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Ambetter Health Billing Code Update for CPT Codes 80320-80377 Effective 10/01/2026

Ambetter·TN · Pathology, Occupational Medicine, Psychiatry·Coding
Effective date
Oct 1, 2026
We identified it
Aug 26, 2026
Days to comply
16 days

Summary

Effective October 1, 2026, Ambetter Health will no longer reimburse CPT codes 80320-80377 (Definitive Drug Testing Procedures). Providers must transition to G-series bundled laboratory codes for these services to maintain reimbursement.

Action Required

Before Oct 1, 2026
By September 30, 2026: Billing team must update billing software to deny or reject all claims submitted with CPT codes 80320-80377 for Ambetter Health plans. Immediately identify all drug testing procedures currently billed under these codes and map them to appropriate G-series bundled laboratory codes. Communicate with providers and laboratory staff to discontinue use of CPT 80320-80377 and transition to G-series codes effective October 1, 2026. Update billing templates, fee schedules, and encounter documentation to reflect the new coding requirements. Test billing system changes before the effective date. Claims submitted with CPT 80320-80377 on or after October 1, 2026 will be denied by Ambetter Health.

Affected Billing Codes

80320
80321
80322
80323
80324
80325
80326
80327
80328
80329
80330
80331
80332
80333
80334
80335
80336
80337
80338
80339
80340
80341
80342
80343
80344
80345
80346
80347
80348
80349
80350
80351
80352
80353
80354
80355
80356
80357
80358
80359
80360
80361
80362
80363
80364
80365
80366
80367
80368
80369
80370
80371
80372
80373
80374
80375
80376
80377