Drug Screen Service Codes Notification
Effective May 1, 2012, WV Medicaid will no longer reimburse for drug screen service codes 80100, 80101 or 80104. Drug screening services must then be reported using service code G0431 (Drug Screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, enzyme assay), per patient encounter) or by using service code G0434 (Drug screen, other than chromatographic; any number of drug classes, by CLIA waived test or moderate complexity test, per patient encounter).
G0431 and G0434 are reimbursed at a maximum of one unit of service per day. Any intent to screen members at a frequency exceeding that requirement will require prior authorization. Prior authorization may be obtained at our Utilization Management Contractors’ website (wvmi.org or apshealthcare.com).