Health Payor Fee Schedule Change

Date: 09/02/21

Thank you for your continued partnership with Ambetter from Sunshine Health. Our goal is always to deliver outstanding service to our members and providers.

Ambetter’s payor fee schedule will be rebased on Oct. 1, 2021 from “Medicare Q4 2015” to “Medicare in effect on the date of service.” The fee schedule will be continually updated in order to correctly reflect current Medicare in effect on the date of service. In conjunction with this update, we will make adjustments to reimbursements for radiology and therapy services. These changes apply to procedures in all places of service, as defined by the Centers for Medicare and Medicaid (CMS).

If you have questions, please reach out to your Provider Relations representative, or contact Provider Services at 1-877-687-1169.