Discontinuance of HCPCS Bundle Code 80050

Date: 09/19/25

This announcement is to notify you of the discontinuance of HCPCS bundle code 80050 for Ambetter Health of Delaware effective 10/20/2025.

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.

The following procedure codes will be covered individually and discontinue their coverage under bundled code HCPCS 80050 effective 10/20/2025:

• 85003 – Comprehensive Metabolic Panel
• 85025, 85027 – Complete Blood Count
• 84443 – Thyroid Stimulating Hormone

NOTE: Submissions of HCPCS bundled code 80050 will receive an automatic denial with explanation code 46 and treatment type NC after 10/19/2025.

For other established codes, please use the Pre-Auth Check Tools on our website to confirm if the code(s) requires authorization.

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Need Help or Have Questions? Reach out to us through the following channels:

1. Provider Services – 1-877-236-1341, Monday – Friday 8am – 5pm EST
2. General inquiries, email - DE_ProviderEngagement@DelawareFirstHealth.com
3. Contact your dedicated Provider Engagement Account Manager