| Wellcare North Carolina Medicaid Clinical | Hospice Services | 2025-11-01 |
| Wellcare North Carolina Medicaid Clinical | Hyperbaric Oxygenation Therapy | 2025-11-01 |
| Wellcare North Carolina Medicaid Clinical | Invasive Electrical Bone Growth Stimulation | 2025-11-01 |
| Wellcare North Carolina Medicaid Clinical | Keloid Excision and Scar Revision | 2025-11-01 |
| Wellcare North Carolina Medicaid Clinical | Medically Monitored Inpatient Withdrawal | 2025-11-01 |
| Wellcare North Carolina Medicaid Clinical | Non-Emergency Medical Transportation | 2025-11-01 |
| Wellcare North Carolina Medicaid Clinical | Nursing Equipment and Supplies | 2025-11-01 |
| Wellcare North Carolina Medicaid Clinical | Opioid Treatment Program Service | 2025-11-01 |
| Wellcare North Carolina Medicaid Clinical | Out-of-State Services | 2025-11-01 |
| Wellcare North Carolina Medicaid Clinical | Physical Health Clinical Policy Committee | 2025-11-01 |