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New Incentive for Medication Assisted Treatment (MAT) Services

Date: 02/14/25

Sunshine Health is offering an incentive to appropriately trained Obstetrician-Gynecologists (OB/GYN) and Behavioral Health providers: They can receive an additional $100 per claim filed per pregnant member for Medication Assisted Treatment (MAT) services.

Providers should use the modifier “TH” to indicate MAT was associated with a pregnancy.

MAT is the use of medications, counseling and behavioral therapies to treat substance use disorders. This is a “whole patient” approach to treat addiction. MAT is not a standalone treatment, but a part of other wraparound services to help generate the best outcome for patients.

How is this information being captured?

Sunshine Health will use claims data to verify if services have been rendered.

Is the incentive available in addition to reimbursement for an office visit?

Yes, the incentive is separate from the office visit reimbursement.

What code indicates that MAT services were completed?

H0020: billing code for methadone administration and other services related to opioid use disorder.

Note: Providers must include modifier (TH) to indicate MAT services are associated with a pregnancy.

Free DEA Training Available

Sunshine Health offers free, self-paced training sessions to help providers fulfill the 8-hour training requirement for all Drug Enforcement Administration (DEA)-registered practitioners on the treatment and management of patients with opioid or other substance use disorders.

Visit Relias to access self-paced Medication Assisted Treatment (MAT) training. If you need to create a login, here’s how:

  • Username: Tax Identification Number (TIN)
  • Password: Password1

Note:  TIN should be entered as numbers only/no dash. Password1 is case sensitive and the password should be changed after you create a login.

To learn more about this course, visit Medication Assisted Treatment (MAT) Training.

Questions?

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

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