Medicare AdvantageBilling CodesHigh impact
Ambetter Health Billing Code Update for CPT Codes 80320-80377 Effective 10/01/2026
Ambetter·IA · Pain Management, Psychiatry, Occupational Medicine +3 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). Billing teams must transition to G-series bundled laboratory codes for all drug testing claims to Ambetter to avoid denials.
Action Required
By September 30, 2026: Billing team must identify all current drug testing claims using CPT codes 80320-80377 billed to Ambetter Health and create a transition plan to G-series bundled laboratory codes. Update billing software to route all Ambetter drug testing claims to appropriate G-series codes effective October 1, 2026. Audit encounter templates and standing orders to replace CPT 80320-80377 with correct G-series alternatives. Contact Ambetter Provider Relations for specific G-code mappings if not already provided. Beginning October 1, 2026, any claims submitted using CPT codes 80320-80377 to Ambetter will be denied.