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Ambetter Health Billing Code Update for various HCPC H Codes: Effective 01/01/2027
Act
by Jan 1, 2027
Effective date
Jan 1, 2027
Identified
Nov 7, 2026
Summary
Published June 22, 2026: Ambetter Health announced that 46 listed HCPCS H codes will no longer be covered beginning January 1, 2027, while HCPCS H0006 will become covered on that same date. Billing teams should identify claims and scheduled services using the listed H codes for January 2027 dates of service and prepare charge entry and provider notification accordingly.
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What to do
by Jan 1, 2027 · 4 steps
01Billing team should flag the listed H codes (H0003 through H2033, excluding H0006) in charge entry and the scheduling system so services planned for Ambetter Health members on or after January 1, 2027 are reviewed before they are scheduled, and should update the payer's fee and coverage tables accordingly.
02Before January 1, 2027: Tell providers and front desk staff that Ambetter Health will not cover the listed H codes from that date and that HCPCS H0006 becomes covered, and have them confirm the service codes on upcoming orders.
03Billing team should also contact the practice's Ambetter Provider Relations Representative with questions about the bulletin, and watch for any further Ambetter notices on these codes.
04Claims for these codes with dates of service on or after January 1, 2027 may be denied as non-covered, so review the impacted services in advance.
Codes mentioned
H0003H0004H0005H0006H0007H0008H0009H0010H0011H0012H0013H0014H0016H0019H0021H0024H0026H0027H0028H0029H0030H0034H0037H0039H0040H0041H0042H0043H0044H0045H0046H0047H1011H2001H2010H2011H2012H2013H2015H2016H2018H2021H2022H2028H2029H2030H2031H2032H2033
Original notice
Ambetter Health Billing Code Update for various HCPC H Codes: Effective 01/01/2027
ambetterhealth.com · Always check the source before changing claims.
Related changes
See all Ambetter changes →Ambetter Health of Delaware Billing Code Update for various HCPC H Codes: Effective 01/01/2027HighEffective Jan 1, 2027 · Claims & BillingAmbetter Health Billing Code Update for various HCPC H Codes: Effective 01/01/2027HighEffective Jan 1, 2027 · Claims & BillingAugust Provider NewsletterHighEffective Jan 1, 2027 · Provider BulletinJune 2026 NewsletterHighEffective Jan 1, 2027 · Provider BulletinBrowse every Ambetter change in the policy list
Related policy hubs
Ambetter policiesPA policy changesCode H0003Code H0004Code H0005Code H0006Code H0007Code H0008Code H0009Code H0010Code H0011Code H0012Code H0013Code H0014Code H0016Code H0019Code H0021Code H0024Code H0026Code H0027Code H0028Code H0029Code H0030Code H0034Code H0037Code H0039Code H0040Code H0041Code H0042Code H0043Code H0044Code H0045Code H0046Code H0047Code H1011Code H2001Code H2010Code H2011Code H2012Code H2013Code H2015Code H2016Code H2018Code H2021Code H2022Code H2028Code H2029Code H2030Code H2031Code H2032Code H2033