Medicare AdvantageBilling CodesHigh impact
Ambetter Health Billing Code Update for CPT Codes 80320-80377 Effective 10/01/2026
Ambetter·NE · Pathology·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 billing G-series bundled laboratory codes instead to maintain reimbursement for these services.
Action Required
By September 30, 2026: Billing team must identify all claims currently using CPT codes 80320-80377 for Ambetter Health members and update billing software to map these codes to the appropriate G-series bundled laboratory codes. Update all internal billing guidelines, encounter templates, and provider documentation to reference the new G-series codes. Communicate the transition to all providers and laboratory staff. Starting October 1, 2026, any claims submitted with CPT codes 80320-80377 to Ambetter Health will be denied for reimbursement. Contact your Ambetter Provider Relations Representative for specific G-series code mappings if not already provided.