| BCBS Texas Medical Policies | Removal of Ascites via Implantable Pump | 2024-07-01 |
| BCBS Texas Medical Policies | Temporomandibular Joint (TMJ) Disorders (TMJD) | 2024-07-01 |
| BCBS Oklahoma Medical Policies | Removal of Ascites via Implantable Pump | 2024-07-01 |
| BCBS Oklahoma Medical Policies | Temporomandibular Joint (TMJ) Disorders (TMJD) | 2024-07-01 |
| BCBS New Mexico Medical Policies | Temporomandibular Joint (TMJ) Disorders (TMJD) | 2024-07-01 |
| BCBS New Mexico Medical Policies | Removal of Ascites via Implantable Pump | 2024-07-01 |
| BCBS Montana Medical Policies | Removal of Ascites via Implantable Pump | 2024-07-01 |
| BCBS Montana Medical Policies | Temporomandibular Joint (TMJ) Disorders (TMJD) | 2024-07-01 |
| Ambetter Health Illinois Clinical | Intradiscal Steroid Injections | 2024-07-01 |
| Ambetter Health Illinois Clinical | Sacroiliac Joint Interventions | 2024-07-01 |