Medicare AdvantageBilling CodesHigh impact
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
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
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.