| Medical Mutual | Sylvant® (siltuximab) (Intravenous) (EOV) | 2026-02-01 |
| Medical Mutual | Yescarta® (axicabtagene ciloleucel) (Intravenous) (EOV) | 2026-02-01 |
| Paramount Healthcare | Total Ankle Arthroplasty | 2026-02-01 |
| Paramount Healthcare | Otoplasty | 2026-02-01 |
| Paramount Healthcare | Endometrial Ablation | 2026-02-01 |
| Paramount Healthcare | Hypoglossal Nerve Stimulation for
Treatment of Obstructive Sleep Apnea | 2026-02-01 |
| Ambetter Health Georgia Clinical | Immobilized Lipase Cartridges (Relizorb) | 2026-02-01 |
| Ambetter Health Iowa Clinical | Immobilized Lipase Cartridges (Relizorb) | 2026-02-01 |
| Ambetter Health Mississippi Magnolia Clinical | Sclerotherapy and Chemical Endovenous Ablation for Varicose Veins and Other | 2026-02-01 |
| Ambetter Health Alabama Clinical | Immobilized Lipase Cartridges (RELiZORB) (CP.MP.252) | 2026-02-01 |