| Ambetter Health Texas Superior Marketplace Clinical | Outpatient Oxygen Use | 2024-11-01 |
| Ambetter Health Texas Superior Marketplace Clinical | Spinal Cord, Peripheral Nerve, and Percutaneous Electrical Nerve Stimulation | 2024-11-01 |
| Ambetter Health Texas Superior Medicaid Clinical | Allergy Testing and Therapy | 2024-11-01 |
| Ambetter Health Texas Superior Medicaid Clinical | Outpatient Oxygen Use | 2024-11-01 |
| Ambetter Health Texas Superior Medicaid Clinical | Spinal Cord, Peripheral Nerve, and Percutaneous Electrical Nerve Stimulation | 2024-11-01 |
| Ambetter Health Texas Wellcare Allwell Medicare Clinical | Allergy Testing and Therapy | 2024-11-01 |
| Ambetter Health Texas Wellcare Allwell Medicare Clinical | Outpatient Oxygen Use | 2024-11-01 |
| Ambetter Health Texas Wellcare Allwell Medicare Clinical | Spinal Cord, Peripheral Nerve, and Percutaneous Electrical Nerve Stimulation | 2024-11-01 |
| BCBS Iowa Medical Policies | Esophageal pH Monitoring | 2024-11-01 |
| BCBS Iowa Medical Policies | High Intensity Focused Ultrasound (HIFU) | 2024-11-01 |