MedicaidCoverageMedium impact
26-079 Coverage for HCPCS Codes G0482 and G0483 Ends on April 1, 2026
Health Net·CA · Family Medicine, Internal Medicine, General Practice +4 more·Prior Authorization
Effective date
Apr 1, 2026
We identified it
Jun 20, 2026
Summary
Effective April 1, 2026, HCPCS codes G0482 and G0483 for high-level definitive drug testing (15+ drug classes) will no longer be covered under Medi-Cal plans as they are deemed not medically necessary. Providers must use G0480 or G0481 instead, both requiring prior authorization.
Action Required
By April 1, 2026: Billing team must update system to block G0482 and G0483 for all Medi-Cal patients and automatically require prior authorization for G0480 and G0481. Update encounter forms and EMR templates to guide providers to use G0480 (1-7 drug classes) or G0481 (8-14 drug classes) instead of the discontinued codes. Claims submitted with G0482 or G0483 will be denied as non-covered benefits for patients 21+ and reviewed for medical necessity denial for patients under 21.