The $20 Secret: How to Maximize Revenue with Sunshine Health After-Hours Bonuses

I don't know about you, but when I first heard about Sunshine Health's after-hours bonus on the SPOT Growth Podcast (Episode 41, highly recommend!), my initial reaction was: "Wait, they pay us extra for what now?"

Turns out, there's a literal $20 bill sitting on the table every time you see a Sunshine Health patient after hours, on weekends, or during holidays. And here's the kicker, most Florida therapy practices aren't capturing it. Why? Because nobody told them how, or they think it's too complicated, or (my personal favorite) they assumed it didn't apply to therapy services.

Let me fix that right now.

What Exactly Is the Sunshine Health After-Hours Bonus?

Here's the deal: Sunshine Health will pay you an extra $20 per visit when you provide services during after-hours time windows. Not $20 per month. Not $20 per patient. Twenty dollars per session.

The qualifying times are actually pretty generous:

• 5:00 PM to 8:00 AM (local time) on weekdays

• All weekend services (yes, the entire weekend)

• All holiday services

• After-hours telehealth (game-changer for scheduling flexibility)

When I first saw this list, I thought, "Okay, so basically everything outside of traditional 9-to-5 clinic hours?" Yep. That's exactly what it is.

Who Can Actually Bill for This?

This is where I see practice owners get confused. The good news: if you're providing Physical Therapy, Occupational Therapy, or Speech Therapy services through Sunshine Health, you're eligible.

Here's the full list of eligible providers:

• MDs and DOs

• Physician Assistants

• Nurse Practitioners

• Psychologists

• Physical Therapists

• Occupational Therapists

• Speech-Language Pathologists

Now, the question I get asked constantly: "What about therapy assistants? Can my COTA or PTA bill for this?"

The answer is usually yes, but (and this is important) you need to verify the specific billing requirements for assistants. Generally speaking, if your assistant can bill the base service code under supervision, they can usually capture the after-hours bonus too. However, I always recommend double-checking your specific plan's provider manual or calling Sunshine Health directly. It's one of those "better safe than sorry" situations where a five-minute phone call could save you from leaving money on the table, or worse, dealing with a clawback later.

The Plans That Qualify (Spoiler: It's Most of Them)

Sunshine Health has several plan types, and the after-hours incentive applies to pretty much all of them:

• Sunshine Health Medicaid (MMA)

• Comprehensive Long Term Care (LTC)

• Pathway to Shine Child Welfare Specialty Plan (CWSP)

• Mindful Pathways Serious Mental Illness Specialty Plan (SMI)

• Power to Thrive HIV/AIDS Specialty Plan (HIV)

• Children's Medical Services (CMS) Health Plan

If you're treating pediatric patients in Florida (which, let's be honest, is most of us in this community), you're probably seeing kids on at least one of these plans.

How to Actually Bill for the Bonus (Don't Skip This Section)

Okay, here's where the rubber meets the road. To get that $20, you need to bill two codes together:

1. Your regular therapy service code (97110, 97530, 92507, etc.)

2. One of these after-hours procedure codes:

3. 99050 – After-hours care in provider's office outside regular office hours

   1. 99051 – After-hours care during regularly scheduled evening, weekend, or holiday office hours

   2. 99060 – After-hours emergency care

The most commonly used for scheduled therapy visits is 99051. That's the one you'll want to attach to your regular therapy CPT codes when the session occurs during after-hours windows.

Good news: you don't need to add any modifiers. Just bill the therapy code and the after-hours code together on the same claim. Sunshine Health's system will recognize the pairing and trigger the incentive payment.

The Pitfall That's Costing You Money (I Learned This the Hard Way)

Here's the mistake I see practices make over and over again: they schedule an appointment at 4:30 PM, it runs until 5:30 PM, and they think, "Great! That ended after 5:00 PM, so it qualifies!"

Wrong.

Sunshine Health looks at the start time of the appointment, not the end time. If your session starts at 4:30 PM, even if it runs until 6:00 PM, it doesn't qualify. The visit must begin during the after-hours window to be eligible for the bonus.

When I first learned this, I literally went back through our schedule and realized we'd been leaving hundreds of dollars on the table every month. We were ending sessions after 5:00 PM all the time, but very few were actually starting after 5:00 PM.

So here's the fix: if you want to capture after-hours bonuses, schedule your first evening appointment to start at 5:00 PM or later, not 4:45 PM. Those 15 minutes matter, and they're worth $20 per patient.

Let's Do Some Quick Math (Because Numbers Are Motivating)

Let's say you add just two evening slots per week, maybe Tuesdays and Thursdays from 5:00-6:00 PM. You fill those with Sunshine Health patients.

• 2 sessions per week × $20 bonus = $40/week

• $40/week × 4 weeks = $160/month

• $160/month × 12 months = $1,920/year

And that's just from adding two after-hours slots.

Now imagine you offer Saturday hours. Let's say you see 8 Sunshine Health patients on a Saturday:

• 8 sessions × $20 = $160 extra for that single Saturday

If you do that twice a month? That's an additional $3,840/year.

These aren't huge operational changes. We're talking about adjusting your schedule to meet families where they are (many parents work traditional hours and need after-hours or weekend appointments), and getting paid extra for the flexibility you're already considering offering.

The Strategy: Think About Your Families

I'm going to be real with you for a second. The after-hours bonus isn't just about the money (though the money is great). It's about accessibility.

Most of the families we serve have parents who work. They're juggling jobs, siblings, appointments, and trying to get their child the therapy services they desperately need. When you offer after-hours or weekend appointments, you're removing a massive barrier for these families.

And Sunshine Health knows this. That's exactly why they're incentivizing after-hours care, they want to improve access and reduce no-shows caused by scheduling conflicts.

So when you add evening or weekend hours, you're:

1. Serving your families better

2. Improving your retention and reducing no-shows

3. Getting paid a bonus for doing it

It's genuinely a win-win-win.

Common Questions I Get About After-Hours Billing

"Do telehealth sessions count?"
Yes! If you're doing telehealth after 5:00 PM, on weekends, or on holidays, you can bill the after-hours code. This is huge for practices that have embraced virtual care.

"Okay but… what counts as a holiday in 2026? I don’t want to accidentally bill this on the wrong day."
Totally fair (and honestly, this was one of my big questions too). Holidays can get weird when different payer docs say different things, and the last thing any of us want is a clawback over a technicality.

So I did what I always do when something feels even slightly fuzzy: I picked up the phone.

Aaron spoke directly with Duenna Dorsett, VP of Provider Relations at Sunshine Health, and she confirmed that all Federal holidays in 2026 will be covered by this after-hours/holiday benefit. And—because I know you’re going to look for it the second you finish reading this—she also shared that their website is being updated soon to reflect this.

Translation: if it’s a Federal holiday in 2026, Sunshine Health is treating it as bonus-eligible for this program.

"What if my office is normally open on Saturdays? Does it still count as 'after-hours'?"
Yes. All weekend services qualify, regardless of whether Saturday is part of your regular schedule.

"Can I bill this for every discipline?"
If you're billing therapy services (PT, OT, ST) and the provider is credentialed with Sunshine Health, yes. Just make sure you're pairing the appropriate service code with the after-hours code.

"Will this mess with my other billing protocols?"
Nope. The after-hours code is an add-on. Your base reimbursement stays the same; this is just extra.

SEO Pro-Tip: Optimize Your "Contact" and "Hours" Pages

If you're going to start offering after-hours appointments, make sure your website reflects this. Update your hours on your Contact page, and consider creating a dedicated landing page that explains your extended availability.

Use phrases like:

• "Evening therapy appointments available"

• "Weekend pediatric therapy in [Your City]"

• "After-hours speech therapy"

• "Saturday OT appointments"

Parents are Googling these exact terms, especially working parents who need flexibility. If your site doesn't mention after-hours availability, you're missing potential patients and missing the chance to fill those bonus-eligible slots.

Squarespace Pro-Tip: Use the Announcement Bar for After-Hours Scheduling

Lauren and Aaron, here's a quick Squarespace hack for you: if you're on a Squarespace 7.1 template, you can enable an Announcement Bar at the top of your site to promote your after-hours availability.

Here's how:

1. Go to Pages in your Squarespace dashboard

2. Click the gear icon next to "Home" or your main page

3. Scroll to Announcement Bar

4. Toggle it on and add text like: "Now scheduling evening & weekend appointments! Call (555) 123-4567"

5. Link the bar to your Contact page or online scheduler

The announcement bar is visible on every page, so families will see it immediately when they land on your site. It's a simple, no-code way to broadcast your extended hours and fill those after-hours slots faster.

You can even rotate the message seasonally: maybe highlight weekend availability during the school year when parents are extra busy.

Don't Leave Money on the Table

Look, I get it. Adding after-hours or weekend availability feels like a big operational shift. You're already stretched thin, schedules are complicated, and the last thing you need is one more thing to manage.

But here's the thing: you're probably already offering some level of flexibility for families. Maybe you occasionally squeeze someone in at 5:15 PM, or you've done the occasional Saturday to help a family out. If you're doing that work anyway, you might as well get the $20 bonus for it.

And if you're not offering after-hours availability yet, this incentive might be exactly the nudge you need to pilot a program. Start small: maybe one evening per week: and see how families respond. I'm willing to bet you'll fill those slots fast and wonder why you didn't do this sooner.

Aaron, Lauren, and I are here to support you through this. If you have questions about billing the after-hours codes or want to chat through the logistics of adding evening hours to your schedule, reach out anytime. We're in this together, and we want to see your practice thrive: not leave thousands of dollars uncaptured because of a scheduling quirk you didn't know about.

Now go check your schedule, move some appointments to start at 5:00 PM instead of 4:45 PM, and watch that extra $20 per visit start rolling in.

Got questions about maximizing your Medicaid reimbursements? Our team at Extra Mile Billing specializes in helping Florida therapy practices capture every dollar they've earned. Let's talk.