| Wellcare Hawai'i Medicaid Clinical | IV Moderate Sedation, IV Deep Sedation, and | 2024-08-01 |
| Wellcare Hawai'i Medicaid Clinical | Orthognathic Surgery | 2024-08-01 |
| Wellcare Hawai'i Medicaid Clinical | Pediatric Heart Transplant | 2024-08-01 |
| Wellcare Hawai'i Medicare Clinical | Allogeneic Hematopoietic Cell Transplants for Sickle Cell | 2024-08-01 |
| Wellcare Hawai'i Medicare Clinical | Sacroiliac Joint Interventions for Pain Management | 2024-08-01 |
| Wellcare Illinois Medicare Clinical | Cosmetic and Reconstructive Procedures | 2024-08-01 |
| Wellcare Illinois Medicare Clinical | Allogeneic Hematopoietic Cell Transplants for Sickle Cell | 2024-08-01 |
| Wellcare Illinois Medicare Clinical | Sacroiliac Joint Interventions for Pain Management | 2024-08-01 |
| Wellcare Mississippi Medicare Clinical | Allogeneic Hematopoietic Cell Transplants for Sickle Cell | 2024-08-01 |
| Wellcare Mississippi Medicare Clinical | Sacroiliac Joint Interventions for Pain Management | 2024-08-01 |