
| Ambetter Health Texas Superior Marketplace Clinical | Pediatric Liver Transplant | 2025-05-01 |
| Ambetter Health Texas Superior Marketplace Clinical | Reduction Mammoplasty and Gynecomastia Surgery | 2025-05-01 |
| Ambetter Health Texas Superior Marketplace Clinical | Total Artificial Heart | 2025-05-01 |
| Ambetter Health Texas Superior Marketplace Clinical | AbobotulinumtoxinA | 2025-05-01 |
| Ambetter Health Texas Superior Marketplace Clinical | Ado-Trastuzumab Emtansine | 2025-05-01 |
| Ambetter Health Texas Superior Marketplace Clinical | Aducanumab-avwa | 2025-05-01 |
| Ambetter Health Texas Superior Marketplace Clinical | Afatinib | 2025-05-01 |
| Ambetter Health Texas Superior Marketplace Clinical | Agalsidase Beta | 2025-05-01 |
| Ambetter Health Texas Superior Marketplace Clinical | Age Limit Override for Codeine, Tramadol, Hydrocodone | 2025-05-01 |