The purpose of the amendment to Rule 59G-4.002, Florida Administrative Code, (F.A.C.), is to update the fee schedule information in the existing rule.

 

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 the fee schedule information in the existing rule.

SUBJECT AREA TO BE ADDRESSED: Provider Reimbursement Schedules and Billing Codes.

An additional area to be addressed during the workshop will be the potential regulatory impact Rule 59G-4.002, Florida Administrative Code, will have as provided for under sections 120.54 and 120.541, Florida Statutes.

RULEMAKING AUTHORITY: 409.919 FS.

LAW IMPLEMENTED: 409.902, 409.905, 409.906, 409.907, 409.908, 409.912, 409.913 FS.

A RULE DEVELOPMENT WORKSHOP WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:

DATE AND TIME: February 26, 2018, 10:30 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: Jessica Kenny. 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 DEVELOPMENT AND A COPY OF THE PRELIMINARY DRAFT, IF AVAILABLE, IS: Jessica Kenny, Bureau of Medicaid Policy, 2727 Mahan Drive, Mail Stop 20, Tallahassee, Florida 32308-5407, telephone: [phone], e-mail: [e-mail].

Please note that a preliminary draft of the reference material, if available, will be posted prior to the workshop 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. February 27, 2018. Comments may be e-mailed to [e-mail]. For general inquiries and questions about the rule, please contact the person specified above.

 

THE PRELIMINARY TEXT OF THE PROPOSED RULE DEVELOPMENT 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 January 1, 20187:

(a) Ambulatory Surgical Center Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______08196.

(b) Assistive Care Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-________08197.

(c) Behavior Analysis Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08198.

(d) Behavioral Health Overlay Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08199.

(e) Birth Center Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08200.

(f) Child Health Services Targeted Case Management Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08201.

(g) Community-Based Substance Abuse County Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08201.

(h) Community Behavioral Health Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08202.

(i) County Health Department Certified Match Program Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08203.

(j) Dental Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08205.

(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-_________08206.

(l) Florida Medicaid Durable Medical Equipment and Medical Supply Services Provider Fee Schedule for Medicaid Recipients Under the Age of 21 Years

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08207.

(l) (m) Early Intervention Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08208.

(m) (n) Transportation Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08209.

(n) (o) Hearing Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08210.

(o) (p) Home Health Visit Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08211.

(p) (q) Immunization Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08212.

(q) (r) Independent Laboratory Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08213.

(r) (s) Licensed Midwife Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08214.

(s) (t) Medicaid Certified School Match Program Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08215.

(t) (u) Medical Foster Care Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08216.

(u) (v) Mental Health Targeted Case Management Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=____________08217.

(v) (w) Occupational Therapy Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08218.

(w) Outpatient Laboratory Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________.

(x) Personal Care Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08219.

(y)  Physical Therapy Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08220.

(z) Physician and Outpatient Laboratory Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08221.

(z) (aa) Physician Pediatric Surgery Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08222.

(aa) (bb) Practitioner Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08841.

        (bb) Practitioner Laboratory Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________.

(cc) Prescribed Drug Fee Schedule (Not Reviewed by the Pharmaceutical and Therapeutic Committee)

https://www.flrules.org/Gateway/reference.asp?No=Ref-________08224.

(dd) Prescribed Pediatric Extended Care Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08225.

(ee) Private Duty Nursing Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08226.

(ff) Radiology Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-__________08227.

(gg) Regional Perinatal Intensive Care Center (RPICC) Neonatal Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-__________08228.

(hh) Regional Perinatal Intensive Care Center (RPICC) Obstetrical Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08229.

(ii) Specialized Therapeutic Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08230.

(jj) Speech-Language Pathology Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08231.

(kk) Targeted Case Management for Children at Risk of Abuse and Neglect Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08232.

(ll) Visual Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08233.

(4) Florida Medicaid Billing Codes Effective January 1, 20187

(a) County Health Department Billing Codes

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08234.

(b) Federally Qualified Health Center Billing Codes

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08235.

(c) Hospice Services Billing Codes

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08236.

(d) Hospital Outpatient Services Billing Codes

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08237.

(e) Intermediate Care Facility for Individuals with Intellectual Disabilities Services Billing Codes

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08238.

(f) Nursing Facility Services Billing Codes

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08239.

(g) Rural Health Clinic Billing Codes

https://www.flrules.org/Gateway/reference.asp?No=Ref-________08240.

(h) Statewide Inpatient Psychiatric Program Services Billing Codes

https://www.flrules.org/Gateway/reference.asp?No=Ref-_________08241.

(5) Florida Medicaid Fee Schedule Effective July 1, 2017:

(a) Respiratory Therapy Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-08842.

(6) Florida Medicaid Fee Schedule Effective October 1, 2017:

(a) Immunization Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-08839.

(7) Florida Medicaid Fee Schedule Effective January 1, 2018:

(a) Prescribed Pediatric Extended Care Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-08840

        (b) Prescribed Drug Fee Schedule ((Not Reviewed by the Pharmaceutical and Therapeutic Committee)

https://www.flrules.org/Gateway/reference.asp?No=Ref-09007

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,_________