| Ambetter Health Indiana Clinical | Cosmetic and Reconstructive Procedures | 2025-08-01 |
| Ambetter Health Indiana Clinical | DME and O&P Criteria | 2025-08-01 |
| Ambetter Health Indiana Clinical | Panniculectomy | 2025-08-01 |
| Ambetter Health Indiana Clinical | Pediatric Heart Transplant | 2025-08-01 |
| Ambetter Health Kansas Sunflower Clinical | DME and O&P Criteria | 2025-08-01 |
| Ambetter Health Kansas Sunflower Clinical | Hematopoietic Cell Transplants for Sickle Cell Anemia and β-Thalassemia | 2025-08-01 |
| Ambetter Health Kansas Sunflower Clinical | Orthognathic Surgery | 2025-08-01 |
| Ambetter Health Kansas Sunflower Clinical | Radiation Therapy for Skin Cancer | 2025-08-01 |
| Ambetter Health Kansas Sunflower Clinical | Cosmetic and Reconstructive Procedures | 2025-08-01 |
| Ambetter Health Kentucky WellCare Clinical | Hematopoietic Cell Transplants for Sickle Cell Anemia and β-Thalassemia | 2025-08-01 |