| Ambetter Health Indiana Clinical | Cosmetic and Reconstructive Procedures | 2024-08-01 |
| Ambetter Health Indiana Clinical | IV Moderate Sedation, IV Deep Sedation and General Anesthesia for Dental Procedures | 2024-08-01 |
| Ambetter Health Indiana Clinical | Pediatric Heart Transplant | 2024-08-01 |
| Ambetter Health Nebraska Clinical | Implantable Hypoglossal Nerve Stimulation | 2024-08-01 |
| Ambetter Health Nevada Silver Summit Clinical | Hematopoietic Cell Transplants for Sickle Cell Anemia and β-Thalassemia | 2024-08-01 |
| Ambetter Health Nevada Silver Summit Clinical | Cosmetic and Reconstructive Procedures | 2024-08-01 |
| Ambetter Health Nevada Silver Summit Clinical | IV Moderate Sedation, IV Deep Sedation and General Anesthesia for Dental Procedures | 2024-08-01 |
| Ambetter Health Nevada Silver Summit Clinical | Panniculectomy | 2024-08-01 |
| Ambetter Health North Carolina Clinical | Hematopoietic Cell Transplants for Sickle Cell Anemia and β-Thalassemia | 2024-08-01 |
| Ambetter Health North Carolina Clinical | Cosmetic and Reconstructive Procedures | 2024-08-01 |