| Buckeye Health Plan Ohio Medicaid Clinical | Vutrisiran (Amvuttra) | 2025-05-01 |
| Buckeye Health Plan Ohio Medicaid Clinical | Odevixibat (Bylvay) | 2025-05-01 |
| Paramount Healthcare | Breast Reconstruction Services | 2025-05-01 |
| BCBS Louisiana | Total Artificial Hearts and Implantable Ventricular Assist Devices | 2025-05-01 |
| BCBS Louisiana | Manipulation Under Anesthesia | 2025-05-01 |
| BCBS Louisiana | Bevacizumab Products | 2025-05-01 |
| BCBS Federal Medical & Drug | 2.04.82 Genetic Testing for Inherited Thrombophilia | 2025-05-01 |
| Ambetter Health Louisiana Clinical | Biofeedback for Behavioral Health Disorders | 2025-05-01 |
| Ambetter Health Louisiana Clinical | Caudal or Interlaminar Epidural Steroid Injections | 2025-05-01 |
| Ambetter Health Louisiana Clinical | Facet Joint Interventions | 2025-05-01 |