| BCBS Highmark NY and West NY | Testosterone Androgens | 2025-04-01 |
| BCBS Highmark Delaware | Assisted Reproductive Technology | 2025-04-01 |
| BCBS Highmark Delaware | Dynamic Splinting Devices | 2025-04-01 |
| BCBS Highmark Delaware | Denileukin diftitox-cxdl (Lymphir) | 2025-04-01 |
| BCBS Highmark Delaware | Bortezomib (Velcade) | 2025-04-01 |
| BCBS Highmark Delaware | Testosterone Androgens | 2025-04-01 |
| BCBS Highmark West Virginia | Assisted Reproductive Technology | 2025-04-01 |
| BCBS Highmark West Virginia | Bortezomib (Velcade) | 2025-04-01 |
| BCBS Highmark West Virginia | Testosterone Androgens | 2025-04-01 |
| Sunshine Health Clinical Policy | Therapeutic Utilization of Inhaled Nitric Oxide | 2025-04-01 |