Medicare AdvantageBilling CodesHigh impact
Ambetter Health Billing Code Update for CPT Codes 80320-80377 Effective 10/01/2026
Ambetter·NC · 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 avoid denials.
Action Required
By September 30, 2026: Billing team must update billing software to discontinue billing CPT codes 80320-80377 for Ambetter Health plans. Identify all G-series bundled laboratory codes that replace these procedures and configure system to automatically map or require manual selection of appropriate G-codes. Review current claims in queue for October 2026 and later. Notify all providers and laboratory staff that CPT 80320-80377 are non-reimbursable effective 10/01/2026 and must use G-series codes instead. Failure to transition will result in claim denials for all drug testing procedures billed to Ambetter Health.