Medicare AdvantageBilling CodesHigh impact
Ambetter Health Billing Code Update for CPT Codes 80320-80377 Effective 10/01/2026
Ambetter·AZ · Pain Management, Psychiatry, Internal Medicine +2 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 billing G-series bundled laboratory codes instead. This change requires immediate updates to billing systems and provider education to prevent claim denials.
Action Required
By September 30, 2026: Billing team must (1) audit all current billing workflows and encounter forms that reference CPT codes 80320-80377; (2) update billing system rules to block claims using these codes for Ambetter Health plans; (3) identify and map the appropriate G-series bundled laboratory codes for replacement; (4) update provider documentation and billing guidelines; (5) communicate with all providers, lab partners, and clinical staff about the transition; (6) conduct system testing to ensure new G-series codes route correctly. All staff involved in ordering, coding, or billing drug testing services must be notified. Failure to transition will result in claim denials for Ambetter Health members.