| Ambetter Health Texas Superior Medicaid Clinical | Cranial Remolding Orthosis | 2025-11-01 |
| Ambetter Health Texas Superior Medicaid Clinical | Eptinezumab-jjmr | 2025-11-01 |
| Ambetter Health Texas Superior Medicaid Clinical | Hyperhidrosis Treatments | 2025-11-01 |
| Ambetter Health Texas Superior Medicaid Clinical | Implantable Intrathecal or Epidural Pain Pump | 2025-11-01 |
| Ambetter Health Texas Superior Medicaid Clinical | Orthognathic Surgery | 2025-11-01 |
| Ambetter Health Texas Superior Medicaid Clinical | Spinal Cord, Peripheral Nerve, and Percutaneous Electrical Nerve Stimulation | 2025-11-01 |
| Ambetter Health Texas Superior Medicaid Clinical | Urinary Incontinence Devices and Treatments | 2025-11-01 |
| Ambetter Health Texas Superior Medicaid Clinical | Ventricular Assist Devices | 2025-11-01 |
| Ambetter Health Texas Superior Medicaid Clinical | Antithymocyte Globulin | 2025-11-01 |
| Ambetter Health Texas Superior Medicaid Clinical | Asfotase Alfa | 2025-11-01 |