Florida Clinical Payment Policies | Ambetter from Sunshine Health

 

Clinical & Payment Policies

Clinical Policies

Clinical policies are one set of guidelines used to assist in administering health plan benefits, either by prior authorization or payment rules.  They include but are not limited to policies relating to evolving medical technologies and procedures, as well as pharmacy policies.  Clinical policies help identify whether services are medically necessary based on information found in generally accepted standards of medical practice; peer-reviewed medical literature; government agency/program approval status; evidence-based guidelines and positions of leading national health professional organizations; views of physicians practicing in relevant clinical areas affected by the policy; and other available clinical information. 

All policies found in the Sunshine Health Clinical Policy Manual apply to Sunshine Health members. Policies in the Sunshine Health Clinical Policy Manual may have either a Sunshine Health or a “Centene” heading.  Sunshine Health utilizes InterQual® criteria for those medical technologies, procedures or pharmaceutical treatments for which a Sunshine Health clinical policy does not exist.  InterQual is a nationally recognized evidence-based decision support tool.  You may access the InterQual® SmartSheet(s)™ for Adult and Pediatric procedures, durable medical equipment and imaging procedures by logging into the secure provider portal or by calling Sunshine Health. In addition, Sunshine Health may from time to time delegate utilization management of specific services; in such circumstances, the delegated vendor’s guidelines may also be used to support medical necessity and other coverage determinations. Other non-clinical policies (e.g., payment policies) or contract terms may further determine whether a technology, procedure or treatment that is not addressed in the Clinical Policy Manuals or  InterQual®criteria is payable by Sunshine Health.   

If you have any questions regarding these policies, please contact Member Services and ask to be directed to the Medical Management department.

Payment Policies

Health care claims payment policies are guidelines used to assist in administering payment rules based on generally accepted principles of correct coding.  They are used to help identify whether health care services are correctly coded for reimbursement.  Each payment rule is sourced by a generally accepted coding principle. They include, but are not limited to claims processing guidelines referenced by the Centers for Medicare and Medicaid Services (CMS), Publication 100-04, Claims Processing Manual for  physicians/non-physician practitioners, the CMS National Correct Coding Initiative policy manual (procedure-to-procedure coding combination edits and medically unlikely edits), Current Procedural Technology guidance published by the American Medical Association (AMA) for reporting medical procedures and services, health plan clinical policies based on the appropriateness of health care and medical necessity, and at times state-specific claims reimbursement guidance.

All policies found in the Sunshine Health Payment Policy Manual apply with respect to Sunshine Health members. Policies in the Sunshine Health Payment Policy Manual may have either a Sunshine Health or a “Centene” heading.  In addition, Sunshine Health may from time to time employ a vendor that applies payment policies to specific services; in such circumstances, the vendor’s guidelines may also be used to determine whether a service has been correctly coded. Other policies (e.g., clinical policies) or contract terms may further determine whether a technology, procedure or treatment that is not addressed in the Payment Policy Manual is payable by Sunshine Health.     

If you have any questions regarding these policies, please contact Member Services and ask to be directed to the Medical Management department.

PolicyEffective Date
30-Day Readmission (PDF)February 5, 2021
3-Day Payment Window (PDF) 
Add on Code Billed Without Primary Code (PDF)January 1, 2013
Allergy Testing and Therapy (PDF)January 1, 2022
Ambulatory EEG (PDF)September 14, 2020
Assistant Surgeon (PDF)January 1, 2014
Bevacizumab (Avastin) (PDF)August 12, 2016
Bilateral Procedures (PDF)January 1, 2014
Billing Requirements for Transgender Services (PDF)April 17, 2023
Bronchial Thermoplasty (PDF) January 15, 2017
Cardiac Biomarker Testing for Acute MI (PDF)June 1, 2018
Cerumen Removal (PDF)January 1, 2014
Clean Claims (PDF) 
Clean Claim Reviews (PDF)November 1, 2012
Clinical Validation of Modifier 25 (PDF)January 1, 2013
CMS Correct Coding Initiative Unbundling Edits (PDF) 
Code Editing Overview (PDF)January 1, 2013
Cosmetic Procedures (PDF)January 1, 2014
Cost to Charge Adjustments on Clean Claim Reviews (PDF)September 1, 2022
Diagnosis of Vaginitis (PDF)January 15, 2017 - September 30, 2017
Diagnosis of Vaginitis (PDF)October 1, 2017 - December 31, 2017
Digital Breast Tomosynthesis (PDF)December 1, 2016 - December 31, 2017
Distinct Procedural Modifiers: XE, XS, XP, & XU (PDF)January 1, 2013
Distinct Procedural Service: Modifier 59 (PDF)January 1, 2013
Duplicate Primary Code Billing (PDF)January 1, 2014
Endometrial Ablation (PDF)April 30, 2022
EpiFix Wound Treatment (PDF)September 1, 2017
Evaluation and Management Services Billed with Treatment Rooms (PDF)January 1, 2022
External Ocular Photography (PDF)January 1, 2022
Facility-based Sleep Studies for Obstructive Sleep Apnea (PDF) 
Facility Charges for Hospital-Based Outpatient Clinics (PDF)September 1, 2022
Fecal Calprotectin Assay (PDF)May 1, 2017
High Complexity Medical Decision-Making (PDF)June 1, 2017
Homocysteine Testing (PDF)March 31, 2022
Hospital Visit Codes Billed with Labs (PDF)January 1, 2013
Incidental Diagnostic and Laboratory Tests Billed with Evaluation and Management Services (PDF)January 1, 2013
Inpatient Consultation (PDF)October 1, 2017
Inpatient Only Procedures (PDF)November 30, 2021
Intravenous Hydration (PDF)January 1, 2013
Leveling of Care: Evaluation and Management Overcoding (PDF)February 5, 2021
Leveling of Emergency Room Services (PDF)May 15, 2019
Low-Frequency Ultrasound Wound Therapy (PDF)September 1, 2017
Maximum Units of Service (PDF)January 1, 2013
Mechanical Stretchc Devices (PDF)September 1, 2017
Moderate Conscious Sedation (PDF)June 26, 2023
Modifier DOS Validation (PDF)January 1, 2013
Modifier to Procedure Code Validation (PDF)January 1, 2013
Monitored Anesthesia Care for Gastrointestinal Endoscopy (PDF) March 1, 2019
Multiple CPT Code Replacement (PDF)
January 1, 2014
Multiple Procedure Payment Reduction (MPPR) for Diagnostic Cardiovascular Procedures (PDF)February 6, 2021
Multiple Procedure Payment Reduction (MPPR) for Diagnostic Cardiovascular Procedures (PDF) February 6, 2021
Multiple Procedure Reduction: Ophthalmology (PDF)
August 23, 2021
Multiple Procedure Payment Reduction (MPPR) for Therapeutic Services (PDF)August 23, 2021
NCCI Unbundling (PDF) 
Never Paid Events (PDF)
January 1, 2013
New Patient (PDF)
January 1, 2014
Non-obstetrical Pelvic and Transvaginal Ultrasounds (PDF)March 1, 2019
Outpatient Consultation (PDF)
January 1, 2014
Paclitaxel Protein Bound (PDF)January 1, 2022
Physician Visit Codes Billed with Labs (PDF) 
Physician's Consultation Services (PDF)December 1, 2017
Place of Service Mismatch (PDF)March 1, 2019
Polymerase Chain Reaction Respiratory Viral Panel Testing (PDF)March 31, 2022
Post-Operative Visits (PDF)
January 1, 2014
Pre-Operative Visits (PDF)
January 1, 2014
Problem Oriented Visits Billed with Preventative Visits (PDF)
September 2, 2022
Problem Oriented Visits with Surgical Procedures (PDF)
December 1, 2017
Professional Component Modifier 26 (PDF)
January 1, 2013
Professional Services (Visit Codes) Billed With Labs (PDF)
January 1, 2013
PROM Testing (PDF)
December 1, 2017
Proton and Neutron Beam Therapy (PDF)
December 1, 2016
Pulse Oximetry with Evaluation & Management Services (PDF)
January 1, 2014
Renal Hemodialysis (PDF)
September, 2022
Reporting Global Maternity Package (PDF)
January 1, 2013
Rituximab (PDF)November 1, 2017
Robotic Surgery (PDF)April 20, 2021
Same Day Visits (PDF)December 1, 2022
Short Inpatient Hospital Stay (PDF) October 1, 2020
Sleep Studies Place of Services (PDF)May 1, 2017
Status "B" Bundled Services (PDF)April 1, 2017
Supplies Billed On Same Day as Surgery (PDF)January 1, 2013
Testing for Select Genitourinary Conditions (formerly Diagnosis of Vaginitis) (PDF)January 1, 2022
Thryoid Hormones and Insulin Testing in Pediatrics (PDF)October 31, 2021
Unbundled Professional Services (PDF) January 1, 2014
Unbundled Surgical Procedures (PDF) 
Unbundling Adjustments on Clean Claim Reviews (PDF)September 1, 2022
Unlisted Procedure Codes (PDF)January 1, 2013
Urine Specimen Validity Testing (PDF)April 20, 2021
Vitamin D Testing in Children and Adolescents (PDF)June 1, 2018
Wheelchair and Accessories (PDF)August 12, 2016
Wireless Motility Capsule (PDF)September 1, 2017