| Health Net Comm & Medi-Cal Plan | Neuromuscular Electrical Stimulation (NMES) | 2025-05-01 |
| Health Net Comm & Medi-Cal Plan | Pediatric Liver Transplant | 2025-05-01 |
| Health Net Comm & Medi-Cal Plan | Reduction Mammoplasty and Gynecomastia Surgery | 2025-05-01 |
| Health Net Comm & Medi-Cal Plan | Total Artificial Heart | 2025-05-01 |
| Ambetter Health Illinois Clinical | Allogeneic Hematopoietic Progenitor Cell Therapy | 2025-05-01 |
| Ambetter Health Illinois Clinical | Fetal Surgery in Utero for Prenatally Diagnosed Malformations | 2025-05-01 |
| Sentara Health Plans | Solid Organ Transplantations, Surgical 236 - Commercial | 2025-05-01 |
| Sentara Health Plans | Solid Organ Transplantations, Surgical 236 - Medicaid | 2025-05-01 |
| Ambetter Health Texas Superior Marketplace Clinical | Apalutamide | 2025-05-01 |
| Ambetter Health Texas Superior Marketplace Clinical | Armodafinil | 2025-05-01 |