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AmbetterExchange · Billing Codes · Coding · OKHigh impact

Ambetter Health Billing Code Update for CPT Codes 80320-80377: Effective 10/01/2026

Act
by Sep 30, 2026
Effective date
Oct 1, 2026
Identified
Aug 26, 2026

Summary

Effective October 1, 2026, Ambetter Health will no longer reimburse CPT codes 80320-80377 (Definitive Drug Testing Procedures). Billing teams must transition to G-series bundled laboratory codes for all drug testing claims to avoid denials.

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What to do

by Sep 30, 2026 · 4 steps
01Billing team must identify all CPT codes 80320-80377 currently in use and map them to appropriate G-series bundled laboratory codes in the billing system.
02Update billing software to reject or automatically convert claims using CPT 80320-80377 to the corresponding G-series codes for Ambetter Health members.
03Notify laboratory partners and providers of the code transition.
04Test the billing system changes before the October 1 effective date.
If missed: Failure to transition to G-series codes will result in claim denials from Ambetter Health.

Codes mentioned

80320803218032280323803248032580326803278032880329803308033180332803338033480335803368033780338803398034080341803428034380344803458034680347803488034980350803518035280353803548035580356803578035880359803608036180362803638036480365803668036780368803698037080371803728037380374803758037680377

Original notice

Ambetter Health Billing Code Update for CPT Codes 80320-80377: Effective 10/01/2026
ambetterhealth.com · Always check the source before changing claims.
View original ↗

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