| Ambetter Health Iowa Clinical | Implantable Intrathecal or Epidural Pain Pump | 2025-11-01 |
| Ambetter Health Iowa Clinical | Implantable Loop Recorder | 2025-11-01 |
| Ambetter Health Iowa Clinical | Obstetrical Home Care Programs | 2025-11-01 |
| Ambetter Health Iowa Clinical | Orthognathic Surgery | 2025-11-01 |
| Ambetter Health Iowa Clinical | Outpatient Oxygen Use | 2025-11-01 |
| Ambetter Health Iowa Clinical | Proton and Neutron Beam Therapies | 2025-11-01 |
| Ambetter Health Iowa Clinical | Selective Dorsal Rhizotomy in CP | 2025-11-01 |
| Ambetter Health Iowa Clinical | Spinal Cord, Peripheral Nerve, and Percutaneous Electrical Nerve Stimulation | 2025-11-01 |
| Ambetter Health Alabama Clinical | Biofeedback | 2025-11-01 |
| Ambetter Health Alabama Clinical | Burn Surgery | 2025-11-01 |