| Ambetter Health Texas Superior Marketplace Clinical | Polymerase chain reaction respiratory viral panel testing | 2023-11-01 |
| Ambetter Health Texas Wellcare Allwell Medicare Clinical | Polymerase chain reaction respiratory viral panel testing | 2023-11-01 |
| Sunshine Health Clinical Policy | Review for Personal Care Services Requests | 2023-11-01 |
| BCBS Iowa Medical Policies | Percutaneous Ultrasonic Tenotomy and Fasciotomy | 2023-11-01 |
| BCBS Iowa Medical Policies | Prolotherapy | 2023-11-01 |
| BCBS Iowa Medical Policies | Thermography and Temperature Gradient Studies | 2023-11-01 |
| BCBS Iowa Medical Policies | Treatments for Occipital Neuralgia, Chronic Headaches and Persistent Idiopathic Facial Pain* | 2023-11-01 |
| BCBS Massachusetts | Pregabalin (Lyrica and Lyrica CR) | 2023-11-01 |
| BCBS Massachusetts | RSV Immunoprophylaxis | 2023-11-01 |
| BCBS South Dakota Medical Policies | Percutaneous Ultrasonic Tenotomy and Fasciotomy | 2023-11-01 |