| Ambetter Health North Carolina Clinical | Long Term Care Placement | 2023-05-01 |
| Wellcare Kentucky Medicaid Clinical | Intestinal and Multivisceral Transplant | 2023-05-01 |
| Wellcare Kentucky Medicaid Clinical | Ventricular Assist Devices | 2023-05-01 |
| Wellcare Hawai'i Medicaid Clinical | Long Term Care Placement | 2023-05-01 |
| Wellcare New Jersey Medicaid Clinical | Long Term Care Placement | 2023-05-01 |
| Ambetter Health Texas Superior Marketplace Clinical | Repair of Nasal Valve Compromise | 2023-05-01 |
| Ambetter Health Texas Wellcare Allwell Medicare Clinical | Repair of Nasal Valve Compromise | 2023-05-01 |
| Sunshine Health Clinical Policy | Peristeen Anal Irrigation System (Coloplast) | 2023-05-01 |
| BCBS Iowa Medical Policies | Fecal Incontinence Management | 2023-05-01 |
| BCBS Iowa Medical Policies | Management of Dry Eye Syndrome | 2023-05-01 |