All PlansCoverageHigh impact
Update for HCPCS Codes G0482 and G0483
Ambetter·TN · Occupational Medicine, Pain Management, Psychiatry·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 Clinical Policy CP.MP.50. Codes G0480 and G0481 remain covered when medical necessity is documented. Billing teams must halt claims submission for G0482 and G0483 and update systems to redirect to alternative covered codes.
Action Required
Effective immediately (06/04/26): Billing team must stop submitting claims for HCPCS codes G0482 and G0483 to avoid denials. Update billing software to block or flag these codes as non-reimbursable. For any pending or in-process claims containing G0482 or G0483, contact the payer or rebill using G0480 or G0481 with documented medical necessity. Update provider templates and encounter forms to reflect that only G0480 and G0481 are billable for drug-of-abuse testing. Train all billing and coding staff on this change. Communicate with all providers ordering drug testing to ensure they understand the coverage limitations. Failure to comply will result in claim denials and potential overpayment recovery.