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 February 1 to December 31, 2025, are eligible for an additional $50 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). The SBIRT model should also be used when treating members by behavioral health providers; physicians in primary care centers; hospital emergency rooms; trauma centers; and in other community medical settings.
Submit These Codes
Code | Description |
H0049 | Alcohol and/or drug screening |
H0050 | Alcohol and/or drug screening, brief intervention, per 15 minutes |
| 99408 | 15–30 minute alcohol and/or substance abuse screening and brief intervention service |
| 99409 | Structured alcohol and/or substance abuse screening and brief intervention services that last more than 30 minutes |
| G0396 | Structured assessment and brief intervention for alcohol or substance abuse, other than tobacco; intervention must be 15 to 30 minutes long |
| G0397 | Describes a structured assessment and intervention for alcohol and/or substance abuse that lasts more than 30 minutes |
Deadline
· Enhanced payments will be applied at the time of claim adjudication.
For More Information
Read the AHCA Guide to Utilizing the Screening, Brief Intervention and Referral to Treatment Model for Medicaid Practitioners.
Live Virtual Training
To register for live training SBIRT webinars, please visit Training Catalog which can be found directly from our Provider Training page.
- Training is focused on screening and referral to treatment for alcohol and substance use for patients in a healthcare setting
- Attendees will gain clinical knowledge and skills to implement SBIRT in their practice
- Providers who complete the training will earn 2.5 training hours and 2 Continuing Education (CE) credits
- Start time is 10 a.m. Eastern and training will last for 2½ hours
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.