MedicaidCoverageMedium impact
26-078 Coverage for HCPCS Codes G0482 and G0483 Ends on April 1, 2026
Health Net·CA · Family Medicine, Internal Medicine, Psychiatry +1 more·Prior Authorization
Effective date
Apr 1, 2026
We identified it
Jun 20, 2026
Summary
Effective April 1, 2026, Medi-Cal plans will no longer cover high-level definitive drug testing codes G0482 and G0483, as they are deemed not medically necessary. Providers must use G0480 or G0481 instead, both requiring prior authorization.
Action Required
Before April 1, 2026: Billing team must update system to stop billing G0482 and G0483 for Medi-Cal patients. Configure prior authorization requirements for G0480 and G0481. Update encounter forms to remind providers that definitive testing above 14 drug classes is rarely medically necessary. For EPSDT patients under 21, claims with G0482/G0483 will face medical director review and likely denial.