| Wellcare Hawaii Medicaid Clinical | Repair of Nasal Valve Compromise | 2026-04-01 |
| Wellcare Hawaii Medicaid Clinical | Therapeutic Utilization of Inhaled Nitric Oxide | 2026-04-01 |
| Wellcare New Jersey Medicaid Clinical | Skin and Soft Tissue Substitutes | 2026-04-01 |
| Wellcare North Carolina Medicaid Clinical | Bariatric Surgery | 2026-04-01 |
| Wellcare North Carolina Medicaid Clinical | Disc Decompression Procedures | 2026-04-01 |
| Wellcare North Carolina Medicaid Clinical | Heart-Lung Transplant | 2026-04-01 |
| Wellcare North Carolina Medicaid Clinical | Intestinal and Multivisceral Transplant | 2026-04-01 |
| Wellcare North Carolina Medicaid Clinical | Therapeutic Utilization of Inhaled Nitric Oxide | 2026-04-01 |
| Ambetter Health Texas Superior Medicaid Clinical | Skin and Soft Tissue Substitutes | 2026-04-01 |
| Ambetter Health Texas Wellcare Allwell Medicare Clinical | Skin and Soft Tissue Substitutes | 2026-04-01 |