The purpose of the amendment to Rule 59G-4.002, Florida Administrative Code, (F.A.C.), is to update fee schedules and billing codes.

AGENCY FOR HEALTH CARE ADMINISTRATION
Medicaid
RULE NO.:RULE TITLE:
59G-4.002Provider Reimbursement Schedules and Billing Codes
PURPOSE AND EFFECT: The purpose of the amendment to Rule 59G-4.002, Florida Administrative Code, (F.A.C.), is to update fee schedules and billing codes.
SUMMARY: The amendment revises the January 1, 2018 Practitioner Fee Schedule, Practitioner Laboratory Fee Schedule, Prescribed Pediatric Extended Care Services Fee Schedule, Outpatient Laboratory Fee Schedule, Ambulatory Surgical Center Services Fee Schedule, Birth Center Fee Schedule, Hospice Services Billing Codes, Hospital Outpatient Services Billing Codes, and Florida Medicaid Durable Medical Equipment and Medical Supply Services Provider Fee Schedule for All Medicaid Recipients.
SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS AND LEGISLATIVE RATIFICATION:
The Agency has determined that this will not have an adverse impact on small business or likely increase directly or indirectly regulatory costs in excess of $200,000 in the aggregate within one year after the implementation of the rule. A SERC has not been prepared by the Agency.
The Agency has determined that the proposed rule is not expected to require legislative ratification based on the statement of estimated regulatory costs or if no SERC is required, the information expressly relied upon and described herein: A checklist was prepared by the Agency to determine the need for a SERC. Based on this information at the time of the analysis and pursuant to section 120.541, Florida Statutes, the rule will not require legislative ratification.
Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.
RULEMAKING AUTHORITY: 409.919 FS.
LAW IMPLEMENTED: 409.902, 409.905, 409.906, 409.907, 409.908, 409.912, 409.913 FS.
A HEARING WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:
DATE AND TIME: November 21, 2018 from 10:30 a.m. to 11:00 a.m.
PLACE: Agency for Health Care Administration, 2727 Mahan Drive, Building 3, Tallahassee, Florida 32308-5407.
Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this workshop/meeting is asked to advise the agency at least 48 hours before the workshop/meeting by contacting: Jesse Bottcher. If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice).
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Jesse Bottcher, Bureau of Medicaid Policy, 2727 Mahan Drive, Mail Stop 20, Tallahassee, Florida 32308-5407, telephone: (850)412-4242, e-mail: Jesse.Bottcher@ahca.myflorida.com.
Please note that a preliminary draft of the reference material, if available, will be posted prior to the public hearing at http://ahca.myflorida.com/Medicaid/review/index.shtml. Official comments to be entered into the rule record will be received from the date of this notice until 5:00 p.m., November 26, 2018. Comments may be e-mailed to MedicaidRuleComments@ahca.myflorida.com. For general inquiries and questions about the rule, please contact the person specified above.

THE FULL TEXT OF THE PROPOSED RULE IS:

59G-4.002 Provider Reimbursement Schedules and Billing Codes.
(1) This rule applies to providers rendering Florida Medicaid services to recipients.
(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.
(3) Florida Medicaid Fee Schedules Effective July January 1, 2018:
(a) Ambulatory Surgical Center Services Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref- ______.
(b) Durable Medical Equipment and Medical Supply Services Provider Fee Schedule for All Medicaid Recipients
https://www.flrules.org/Gateway/reference.asp?No=Ref-_______.
(c) Outpatient Laboratory Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-_______.
(d) Practitioner Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-_______.
(e) Practitioner Laboratory Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-_______.
(f) Prescribed Pediatric Extended Care Services Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-_______.
(g) Birth Center Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-_______.
(h) Hospice Services Billing Codes
https://www.flrules.org/Gateway/reference.asp?No=Ref-_______.
(i) Hospital Outpatient Services Billing Codes
https://www.flrules.org/Gateway/reference.asp?No=Ref-_______.
(4) Florida Medicaid Fee Schedules Effective January 1, 2018:
(a) Ambulatory Surgical Center Services Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref- 09184.
(a) (b) Assistive Care Services Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09185.
(b) (c) Behavior Analysis Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09186.
(c) (d) Behavioral Health Overlay Services Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09187.
(e) Birth Center Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09188.
(d)(f) Child Health Targeted Case Management Services Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09189.
(e)(g) Community-Based Substance Abuse County Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09190.
(f)(h) Community Behavioral Health Services Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09191.
(g)(i) County Health Department Certified Match Program Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09192.
(h)(j) Dental Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09193.
(k) Florida Medicaid Durable Medical Equipment and Medical Supply Services Provider Fee Schedule for All Medicaid Recipients
https://www.flrules.org/Gateway/reference.asp?No=Ref-09194.
(i)(l) Early Intervention Services Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09195.
(j)(m) Transportation Services Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09196.
(k)(n) Hearing Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09197.
(l)(o) Home Health Visit Services Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09198.
(m)(p) Immunization Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09199.
(n)(q) Independent Laboratory Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09200.
(o)(r) Licensed Midwife Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09201.
(p)(s) Medicaid Certified School Match Program Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09202.
(q)(t) Medical Foster Care Services Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09203.
(r)(u) Mental Health Targeted Case Management Services Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09204.
(s)(v) Occupational Therapy Services Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09205.
(w) Outpatient Laboratory Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09206.
(t)(x) Personal Care Services Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09207.
(u)(y) Physical Therapy Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09208.
(v)(z) Physician Pediatric Surgery Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09209.
(aa) Practitioner Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09210.
(bb) Practitioner Laboratory Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref- 09211.
(w)(cc) Prescribed Drug Fee Schedule (Not Reviewed by the Pharmaceutical and Therapeutic Committee)
https://www.flrules.org/Gateway/reference.asp?No=Ref-09212.
(dd) Prescribed Pediatric Extended Care Services Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09213.
(x)(ee) Private Duty Nursing Services Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09214.
(y)(ff) Radiology Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09215.
(z)(gg) Regional Perinatal Intensive Care Center (RPICC) Neonatal Services Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09216.
(aa)(hh) Regional Perinatal Intensive Care Center (RPICC) Obstetrical Services Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09217.
(bb)(ii) Respiratory Therapy Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09218.
(cc)(jj) Specialized Therapeutic Services Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09219.
(dd)(kk) Speech-Language Pathology Services Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09220.
(ee)(ll) Targeted Case Management for Children at Risk of Abuse and Neglect Services Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09221.
(ff)(mm) Visual Services Fee Schedule
https://www.flrules.org/Gateway/reference.asp?No=Ref-09222.
(5)(4) Florida Medicaid Billing Codes Effective January 1, 2018:
(a) County Health Department Billing Codes
https://www.flrules.org/Gateway/reference.asp?No=Ref-09223.
(b) Federally Qualified Health Center Billing Codes
https://www.flrules.org/Gateway/reference.asp?No=Ref-09224.
(c) Hospice Services Billing Codes
https://www.flrules.org/Gateway/reference.asp?No=Ref- 09225.
(d) Hospital Outpatient Services Billing Codes
https://www.flrules.org/Gateway/reference.asp?No=Ref-09226.
(c)(e) Intermediate Care Facility for Individuals with Intellectual Disabilities Services Billing Codes
https://www.flrules.org/Gateway/reference.asp?No=Ref-09227.
(d)(f) Nursing Facility Services Billing Codes
https://www.flrules.org/Gateway/reference.asp?No=Ref-09228.
(e)(g) Rural Health Clinic Billing Codes
https://www.flrules.org/Gateway/reference.asp?No=Ref-09229.
(f)(h) Statewide Inpatient Psychiatric Program Services Billing Codes
https://www.flrules.org/Gateway/reference.asp?No=Ref-09230.
Rulemaking Authority 409.919 FS. Law Implemented 409.902, 409.905, 409.906, 409.907, 409.908, 409.912, 409.913 FS. History–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, 2-7-18,_________.

NAME OF PERSON ORIGINATING PROPOSED RULE: Matt Brackett
NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Justin M. Senior
DATE PROPOSED RULE APPROVED BY AGENCY HEAD: October 23, 2018
DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: June 22, 2018

Document Information

Comments Open:: 10/31/2018
Summary:: The amendment revises the January 1, 2018 Practitioner Fee Schedule, Practitioner Laboratory Fee Schedule, Prescribed Pediatric Extended Care Services Fee Schedule, Outpatient Laboratory Fee Schedule, Ambulatory Surgical Center Services Fee Schedule, Birth Center Fee Schedule, Hospice Services Billing Codes, Hospital Outpatient Services Billing Codes, and Florida Medicaid Durable Medical Equipment and Medical Supply Services Provider Fee Schedule for All Medicaid Recipients.
Purpose:: The purpose of the amendment to Rule 59G-4.002, Florida Administrative Code, (F.A.C.), is to update fee schedules and billing codes.
Rulemaking Authority:: 409.919 FS.
Law:: 409.902, 409.905, 409.906, 409.907, 409.908, 409.912, 409.913 FS.
Contact:: Jesse Bottcher, Bureau of Medicaid Policy, 2727 Mahan Drive, Mail Stop 20, Tallahassee, Florida 32308-5407, telephone: 850-412-4242, e-mail: Jesse.Bottcher@ahca.myflorida.com. Please note that a preliminary draft of the reference material, if available, will be posted prior to the public hearing at http://ahca.myflorida.com/Medicaid/review/index.shtml. Official comments to be entered into the rule record will be received from the date of this notice until 5:00 p.m., November 26, 2018. ...
Related Rules: (1): 59G-4.002. Medicaid Provider Reimbursement Schedule