| BCBS Highmark West Virginia | Golimumab (Simponi, Simponi Aria) | 2025-12-01 |
| BCBS Highmark West Virginia | Obinutuzumab (Gazyva) | 2025-12-01 |
| Ambetter Health Florida Clinical | Concert Genetic Testing: Hematology | 2025-12-01 |
| Ambetter Health Florida Clinical | Concert Genetic Testing: Otolaryngology | 2025-12-01 |
| Ambetter Health Texas Superior Marketplace Clinical | Avatrombopag | 2025-12-01 |
| Ambetter Health Texas Superior Medicaid Clinical | Bitopertin | 2025-12-01 |
| Ambetter Health Texas Wellcare Allwell Medicare Clinical | Avatrombopag | 2025-12-01 |
| Ambetter Health Texas Superior Marketplace Clinical | Biologic DMARDs | 2025-12-01 |
| Ambetter Health Texas Superior Marketplace Clinical | Bitopertin | 2025-12-01 |
| Ambetter Health Texas Superior Medicaid Clinical | DB-OTO | 2025-12-01 |