ExchangeBilling CodesHigh impact
Ambetter Health Billing Code Update for CPT Codes 80320-80377 Effective 10/01/2026
Ambetter·IL · 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). Billing teams must transition to G-series bundled laboratory codes for all drug testing claims to Ambetter to avoid denials.
Action Required
By September 1, 2026: Billing team must update billing system to replace all CPT codes 80320-80377 with appropriate G-series bundled laboratory codes for Ambetter Health claims. Review current drug testing workflows and identify all instances where codes 80320-80377 are used. Update fee schedules, billing rules, and encounter templates to reflect the transition to G-series codes. Communicate changes to providers and laboratory staff. Test billing system changes with sample claims before the October 1, 2026 effective date. Failure to transition will result in claim denials for all drug testing procedures billed to Ambetter Health.