| Sentara Health Plans Avalon | M2177: Fibromyalgia Testing | 2025-07-01 |
| Sentara Health Plans Avalon | T2015: Prescription Medication and Illicit Drug Testing in the Outpatient Setting | 2025-07-01 |
| Ambetter Health Louisiana Clinical | Diaphragmatic/Phrenic Nerve Stimulation | 2025-07-01 |
| Ambetter Health Louisiana Clinical | Intradiscal Steroid Injections for Pain Management | 2025-07-01 |
| Ambetter Health Louisiana Clinical | Lantidra (donislecel): Allogeneic Pancreatic Islet Cellular Therapy | 2025-07-01 |
| Ambetter Health Louisiana Clinical | Posterior Tibial Nerve Stimulation for Voiding Dysfunction | 2025-07-01 |
| Ambetter Health Louisiana Clinical | Sacroiliac Joint Interventions for Pain Management | 2025-07-01 |
| Ambetter Health Louisiana Clinical | SNRB/TFESI | 2025-07-01 |
| Ambetter Health Louisiana Clinical | Trigger Point Injections for Pain Management | 2025-07-01 |
| Ambetter Health Louisiana Clinical | Vagus Nerve Stimulation | 2025-07-01 |