| Ambetter Health Texas Superior Medicaid Clinical | Assistive Communication Device | 2025-09-01 |
| Ambetter Health Texas Superior Medicaid Clinical | Child and Adolescent Strength and Needs (CANS 3.0) Medical Necessity Criteria | 2025-09-01 |
| Ambetter Health Texas Superior Medicaid Clinical | Elective Deliveries Before 39 Weeks Gestational Age | 2025-09-01 |
| Ambetter Health Texas Superior Medicaid Clinical | Excision of Lesions | 2025-09-01 |
| Ambetter Health Texas Superior Medicaid Clinical | Mastectomy for Pubertal Gynecomastia | 2025-09-01 |
| Ambetter Health Texas Superior Medicaid Clinical | Non-Emergent Ambulance Transportation | 2025-09-01 |
| Ambetter Health Texas Superior Medicaid Clinical | Physical, Occupational, and Speech Therapy Services | 2025-09-01 |
| Ambetter Health Texas Superior Medicaid Clinical | Skilled Nursing Visits | 2025-09-01 |
| Ambetter Health Texas Wellcare Allwell Medicare Clinical | Applied Behavior Analysis | 2025-09-01 |
| Ambetter Health Texas Wellcare Allwell Medicare Clinical | IV Moderate Sedation, IV Deep Sedation, and General Anesthesia for Dental Procedures | 2025-09-01 |