| BCBS South Dakota Medical Policies | Laparoscopic, Percutaneous and Transcervical Techniques for Uterine Fibroid Myolysis | 2023-10-01 |
| BCBS South Dakota Medical Policies | Lung and Lobar Lung Transplant* | 2023-10-01 |
| BCBS South Dakota Medical Policies | Pancreatic Islet Cell Transplant | 2023-10-01 |
| BCBS South Dakota Medical Policies | Serologic Testing for Biomarkers of Irritable Bowel Syndrome (IBS) | 2023-10-01 |
| BCBS South Dakota Medical Policies | Small Bowel/Liver and Multivisceral Transplant* | 2023-10-01 |
| BCBS South Dakota Medical Policies | Temporarily Implanted Nitinol Device (iTind) for Benign Prostatic Hyperplasia | 2023-10-01 |
| BCBS Highmark Penn CPA/SEPA/WPA/NEPA | Vision Therapy (Orthoptics and Pleoptics) | 2023-10-01 |
| BCBS Highmark Penn CPA/SEPA/WPA/NEPA | Cognitive Rehabilitation | 2023-10-01 |
| BCBS Highmark Penn CPA/SEPA/WPA/NEPA | Electroretinography | 2023-10-01 |
| BCBS Highmark Penn CPA/SEPA/WPA/NEPA | Repository Corticotropin Intramuscular Injection (Acthar Gel) | 2023-10-01 |