Medicare AdvantageCoverageHigh impact
Ambetter Health Billing Code Update for CPT Codes 80320-80377 Effective 10/01/2026
Ambetter·GA · Pathology, Occupational Medicine, Pain Management +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 billing G-series bundled laboratory codes instead. This is a coverage elimination requiring immediate billing system updates to prevent claim denials.
Action Required
By September 30, 2026: Billing team must immediately audit all claims currently billing CPT codes 80320-80377 for Ambetter Health patients and identify appropriate G-series bundled laboratory code replacements. Update billing software to block or redirect claims using CPT codes 80320-80377 for Ambetter Health effective October 1, 2026. Create a mapping document linking each discontinued CPT code to its corresponding G-series bundled code. Train all billing staff and providers on the transition before the effective date. Contact Ambetter Health Provider Relations Representative to clarify which specific G-series codes apply to your practice's drug testing procedures. After October 1, 2026, all claims submitted with CPT codes 80320-80377 will be denied by Ambetter Health, resulting in lost revenue and potential patient balance issues.