All PlansCoverageHigh impact
Update for HCPCS Codes G0482 and G0483
Ambetter·NC · Pain Management, Psychiatry, Occupational Medicine +2 more·Medical Policy
Effective date
Jun 10, 2026
We identified it
Aug 26, 2026
Summary
Effective immediately, HCPCS codes G0482 and G0483 (definitive drug testing with 15-21 and 22+ drug classes respectively) are no longer reimbursable under this payer's Clinical Policy CP.MP.50. Only codes G0480 and G0481 are covered when medical necessity is documented. Billing teams must stop billing G0482 and G0483 and transition to the covered alternatives.
Action Required
Effective immediately (06/10/26): Billing team must stop billing HCPCS codes G0482 and G0483 to this payer. Update billing system to deny or auto-correct claims using these codes. Providers ordering definitive drug testing must now use only G0480 or G0481 with documented medical necessity. Update EMR templates and order entry systems to reflect covered alternatives. Communicate change to all providers performing drug testing, especially in pain management and occupational medicine. Any claims submitted with G0482 or G0483 after the effective date will be denied by this payer. Verify patient eligibility and clarify which codes are covered before processing claims.