| Ambetter Health Texas Superior Medicaid Clinical | Neuromuscular Electrical Stimulation (NMES) | 2025-05-01 |
| Ambetter Health Texas Superior Medicaid Clinical | Pediatric Liver Transplant | 2025-05-01 |
| Ambetter Health Texas Superior Medicaid Clinical | Reduction Mammoplasty and Gynecomastia Surgery | 2025-05-01 |
| Ambetter Health Texas Superior Medicaid Clinical | Total Artificial Heart | 2025-05-01 |
| Ambetter Health Texas Superior Medicaid Clinical | AbobotulinumtoxinA | 2025-05-01 |
| Ambetter Health Texas Superior Medicaid Clinical | Ado-Trastuzumab Emtansine | 2025-05-01 |
| Ambetter Health Texas Superior Medicaid Clinical | Alemtuzumab | 2025-05-01 |
| Ambetter Health Texas Superior Medicaid Clinical | Alirocumab | 2025-05-01 |
| Ambetter Health Texas Wellcare Allwell Medicare Clinical | Allogeneic Hematopoietic Progenitor Cell Therapy | 2025-05-01 |
| Ambetter Health Texas Wellcare Allwell Medicare Clinical | Caudal or Interlaminar Epidural Steroid Injections | 2025-05-01 |