Medicare AdvantageCoverageHigh impact
Ambetter Health Billing Code Update for CPT Codes 80320-80377 Effective 10/01/2026
Ambetter·NH · 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 submitted to this payer.
Action Required
By September 30, 2026: Billing team must immediately identify all CPT codes 80320-80377 currently used in the billing system for Ambetter Health claims. Update billing software to map these codes to appropriate G-series bundled laboratory codes effective October 1, 2026. Review all pending and scheduled drug testing orders for Ambetter members and communicate to providers the required code substitution. Establish internal audit process to catch any claims submitted with CPT 80320-80377 to Ambetter after the effective date. Claims submitted with non-covered codes will be denied. Contact Ambetter Provider Relations Representative to confirm correct G-series bundled code mappings for your specific testing procedures.