Medical Foster Care Parents Must Submit Original Claim Numbers
Date: 02/14/25
Sunshine Health has an important message for our Medical Foster Care providers: They are required to submit or correct eligible claims using the original claim numbers.
Claims submitted on or after October 1, 2024, must reflect updated Medicaid rates, along with the procedure code and appropriate modifiers that correspond to the necessary level of care for the services provided.
Corrected claims should be resubmitted via the Sunshine Health Secure Provider Portal for review by our claims department.
This process is essential to address discrepancies between the previous and new Medicaid rates, as shown below.
Code | Modifier | Description of Service | Service Maximum Fee |
|---|---|---|---|
S5145 | HA | Level I Medical Foster Care Service | $48.47 per day |
S5145 | TF | Level II Medical Foster Care Service | $60.59 per day |
S5145 | TG | Level III Medical Foster Care Service | $84.81 per day |
Resources
- Provider Services: Call 1-844-477-8313 if you have questions.
- MFC Quick Reference Guide: Visit for information about this specialty area.
Questions?
Sunshine Health has a wealth of resources available to help answer your questions and address your concerns:
- Provider Services: Call 1-844-477-8313
- Provider Portal: Visit the Secure Provider Portal to check member eligibility, submit claims and more.
- Provider Engagement: Use the Find Your Account Manager tool to find the Provider Engagement Account Manager (PEAM) supporting your specialty and region.
- Provider News: Bookmark Provider News to keep up with the latest updates.
- Provider Newsflash: Subscribe to our e-newsletter to get regular updates.
- Provider Resources: Visit Manuals, Forms and Resources to find provider manuals, important forms and other resources.
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