| BCBS South Dakota Medical Policies | Diaphragmatic/Phrenic Nerve Stimulation and Diaphragm Pacing Systems | 2025-08-01 |
| BCBS South Dakota Medical Policies | Implantable Peripheral Nerve Stimulation and Restorative Neurostimulation for the Treatment of Chronic Pain | 2025-08-01 |
| BCBS South Dakota Medical Policies | Non-Implantable Percutaneous Electrical Nerve Stimulation and Percutaneous Neuromodulation Therapy | 2025-08-01 |
| BCBS South Dakota Medical Policies | Periureteral Bulking Agents as a Treatment of Vesicoureteral Reflux | 2025-08-01 |
| Ambetter Health Arizona Clinical | Hematopoietic Cell Transplants for Sickle Cell Anemia and β-Thalassemia | 2025-08-01 |
| Ambetter Health Arizona Clinical | Cosmetic and Reconstructive Procedures | 2025-08-01 |
| Ambetter Health Arizona Clinical | DME and O&P Criteria | 2025-08-01 |
| Ambetter Health Arizona Clinical | Experimental Technologies | 2025-08-01 |
| Ambetter Health Arizona Clinical | Panniculectomy | 2025-08-01 |
| Ambetter Health Arizona Clinical | Pediatric Heart Transplant | 2025-08-01 |