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AmbetterExchange · Billing Codes · Provider Bulletin · NCHigh impact

June 2026 Newsletter

Act
by Jan 1, 2027 (source-stated date)
Effective date
Jan 1, 2027
Identified
Aug 26, 2026

Summary

Ambetter of North Carolina's June 2026 provider newsletter says it will stop covering 48 HCPCS H codes beginning January 1, 2027, and will cover H0006 from that date. The newsletter also says drug testing codes G0482 and G0483 are no longer reimbursable under the drugs-of-abuse policy (no date is given), and it lists clinical policy revisions effective August 15, 2026 and a reminder to verify member eligibility by paid-through dates.

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What to do

by Jan 1, 2027 (source-stated date) · 9 steps
01Billing team should list every H code in the newsletter (H0003 through H2033, 48 codes in all) that the practice uses for Ambetter of North Carolina members, and decide how each service will be billed from that date.
02The newsletter says H0006 will be covered from January 1, 2027 and does not say whether it replaces the same services, so confirm with the plan's Provider Relations Representative before changing codes.
03Update charge entry, the fee schedule and encounter forms, and tell providers and scheduling staff before that date so new appointments are set up correctly.
04Drug testing billing staff should stop billing G0482 and G0483 for Ambetter of North Carolina members, since the newsletter says they are no longer reimbursable under policy CP.MP.50, which it calls currently in effect; the newsletter gives no date for this change, so confirm the start date with the plan.
05It says G0480 and G0481 are covered when medical necessity is indicated, so check those services against the policy.
06Clinical policy revisions effective August 15, 2026 (already in effect, so confirm current applicability) include CP.MP.102, CP.MP.136, CP.MP.162, CP.MP.184, CP.MP.55, CP.MP.57, CP.BH.105, CP.BH.104, CP.BH.200 and CP.BH.201, and CP.MP.252 is new; the newsletter lists these by name only, so review the policy text on the plan site before scheduling affected services.
07Before each date of service, verify member status in Availity or the Centene provider portal, checking the premium paid-through date and the claims paid-through date.
08The newsletter warns that unpaid premiums can lead to retroactive termination, and that previous claims may then be denied.
09Collect payment from a member in advance only when the verified status makes clear that it is allowed.

Codes mentioned

H0003H0004H0005H0006H0007H0008H0009H0010H0011H0012H0013H0014H0016H0019H0021H0024H0026H0027H0028H0029H0030H0034H0037H0039H0040H0041H0042H0043H0044H0045H0046H0047H1011H2001H2010H2011H2012H2013H2015H2016H2018H2021H2022H2028H2029H2030H2031H2032H2033G0482G0483G0480G0481

Original notice

June 2026 Newsletter
ambetterhealth.com · Always check the source before changing claims.
View original ↗

Related changes

See all Ambetter changes →
Ambetter Health Billing Code Update for various HCPC H Codes: Effective 01/01/2027MediumEffective Jan 1, 2027 · Claims & BillingAmbetter Health of Delaware Billing Code Update for various HCPC H Codes: Effective 01/01/2027HighEffective Jan 1, 2027 · Claims & BillingAmbetter Health Billing Code Update for various HCPC H Codes: Effective 01/01/2027HighEffective Jan 1, 2027 · Claims & BillingAugust Provider NewsletterHighEffective Jan 1, 2027 · Provider BulletinBrowse every Ambetter change in the policy list

Related policy hubs

Ambetter policiesNC policy changesCode H0003Code H0004Code H0005Code H0006Code H0007Code H0008Code H0009Code H0010Code H0011Code H0012Code H0013Code H0014Code H0016Code H0019Code H0021Code H0024Code H0026Code H0027Code H0028Code H0029Code H0030Code H0034Code H0037Code H0039Code H0040Code H0041Code H0042Code H0043Code H0044Code H0045Code H0046Code H0047Code H1011Code H2001Code H2010Code H2011Code H2012Code H2013Code H2015Code H2016Code H2018Code H2021Code H2022Code H2028Code H2029Code H2030Code H2031Code H2032Code H2033Code G0482Code G0483Code G0480Code G0481

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