Discontinuance of HCPCS Bundle Code 80050: Effective 1/1/26

Date: 10/22/25

Ambetter from Superior HealthPlan will cover procedure codes 85003 (Comprehensive Metabolic Panel), 85025 & 85027 (Complete Blood Count), and 84443 (Thyroid Stimulating Hormone) individually and discontinue their coverage under bundled code HCPCS 80050 beginning on January 1, 2026.

The Centers for Medicare & Medicaid Services previously removed 80050 from the Medicare Clinical Lab Fee schedule, citing an overuse of the bundled code when not all services were being performed. Ambetter Health will adopt this policy and cover the codes below only when submitted individually.

Procedure Codes Covered Individually Effective 1/1/26
Procedure	Procedure Codes
Comprehensive Metabolic Panel	80053
Complete Blood Count	85025, 85027
Thyroid Stimulating Hormone	84443

 

Submissions of HCPCS bundled code 80050 will receive an automatic denial with explanation code 46 and treatment type NC after December 31, 2025.

For additional assistance or questions, please contact your Provider Engagement team.

Thank you for your partnership and commitment to improving the health of our communities, one person at a time.