MedicaidBilling CodesHigh impact
New Coverage Policy for Testing for Drugs of Abuse
Wisconsin Medicaid (ForwardHealth)·WI · Pain Management, Psychiatry, Family Medicine +3 more·Medical Policy
Effective date
Jan 1, 2015
We identified it
Jun 20, 2026
Summary
Effective January 1, 2015, Wisconsin Medicaid and BadgerCare Plus requires providers to use specific HCPCS codes (G0431, G0434, G6030-G6058) for drug abuse testing instead of CPT codes 80300-80377. Claims submitted with the old CPT codes will not be reimbursed.
Action Required
Immediately: Billing team must update billing system to use HCPCS codes G0431, G0434, and G6030-G6058 for all drug abuse testing claims for Wisconsin Medicaid and BadgerCare Plus members. Stop using CPT codes 80300-80377 as these will not be reimbursed. Update encounter forms and ensure all ordering providers are Medicaid-enrolled with their NPI included on claims. Maintain documentation supporting test complexity levels for G0431 submissions.