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New Incentive for After-Hours Availability

Date: 02/13/25

Sunshine Health is incentivizing all providers with an additional $20 per member for services rendered after hours. It’s important to us that members have access to care. Offering services after hours is an effective way for providers to increase their availability to our members.

How are we capturing this information?

  • Sunshine Health will utilize claims data to verify when services have been rendered after hours

How do I indicate services were rendered after hours?

  • Providers must use one of these procedure codes:
    • 99050: After-hours care provided in provider’s office outside of regular office hours
    • 99051: After-hours care provided during regularly scheduled evening, weekend or holiday office hours
    • 99060: After-hours Emergency Care

What is considered after hours?

  • Hours from 5 p.m. to 8 a.m. Eastern
  • All weekends
  • All holidays
  • Includes after-hours telehealth services

Standards for Appointment Scheduling

Manuals, Forms and Resources: Find the Standards for Appointment Scheduling for your health plan and other provider resources.

Questions?

Sunshine Health has a wealth of resources available to help answer your questions and address your concerns:

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