| Ambetter Health Texas Superior Medicaid Clinical | Avacincaptad Pegol | 2025-11-01 |
| Ambetter Health Texas Superior Medicaid Clinical | Azacitidine | 2025-11-01 |
| Ambetter Health Texas Superior Medicaid Clinical | Baclofen | 2025-11-01 |
| Ambetter Health Texas Superior Medicaid Clinical | Belatacept | 2025-11-01 |
| Ambetter Health Texas Superior Medicaid Clinical | Belinostat | 2025-11-01 |
| Ambetter Health Texas Wellcare Allwell Medicare Clinical | Hyperhidrosis Treatments | 2025-11-01 |
| Ambetter Health Texas Wellcare Allwell Medicare Clinical | Implantable Intrathecal or Epidural Pain Pump | 2025-11-01 |
| Ambetter Health Texas Wellcare Allwell Medicare Clinical | Orthognathic Surgery | 2025-11-01 |
| Ambetter Health Texas Wellcare Allwell Medicare Clinical | Proton and Neutron Beam Therapies | 2025-11-01 |
| Ambetter Health Texas Wellcare Allwell Medicare Clinical | Urinary Incontinence Devices and Treatments | 2025-11-01 |