| Ambetter Health Iowa Clinical | DME and O&P Criteria | 2025-08-01 |
| Ambetter Health Iowa Clinical | Radiation Therapy for Skin Cancer | 2025-08-01 |
| Ambetter Health Alabama Clinical | Hematopoietic Cell Transplants for Sickle Cell Anemia and β-Thalassemia | 2025-08-01 |
| Ambetter Health Alabama Clinical | Cosmetic and Reconstructive Procedures | 2025-08-01 |
| Ambetter Health Alabama Clinical | DME and O&P Criteria | 2025-08-01 |
| Ambetter Health Alabama Clinical | Panniculectomy | 2025-08-01 |
| Ambetter Health Alabama Clinical | Pediatric Heart Transplant | 2025-08-01 |
| Ambetter Health Alabama Clinical | Radiation Therapy for Skin Cancer | 2025-08-01 |
| Ambetter Health Georgia Clinical | Hematopoietic Cell Transplants for Sickle Cell Anemia and β-Thalassemia | 2025-08-01 |
| Ambetter Health Georgia Clinical | Cosmetic and Reconstructive Procedures | 2025-08-01 |