| HealthPartners | Onasemnogene abeparvovec-xioi (Zolgensma®) – | 2025-07-01 |
| HealthPartners | Oncology - daratumumab and daratumumab | 2025-07-01 |
| HealthPartners | Oncology - pembrolizumab (Keytruda®), | 2025-07-01 |
| HealthPartners | Pegloticase (Krystexxa®) - Minnesota Health Care | 2025-07-01 |
| HealthPartners | Romosozumab-aqqg (Evenity®) – Minnesota Health | 2025-07-01 |
| Ambetter Health Illinois Clinical | Intradiscal Steroid Injections for Pain Management | 2025-07-01 |
| Ambetter Health Illinois Clinical | Sacroiliac Joint Interventions for Pain Management | 2025-07-01 |
| Ambetter Health Michigan Meridian Clinical | Sacroiliac Joint Interventions for Pain Management | 2025-07-01 |
| Sentara Health Plans | ASAM Level 2.1 Intensive Outpatient Services - Medicaid | 2025-07-01 |
| Sentara Health Plans | ASAM Level 2.1 Intensive Outpatient Services - Medicaid | 2025-07-01 |