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New limits on drug testing reimbursements

03/29/2016

New restrictions on reimbursement for drug testing services are now in effect. Laboratory reimbursements will be limited to one unit of one code per date of service for any code in the ranges G0477-G0479 and G0480-G0483.

This update to ConnectiCare’s drug testing services policy complies with Center for Medicare & Medicaid Services guidelines and affects both our commercial and Medicare plans. It will be applied to services on or after Jan. 1, 2016.

Please note, ConnectiCare’s "Approved In-Office Laboratory & Radiology Procedures" do allow codes G0477 or G0478 for the use of pain management specialists only:

For more information about the CMS guidelines, refer to this CMS document.