Medicare AdvantageBilling CodesHigh impact
Ambetter Health Billing Code Update for CPT Codes 80320-80377 Effective 10/01/2026
Ambetter·SC · 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 to maintain reimbursement for these services.
Action Required
By September 30, 2026: Billing team must update billing software to discontinue reimbursement of CPT codes 80320-80377 for Ambetter Health plans. Identify all current claims using these codes and map them to corresponding G-series bundled laboratory codes. Update claim templates, superbills, and encounter forms to reflect the new G-series codes. Communicate the change to all providers and laboratory staff to ensure compliance. Beginning October 1, 2026, all drug testing procedure claims for Ambetter members must be submitted using G-series bundled codes only. Claims submitted with CPT 80320-80377 will be denied.