CPT® 80050 CODE REIMBURSEMENT UPDATE

Date: 11/14/22

YouthCare recently conducted a review of CPT and HCPCS codes being reimbursed for Illinois Department of Healthcare and Family Services programs. We identified that YouthCare previously reimbursed CPT 80050 Organ or Disease-Oriented Panels. Meridian Medicaid Plan, YouthCare, and Meridian Medicare-Medicaid Plan programs do not cover these metabolic panels. As such, YouthCare will no longer allow reimbursement for CPT 80050.

However, the components of the code, CPT 80053: Organ or Disease Oriented Panels, CPT 85025: Pathology and Laboratory/Hematology and Coagulation, and CPT 84443: Chemistry Procedures, remain covered and reimbursable. Providers who have been incorrectly reimbursed will be notified of recoupment. Providers will be able to rebill with the correct codes.