Ambetter Payment Policy Updates Effective September 2025

Date: 08/15/25

Thank you for your continued partnership with Sunflower Health Plan. As you know, we are committed to continuously evaluating and improving overall Payment Integrity solutions as required by State and Federal governing entities. We are writing today to inform you of policy revisions that Sunflower Health Plan - Ambetter will be implementing the updates effective on or after September 15, 2025.

Policy Numbers and Names

• MP.121 Homocysteine Testing
• BH.124 Attention Deficit Hyperactivity Disorder Assessment and Treatment
• MP.209 Gastrointestinal Pathogen Nucleic Acid Detection Panel Testing
• MP.181 Polymerase Chain Reaction Respiratory Viral Panel Testing
• MP.113 Holter Monitors
• MP.97 Testing for Select Genitourinary Conditions
• MP.99 Wheelchair Seating
• MP.155 EEG in the Evaluation of Headache
• MP.100 Allergy Testing and Therapy

Thank you for your continued participation and cooperation in our ongoing efforts to render quality health care to our members. We look forward to helping you provide the highest quality of care for our members.

If you have questions about this bulletin or other provider resources, please contact your Provider Relations Representative or call Provider Services at 1-844-518-9505 (TTY 711).

Ambetter from Sunflower Health Plan is underwritten by Celtic Insurance Company, which is a Qualified Health Plan issuer in the Kansas Health Insurance Marketplace. ©yyyy Celtic Insurance Company. All rights reserved.