Medicare AdvantageBilling CodesHigh impact
Ambetter Health Billing Code Update for CPT Codes 80320-80377 Effective 10/01/2026
Ambetter·DE · Pathology, Internal Medicine, Family Medicine +1 more·Coding
Effective date
Oct 1, 2026
We identified it
Aug 26, 2026
Summary
Effective October 1, 2026, Ambetter Health will no longer reimburse CPT codes 80320-80377 (Definitive Drug Testing Procedures). Providers must transition to G-series bundled laboratory codes for these services to maintain reimbursement.
Action Required
By September 30, 2026: Billing team must update billing software to map all CPT codes 80320-80377 to the appropriate G-series bundled laboratory codes. Audit all recurring orders and protocols that reference CPT 80320-80377 and update them to use G-series alternatives. Notify providers and laboratory staff of the transition. Beginning October 1, 2026, do not bill CPT 80320-80377 to Ambetter Health—all claims will be denied. Contact Ambetter Provider Relations Representative if G-series code mapping guidance is needed.