| Wellcare North Carolina Medicaid Clinical | Small Bowel and Small Bowel/Liver and | 2025-02-01 |
| Wellcare North Carolina Medicaid Clinical | Special Ophthalmological Services | 2025-02-01 |
| Wellcare North Carolina Medicaid Clinical | Testing for Select Genitourinary Conditions | 2025-02-01 |
| Wellcare North Carolina Medicaid Clinical | Urinary Incontinence Devices and Treatments | 2025-02-01 |
| Wellcare North Carolina Medicare Clinical | CPG Grid Adopted Clinical Practice and Preventive Health Guidelines | 2025-02-01 |
| Wellcare North Carolina Medicare Clinical | Lung Transplantation | 2025-02-01 |
| Wellcare North Carolina Medicare Clinical | Intensity Modulated Radiation Therapy (IMRT) | 2025-02-01 |
| Wellcare North Carolina Medicare Clinical | Donor Lymphocyte Infusion | 2025-02-01 |
| Wellcare North Carolina Medicare Clinical | Implantable Wireless Pulmonary Artery Pressure Monitoring | 2025-02-01 |
| Wellcare North Carolina Medicare Clinical | Peripheral Nerve Blocks and Ablation of Peripheral | 2025-02-01 |