| Wellcare Hawai'i Medicare Clinical | Stereotactic Radiation Therapy: Stereotactic | 2025-12-01 |
| Wellcare Hawai'i Medicare Clinical | Cosmetic and Reconstructive Procedures | 2025-12-01 |
| Wellcare Illinois Medicare Clinical | Stereotactic Radiation Therapy: Stereotactic | 2025-12-01 |
| Wellcare Illinois Medicare Clinical | Cosmetic and Reconstructive Procedures | 2025-12-01 |
| Wellcare Illinois Medicare Clinical | Sacroiliac Joint Interventions for Pain Management | 2025-12-01 |
| Wellcare Illinois Medicare Clinical | Outpatient Oxygen Use | 2025-12-01 |
| Wellcare Illinois Medicare Clinical | Transplant Service Documentation Requirements | 2025-12-01 |
| Wellcare Illinois Medicare Clinical | Lantidra (donislecel): Allogeneic Pancreatic Islet | 2025-12-01 |
| Wellcare Mississippi Medicare Clinical | Stereotactic Radiation Therapy: Stereotactic | 2025-12-01 |
| Wellcare Mississippi Medicare Clinical | Cosmetic and Reconstructive Procedures | 2025-12-01 |