| Sentara Health Plans | Sacroiliac Fusion, Open and Percutaneous, - Commercial | 2025-10-01 |
| Sentara Health Plans | Sacroiliac Fusion, Open and Percutaneous, Surgical - Medicaid | 2025-10-01 |
| Sentara Health Plans | Skin and Tissue Substitutes, Surgical 73 - Medicaid | 2025-10-01 |
| Sentara Health Plans | Subcutaneous and Substernal Implantable - Commercial | 2025-10-01 |
| Sentara Health Plans | Subcutaneous and Substernal Implantable - Medicaid | 2025-10-01 |
| Sentara Health Plans | Tissue Transplantation of the Knee, Ankle and - Medicare | 2025-10-01 |
| BCBS Highmark Penn CPA/SEPA/WPA/NEPA | Foot Care Services | 2025-10-01 |
| BCBS Highmark Penn CPA/SEPA/WPA/NEPA | Chronic Wound Management | 2025-10-01 |
| BCBS Highmark Penn CPA/SEPA/WPA/NEPA | Physical Medicine | 2025-10-01 |
| BCBS Highmark Penn CPA/SEPA/WPA/NEPA | Lower Limb Prostheses | 2025-10-01 |