All PlansCoverageHigh impact
Update for HCPCS Codes G0482 and G0483
Ambetter·LA · Occupational Medicine, Pain Management, Psychiatry +1 more·Medical Policy
Effective date
Jun 4, 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 the updated Clinical Policy CP.MP.50. Codes G0480 and G0481 remain covered when medical necessity is documented. The billing team must immediately stop billing G0482 and G0483 and update systems to reflect this change.
Action Required
Effective immediately (June 4, 2026): Billing team must (1) Update billing software to deny/block claims for HCPCS codes G0482 and G0483 to prevent submission; (2) Update internal billing guidelines and provider alerts to communicate that G0482 and G0483 are NO LONGER REIMBURSABLE; (3) Configure system to route any existing pending claims with G0482/G0483 for manual review and correction before submission; (4) Ensure providers and lab partners know to use G0480 or G0481 only when medical necessity can be documented; (5) Contact Provider Relations Representative if clarification needed on medical necessity criteria. Failure to implement these changes will result in claim denials for G0482 and G0483.