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| BCBS South Dakota Medical Policies | Cognitive Rehabilitation | 2024-05-01 |
| BCBS South Dakota Medical Policies | Continuous Passive Motion (CPM) Devices in the Home Setting | 2024-05-01 |
| BCBS South Dakota Medical Policies | Miscellaneous Bariatric Procedures | 2024-05-01 |
| BCBS South Dakota Medical Policies | Pneumatic Compression Devices in the Home Setting | 2024-05-01 |
| Health Net Comm & Medi-Cal Plan | Home Ventilators | 2024-05-01 |
| Sunshine Health Clinical Policy | Step Therapy | 2024-05-01 |
| Ambetter Health Texas Superior Marketplace Clinical | Imatinib | 2024-05-01 |
| Ambetter Health Texas Wellcare Allwell Medicare Clinical | Imatinib | 2024-05-01 |
| Ambetter Health Texas Wellcare Allwell Medicare Clinical | Hydroxyprogesterone Caproate | 2024-05-01 |