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Stay Connected on the Go! Download our Health Insurance Portal mobile app to search for care, view benefits and access your Member ID card. LEARN MORE AND DOWNLOAD THE APP
Stay Connected on the Go! Download our Health Insurance Portal mobile app to search for care, view benefits and access your Member ID card. LEARN MORE AND DOWNLOAD THE APP

Medication Assisted Treatment (MAT) Incentive

Sunshine Health recognizes that Medication Assisted Treatment (MAT) is essential to improving outcomes for members with substance use disorders (SUD) and supporting providers in delivering high-quality care.

To support that goal, Sunshine Health offers a $100 incentive payment for each claim filed per pregnant member who receives MAT services provided by an appropriately trained Obstetrician-Gynecologists (OB/GYN) or Behavioral Health provider.

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 and modifier indicate that MAT services were completed?

  • H0020: Use this billing code for methadone administration and other services related to opioid use disorder.
  • TH: Providers must include this modifier (TH) to indicate MAT services are associated with pregnancy.

If you have any questions about the incentive, please contact your Provider Engagement Account Manager (PEAM) or call Provider Services at 1-844-477-8313.

MAT DEA Training

Sunshine Health offers free, self-paced MAT training sessions with 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:

  • The username (numbers only/no dash): Tax Identification Number (TIN)
  • Password (case sensitive): Password1
  • 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, visit Medication Assisted Treatment (MAT) Training

Note: DEA‑registered practitioners must attest to completing this training by checking the required box on their DEA registration or renewal application. The deadline to complete the training is the practitioner’s next DEA registration submission.