| Sentara Health Plans | Dermatologic Conditions, Surgical 09 - Medicaid | 2025-10-01 |
| Sentara Health Plans | Leadless Cardiac Pacemaker, Surgical 126 - Commercial | 2025-10-01 |
| Sentara Health Plans | Leadless Cardiac Pacemaker, Surgical 126 - Medicaid | 2025-10-01 |
| Sentara Health Plans | Percutaneous Spinal Augmentation, Surgical 231 - Medicaid | 2025-10-01 |
| Sentara Health Plans | Sacroiliac Fusion, Open and Percutaneous, - Commercial | 2025-10-01 |
| Sentara Health Plans | Sacroiliac Fusion, Open and Percutaneous, Surgical - Medicaid | 2025-10-01 |
| Sentara Health Plans | Skin and Tissue Substitutes, Surgical 73 - Medicaid | 2025-10-01 |
| Sentara Health Plans | Subcutaneous and Substernal Implantable - Commercial | 2025-10-01 |
| Sentara Health Plans | Subcutaneous and Substernal Implantable - Medicaid | 2025-10-01 |
| Sentara Health Plans | Tissue Transplantation of the Knee, Ankle and - Medicare | 2025-10-01 |