CommercialBilling CodesHigh impact
26-851 Definitive Drug Testing Billing Change, Effective October 1, 2026
Health Net·CA · Psychiatry, Pain Management, Occupational Medicine +3 more·Reimbursement
Effective date
Oct 1, 2026
We identified it
Jul 28, 2026
Summary
Health Net will no longer reimburse CPT codes 80320-80377 for definitive drug testing effective October 1, 2026. Providers must transition to HCPCS G-series bundled laboratory codes (G0480-G0483) to avoid claim denials. All billing systems, charge masters, and workflows must be updated before the effective date.
Action Required
By September 30, 2026: Billing team must complete the following actions to prevent claim denials: (1) Stop billing CPT codes 80320-80377 for definitive drug testing; (2) Update billing software, charge masters, and encounter forms to require HCPCS G-series bundled laboratory codes (G0480-G0483) for all definitive drug testing claims; (3) Create billing rules to block or reject any claims using CPT 80320-80377 on or after October 1, 2026; (4) Educate all billing, coding, and clinical staff on the code transition and the consequences of using outdated codes. Providers must also be notified of this change. Claims submitted with CPT codes 80320-80377 on or after October 1, 2026, will be denied by Health Net. Contact Health Net Provider Services for questions: Behavioral Health 844-966-0298, Ambetter PPO 844-463-8188, Ambetter HMO 888-926-2164, or email Provider_Services.