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New Clinical Payment Policy Effective September 1, 2026 - Drugs of Abuse: Definitive Testing for more than 14 Drugs/Drug Classes

Date: 06/09/26

Superior HealthPlan and Ambetter Health (Ambetter from Superior HealthPlan and Ambetter Health Solutions) present a new payment policy. The following policy is posted on Superior’s Clinical, Payment and Pharmacy Policies webpage for review, prior to its implementation.

POLICY

EFFECTIVE DATE

APPLICABLE PRODUCTS

NEW POLICY OVERVIEW OR UPDATED POLICY REVISIONS

 Clinical Policy: Drugs of Abuse: Definitive Testing for more than 14 Drugs/Drug Classes

(TX.CP.MP.50-A)

September 1, 2026

Medicaid (STAR, STAR Health, STAR Kids, STAR+PLUS), CHIP),
Ambetter Health

 It is the policy of Centene Advanced Behavioral Health and the Texas health plans affiliated with Centene Corporation that outpatient confirmatory/definitive (quantitative) drug testing of more than 14 drugs/drug classes is not medically necessary.

 

To review all clinical payment or payment policies, please visit Superior’s Clinical, Payment and Pharmacy Polices webpage.

For questions or additional information, please contact your Provider Representative. To access their contact information visit Find My Provider Representative