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Update for CPT Codes 80320-80377: Effective 10/1/2026
Effective date
Oct 1, 2026
Identified
Nov 4, 2026
Summary
Effective October 1, 2026, AmBetter Health will no longer reimburse CPT codes 80320–80377 (Definitive Drug Testing Procedures). Billing teams must stop submitting claims for these codes and instead bill the appropriate G-series bundled laboratory codes to avoid claim denials.
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What to do
Action · 6 steps
01Effective October 1, 2026.
02Billing team: Update charge entry and claim edits to stop submitting CPT codes 80320–80377 for AmBetter Health members in New Jersey.
03Billing team: Replace CPT codes 80320–80377 with the appropriate G-series bundled laboratory codes in charge entry templates and billing system configurations.
04Tell providers and laboratory staff to use G-series bundled codes instead of CPT 80320–80377 when ordering definitive drug testing procedures for AmBetter members.
05Watch for claim denials on any CPT 80320–80377 claims submitted on or after October 1, 2026, and resubmit with the correct G-series code.
06Contact your AmBetter Provider Relations Representative if you need guidance on which G-series codes apply to specific test scenarios.
Codes mentioned
80320803218032280323803248032580326803278032880329803308033180332803338033480335803368033780338803398034080341803428034380344803458034680347803488034980350803518035280353803548035580356803578035880359803608036180362803638036480365803668036780368803698037080371803728037380374803758037680377
Original notice
Update for CPT Codes 80320-80377: Effective 10/1/2026
ambetterhealth.com · Always check the source before changing claims.
Related changes
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