Medicare AdvantageCoverageHigh impact
Ambetter from Meridian Billing Code Update for various HCPC H Codes: Effective 01/01/2027
Ambetter·MI · Psychiatry·Claims & Billing
Effective date
Jan 1, 2027
We identified it
Aug 26, 2026
Summary
Effective January 1, 2027, Ambetter from Meridian will no longer cover 45 HCPCS H codes (behavioral health and social services codes), while H0006 will begin coverage on that same date. Billing teams must identify all claims using the discontinued codes and implement alternative billing strategies or have claims denied.
Action Required
By December 15, 2026: Billing team must audit all current claims and encounter templates to identify services billed using H codes H0003-H0047 and H1011, H2001-H2033. Update billing system to flag or block submission of the 45 discontinued codes (all except H0006) for Ambetter from Meridian claims effective 01/01/2027. For services currently billed with discontinued H codes, identify appropriate alternative CPT codes or determine if services will no longer be reimbursed. Add alert in billing software to route claims with these codes to manual review before transmission. Notify providers of the change and affected service lines. For H0006, ensure billing system is configured to accept this code starting 01/01/2027. Failure to implement these changes will result in claim denials for all discontinued H code submissions to Ambetter from Meridian after the effective date.