Payment Policy Change - In House Labs

Date: 12/27/18

Thank you for participating with Ambetter from Sunflower Health Plan. Ambetter values your dedication to our members.

Effective March 1, 2019, Ambetter from Sunflower Health Plan will limit the performance of in-office testing to the CPT and HCPCS codes listed in the Short Turnaround Time (STAT) laboratory code list found in our Payment Policy: Physician's Office Lab Testing (CC.PP.055). The intent of this policy change is to ensure higher quality laboratory tests are performed in the correct setting.

All affected claims submitted between June 15, 2018, and November 15, 2018, will be reprocessed for payment.

If you have additional questions about this policy, please contact your provider network specialist or call Customer Service at 1-844-518-9505.