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Florida Administrative Code (Last Updated: April 18, 2024) |
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59. Agency for Health Care Administration |
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59G. Medicaid |
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59G-4. Medicaid Policy |
1(1) This rule applies to providers rendering Florida Medicaid services to recipients.
13(2) Florida Medicaid reimburses for services rendered in the fee-for-service delivery system based on a fee schedule, cost report, or contract. The following fee schedules and billing codes are incorporated by reference and available on the Agency for Health Care Administration’s website at http://ahca.myflorida.com/Medicaid/review/index.shtml.
57(3) Florida Medicaid Fee Schedules Effective July 1, 2022:
66(a) Assistive Care Services Fee Schedule
72https://www.flrules.org/Gateway/reference.asp?No=Ref-1608974.
75(b) Behavior Analysis Fee Schedule
80https://www.flrules.org/Gateway/reference.asp?No=Ref-1453982.
83(c) Behavioral Health Overlay Services Fee Schedule
90https://www.flrules.org/Gateway/reference.asp?No=Ref-1609092.
93(d) Birth Center Fee Schedule
98https://www.flrules.org/Gateway/reference.asp?No=Ref-16091100.
101(e) Community-Based Substance Abuse County Match Fee Schedule
109https://www.flrules.org/Gateway/reference.asp?No=Ref-14543111.
112(f) Community Behavioral Health Services Fee Schedule
119https://www.flrules.org/Gateway/reference.asp?No=Ref-16092121.
122(g) County Health Department Certified Match Program Fee Schedule
131https://www.flrules.org/Gateway/reference.asp?No=Ref-14545133.
134(h) Dental General Fee Schedule
139https://www.flrules.org/Gateway/reference.asp?No=Ref-16093141.
142(i) Durable Medical Equipment and Medical Supply Services Provider Fee Schedule for All Medicaid Recipients
157https://www.flrules.org/Gateway/reference.asp?No=Ref-14547159.
160(j) Early Intervention Services Fee Schedule
166https://www.flrules.org/Gateway/reference.asp?No=Ref-14548168.
169(k) Hearing Services Fee Schedule
174https://www.flrules.org/Gateway/reference.asp?No=Ref-16094176.
177(l) Home Health Visit Services Fee Schedule
184https://www.flrules.org/Gateway/reference.asp?No=Ref-16095186.
187(m) Independent Laboratory Fee Schedule
192https://www.flrules.org/Gateway/reference.asp?No=Ref-16096194.
195(n) Licensed Midwife Fee Schedule
200https://www.flrules.org/Gateway/reference.asp?No=Ref-16097202.
203(o) Medicaid Certified School Match Program Fee Schedule
211https://www.flrules.org/Gateway/reference.asp?No=Ref-14553213.
214(p) Medical Foster Care Services Fee Schedule
221https://www.flrules.org/Gateway/reference.asp?No=Ref-16098223.
224(q) Occupational Therapy Services Fee Schedule
230https://www.flrules.org/Gateway/reference.asp?No=Ref-16099232.
233(r) Personal Care Services Fee Schedule
239https://www.flrules.org/Gateway/reference.asp?No=Ref-16100241.
242(s) Physical Therapy Fee Schedule
247https://www.flrules.org/Gateway/reference.asp?No=Ref-16101249.
250(t) 251Physician Pediatric Surgery Fee Schedule
256https://www.flrules.org/Gateway/reference.asp?No=Ref-14559258.
259(u) 260Practitioner Fee Schedule
263https://www.flrules.org/Gateway/reference.asp?No=Ref-16102265.
266(v) 267Practitioner Laboratory Fee Schedule
271https://www.flrules.org/Gateway/reference.asp?No=Ref-16103273.
274(w) Prescribed Drugs Immunization Fee Schedule
280https://www.flrules.org/Gateway/reference.asp?No=Ref-14562282.
283(x) Prescribed Pediatric Extended Care Services Fee Schedule
291https://www.flrules.org/Gateway/reference.asp?No=Ref-16104293.
294(y) Private Duty Nursing Services Fee Schedule
301https://www.flrules.org/Gateway/reference.asp?No=Ref-16105303.
304(z) Radiology Fee Schedule
308https://www.flrules.org/Gateway/reference.asp?No=Ref-16106310.
311(aa) Regional Perinatal Intensive Care Center (RPICC) Neonatal Services Fee Schedule
322https://www.flrules.org/Gateway/reference.asp?No=Ref-14566324.
325(bb) Regional Perinatal Intensive Care Center (RPICC) Obstetrical Services Fee Schedule
336https://www.flrules.org/Gateway/reference.asp?No=Ref-14567338.
339(cc) Respiratory Therapy Fee Schedule
344https://www.flrules.org/Gateway/reference.asp?No=Ref-16107346.
347(dd) Specialized Therapeutic Services Fee Schedule
353https://www.flrules.org/Gateway/reference.asp?No=Ref-16108355.
356(ee) Speech-Language Pathology Services Fee Schedule
362https://www.flrules.org/Gateway/reference.asp?No=Ref-16109364.
365(ff) Targeted Case Management Services Fee Schedule
372https://www.flrules.org/Gateway/reference.asp?No=Ref-16110374.
375(gg) Transportation Services Fee Schedule
380https://www.flrules.org/Gateway/reference.asp?No=Ref-16111382.
383(hh) Visual Services Fee Schedule
388https://www.flrules.org/Gateway/reference.asp?No=Ref-16112390.
391(4) Florida Medicaid Fee Schedules Effective January 1, 2023:
400(a) Assistive Care Services Fee Schedule
406https://www.flrules.org/Gateway/reference.asp?No=Ref-16113408.
409(b) Behavior Analysis Fee Schedule
414https://www.flrules.org/Gateway/reference.asp?No=Ref-16114416.
417(c) Behavioral Health Overlay Services Fee Schedule
424https://www.flrules.org/Gateway/reference.asp?No=Ref-16115426.
427(d) Birth Center Fee Schedule
432https://www.flrules.org/Gateway/reference.asp?No=Ref-16116434.
435(e) Community-Based Substance Abuse County Match Fee Schedule
443https://www.flrules.org/Gateway/reference.asp?No=Ref-16117445.
446(f) Community Behavioral Health Services Fee Schedule
453https://www.flrules.org/Gateway/reference.asp?No=Ref-16118455.
456(g) County Health Department Certified Match Program Fee Schedule
465https://www.flrules.org/Gateway/reference.asp?No=Ref-16157467.
468(h) Dental General Fee Schedule
473https://www.flrules.org/Gateway/reference.asp?No=Ref-16119475.
476(i) Durable Medical Equipment and Medical Supply Services Provider Fee Schedule for All Medicaid Recipients
491https://www.flrules.org/Gateway/reference.asp?No=Ref-16120493.
494(j) Early Intervention Services Fee Schedule
500https://www.flrules.org/Gateway/reference.asp?No=Ref-16121502.
503(k) Hearing Services Fee Schedule
508https://www.flrules.org/Gateway/reference.asp?No=Ref-16122510.
511(l) Home Health Visit Services Fee Schedule
518https://www.flrules.org/Gateway/reference.asp?No=Ref-16123520.
521(m) Independent Laboratory Fee Schedule
526https://www.flrules.org/Gateway/reference.asp?No=Ref-16124528.
529(n) Licensed Midwife Fee Schedule
534https://www.flrules.org/Gateway/reference.asp?No=Ref-16125536.
537(o) Medicaid Certified School Match Program Fee Schedule
545https://www.flrules.org/Gateway/reference.asp?No=Ref-16126547.
548(p) Medical Foster Care Services Fee Schedule
555https://www.flrules.org/Gateway/reference.asp?No=Ref-16127557.
558(q) Occupational Therapy Services Fee Schedule
564https://www.flrules.org/Gateway/reference.asp?No=Ref-16128566.
567(r) Personal Care Services Fee Schedule
573https://www.flrules.org/Gateway/reference.asp?No=Ref-16129575.
576(s) Physical Therapy Fee Schedule
581https://www.flrules.org/Gateway/reference.asp?No=Ref-16130583.
584(t) Physician Pediatric Surgery Fee Schedule
590https://www.flrules.org/Gateway/reference.asp?No=Ref-16131592.
593(u) Practitioner Fee Schedule
597https://www.flrules.org/Gateway/reference.asp?No=Ref-16132599.
600(v) Practitioner Laboratory Fee Schedule
605https://www.flrules.org/Gateway/reference.asp?No=Ref-16133607.
608(w) Prescribed Drugs Immunization Fee Schedule
614https://www.flrules.org/Gateway/reference.asp?No=Ref-16134616.
617(x) Prescribed Pediatric Extended Care Services Fee Schedule
625https://www.flrules.org/Gateway/reference.asp?No=Ref-16135627.
628(y) Private Duty Nursing Services Fee Schedule
635https://www.flrules.org/Gateway/reference.asp?No=Ref-16136637.
638(z) Radiology Fee Schedule
642https://www.flrules.org/Gateway/reference.asp?No=Ref-16137644.
645(aa) Regional Perinatal Intensive Care Center (RPICC) Neonatal Services Fee Schedule
656https://www.flrules.org/Gateway/reference.asp?No=Ref-16138658.
659(bb) Regional Perinatal Intensive Care Center (RPICC) Obstetrical Services Fee Schedule
670https://www.flrules.org/Gateway/reference.asp?No=Ref-16139672.
673(cc) Respiratory Therapy Services Fee Schedule
679https://www.flrules.org/Gateway/reference.asp?No=Ref-16140681.
682(dd) Specialized Therapeutic Services Fee Schedule
688https://www.flrules.org/Gateway/reference.asp?No=Ref-16141690.
691(ee) Speech-Language Pathology Services Fee Schedule
697https://www.flrules.org/Gateway/reference.asp?No=Ref-16142699.
700(ff) Targeted Case Management Services Fee Schedule
707https://www.flrules.org/Gateway/reference.asp?No=Ref-16143709.
710(gg) Transportation Services Fee Schedule
715https://www.flrules.org/Gateway/reference.asp?No=Ref-16144717.
718(hh) Visual Services Fee Schedule
723https://www.flrules.org/Gateway/reference.asp?No=Ref-16145725.
726(5) Florida Medicaid Billing Codes Effective January 1, 2023:
735(a) County Health Department Billing Codes
741https://www.flrules.org/Gateway/reference.asp?No=Ref-16147743.
744(b) Federally Qualified Health Center Billing Codes
751https://www.flrules.org/Gateway/reference.asp?No=Ref-16148753.
754(c) Hospice Services Billing Codes
759https://www.flrules.org/Gateway/reference.asp?No=Ref-16149761.
762(d) Hospital Outpatient Services Billing Codes
768https://www.flrules.org/Gateway/reference.asp?No=Ref-16150770.
771(e) Intermediate Care Facility for Individuals with Intellectual Disabilities Services Billing Codes
783https://www.flrules.org/Gateway/reference.asp?No=Ref-16151785.
786(f) Nursing Facility Services Billing Codes
792https://www.flrules.org/Gateway/reference.asp?No=Ref-16152794.
795(g) Prescribed Drugs Physician Administered Billing Codes
802https://www.flrules.org/Gateway/reference.asp?No=Ref-16153804.
805(h) Rural Health Clinic Billing Codes
811https://www.flrules.org/Gateway/reference.asp?No=Ref-16154813.
814(i) Statewide Inpatient Psychiatric Program Services Billing Codes
822https://www.flrules.org/Gateway/reference.asp?No=Ref-16155824.
825(6) This rule is in effect for five years from its effective date.
838Rulemaking Authority 840409.919 FS. 842Law Implemented 844409.902, 845409.905, 846409.906, 847409.907, 848409.908, 849409.912, 850409.913 FS. 852History–New 8-18-05, Amended 11-30-05, 4-16-06, 10-11-06, 3-27-07, 7-25-07, 9-29-08, 4-28-09, 2-11-10, 1-31-11, 7-16-13, 5-21-14, 6-20-16, 6-22-17, 2-8-18, 5-7-18, 1-7-19, 7-17-19, 12-15-20, 9-29-21, 8-2-22, 12-31-23.
