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Enhanced Payments for SBIRT Assessments

Sunshine Health is offering providers enhanced payments to help deliver the best healthcare possible to our pregnant members.

Providers who complete a Screening, Brief Intervention, and Referral to Treatment (SBIRT) assessment within each member’s first trimester between dates of service from May 1 to December 31, 2024, are eligible for an additional $25 reimbursement per member.

Sunshine Health’s Enhanced Payment Program is in addition to the compensation arrangement in the participation agreement in our provider network, as well as other health plan incentive programs that providers participate in.

 

Who is Eligible?

Primary care physicians (PCPs), including MDs and DOs; advanced practice nurses (APRNs); physician assistants (PAs); midwives; and obstetrician-gynecologists (OB/GYNs).

 

Submit These Codes

Code

Description

H0049

Alcohol and/or drug screening

H0050

Alcohol and/or drug screening, brief intervention, per 15 minutes

 

Deadline

  • Claims must be received by March 31, 2025.
  • A one-time payment will be made by June 30, 2025.

 

For More Information

Read the AHCA Guide to Utilizing the Screening, Brief Intervention and Referral to Treatment Model for Medicaid Practitioners.

 

Questions

If you have any questions, please call Sunshine Health Provider Services at 1-844-477-8313 or visit the Secure Provider Portal. Our Provider Engagement staff are also here to help answer questions. Visit the Find Your Administrator tool to confirm the individual supporting your specialty and region. We encourage you stay up to date on Sunshine Health provider notices by reviewing and bookmarking Provider News.