All PlansCoverageHigh impact
Update for HCPCS Codes G0482 and G0483
Ambetter·NJ · Occupational Medicine, Pain Management, Psychiatry +2 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 demonstrated. Billing teams must stop submitting claims for G0482 and G0483 to avoid denials.
Action Required
Effective immediately (06/04/26): Billing team must update billing system to deny or block submission of HCPCS codes G0482 and G0483 for all claims. Remove these codes from encounter templates and order entry systems. Update coding guidelines and provider education materials to reflect that only G0480 and G0481 are reimbursable for drug testing when medical necessity is documented. Communicate this change to all providers, lab coordinators, and billing staff. Any claims already submitted with G0482 or G0483 after 06/04/26 will be denied; monitor for claim rejections and resubmit with G0480 or G0481 if applicable. Contact Provider Relations Representative at AmBetter Health for clarification on medical necessity criteria.