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Medicare AdvantageCoverageHigh impact

Update for HCPCS Codes G0482 and G0483

Ambetter·FL · Occupational Medicine, Pain Management, Psychiatry·Medical Policy
Effective date
Jun 17, 2026
We identified it
Aug 26, 2026
Days to comply

Summary

Effective immediately, HCPCS codes G0482 and G0483 (definitive drug testing with 15-21 and 22+ drug classes respectively) are no longer reimbursable by Ambetter Health, aligned with Clinical Policy CP.MP.50. Codes G0480 and G0481 remain covered when medical necessity is documented. Billing teams must immediately stop billing G0482 and G0483 and redirect to covered alternatives.

Action Required

Action needed
Effective immediately (06/17/26): Billing team must cease all claims submission for HCPCS codes G0482 and G0483. Update billing software to block or flag these codes as non-reimbursable for Ambetter Health plans. For all drug-of-abuse testing orders, providers must use codes G0480 or G0481 instead and document medical necessity in the patient record. Retrain billing staff on the change and audit pending/recent claims for G0482/G0483 to identify and correct before submission or resubmit with correct codes. Contact Provider Engagement Account Manager at 1-877-687-1169 or via Secure Provider Portal if claims have already been denied under this policy. Failure to comply will result in claim denials and potential compliance issues.

Affected Billing Codes

G0482
G0483
G0480
G0481