Medicare AdvantageBilling CodesMedium impact
Concert Genetics Policy CG.PP.551A
Ambetter·NE · Genetics·Claims & Billing
Effective date
Oct 1, 2026
We identified it
Sep 5, 2026
Summary
Ambetter Health is implementing a new genetic testing payment policy (CG.PP.551A) effective October 1, 2026, requiring Concert Genetics' unique test identifier (GTU) on all genetic testing claims for the Concert QAI program. Labs must ensure GTU identifiers are included on claims to avoid editing or denial, though pre-registration with Concert is not mandatory.
Action Required
By September 30, 2026: Billing team must update claim submission workflows and billing system templates to require the Concert Genetics GTU (genetic test unit identifier) on all genetic testing claims submitted to Ambetter Health. Coordinate with ordering providers and genetic testing laboratories to obtain and populate GTU identifiers on every genetic test claim. Update internal documentation and staff training on the new GTU requirement. Effective October 1, 2026, all genetic testing claims without the GTU identifier will be subject to claim editing by Ambetter Health. Contact Ambetter Provider Services at 1-833-890-0329 (TTY 711) to confirm lab registration status and obtain GTU assignment information for your facility's genetic tests.