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Behavioral Health (BH) Outpatient Service Limits to Resume July 1, 2026

Date: 06/03/26

The Agency for Health Care Administration (AHCA)’s temporary waiver of service limits for certain community behavioral health (BH) outpatient services is expiring. As a result, Sunshine Health will resume applying applicable Medicaid service limits for adults ages 21 years and older.

BH service limits will be reinstated starting Wednesday, July 1, 2026.

The waiver allowed certain BH outpatient service limits to remain waived while it was in effect. With the waiver expiring, Sunshine Health will reinstitute the service limits that were in place prior to the waiver, consistent with AHCA guidance and Medicaid coverage requirements.

Providers should review applicable service limits when planning care and submitting claims or authorization requests. Services must continue to be medically necessary, and prior authorization requirements may apply.

If you have questions, contact your Sunshine Health Provider Engagement Account Manager (PEAM) or call Provider Services at 1-844-477-8313.  

Questions?

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

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