| Wellcare North Carolina Medicaid Clinical | Caudal or Interlaminar Epidural Steroid | 2011-01-01 |
| BCBS Kansas | Periureteral Bulking Agents as a Treatment of Vesicoureteral Reflux (VUR) | 2010-08-17 |
| Wellcare North Carolina Medicaid Clinical | Lyfgenia - Pharmacy Prior Approval Criteria | 2010-08-01 |
| Medicare NCD | NCD 220.3 - Magnetic Resonance Angiography - RETIRED | 2010-07-01 |
| Medicare NCD | NCD 150.12 - Collagen Meniscus Implant | 2010-05-01 |
| Medicare NCD | NCD 220.6.13 - FDG PET for Dementia and Neurodegenerative Diseases | 2010-05-01 |
| Medicare NCD | NCD 220.6.15 - FDG PET for All Other Cancer Indications Not Previously Specified (Replaced with Section 220.6.17) - RETIRED | 2010-05-01 |
| Medicare NCD | NCD 220.6.14 - FDG PET for Brain, Cervical, Ovarian, Pancreatic, Small Cell Lung, and Testicular Cancers (Replaced with Section 220.6.17) - RETIRED | 2010-05-01 |
| Medicare NCD | NCD 220.6.10 - FDG PET for Breast Cancer (Replaced with Section 220.6.17) - RETIRED | 2010-05-01 |
| Medicare NCD | NCD 220.6.4 - FDG PET for Colorectal Cancer (Replaced with Section 220.6.17) - RETIRED | 2010-05-01 |