The purpose of the amendment to Rule 59G-4.002 is to record effective dates for practitioner codes and fees.
AGENCY FOR HEALTH CARE ADMINISTRATION
RULE NO.:RULE TITLE:
59G-4.002Medicaid Provider Reimbursement Schedules
PURPOSE AND EFFECT: The purpose of the amendment to Rule 59G-4.002, f.a.c., is to record effective dates for practitioner codes and fees.
SUMMARY: The current amendment to Rule 59G-4.002, f.a.c., incorporates by reference the Florida Medicaid Provider Reimbursement Schedules including changes to the following: 1) practitioner procedure codes and fees, effective July 1, 2012; 2) practitioner procedure codes and fees, effective January 1, 2013; 3) practitioner procedure codes and fees, effective July 1, 2013; and 4) addition of physician primary care rate increase fee schedule, effective January 1, 2013 and July 1, 2013.
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: Friday, March 21, 2014, 10:00 a.m. ‒ 11:00 a.m.
PLACE: Agency for Health Care Administration, 2727 Mahan Drive, Building 3, Conference Room D, 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: Fred Lawrence at the Bureau of Medicaid Services, (850)412-4208. 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: Fred Lawrence, Medicaid Services, 2727 Mahan Drive, Mail Stop 20, Tallahassee, Florida 32308-5407, telephone: (850)412-4208, e-mail: fred.lawrence@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. Comments will be received until 5:00 p.m. on Friday, March 28, 2014.
THE FULL TEXT OF THE PROPOSED RULE IS:
59G-4.002 Medicaid Provider Reimbursement Schedules.
(1) Medicaid providers who render advanced registered nurse practitioner, birth center, chiropractic, dental, hearing, licensed midwife, optometric, outpatient hospital laboratory, physician, physician assistant, podiatry, registered nurse first assistant, and visual provide the following services are reimbursed according to the following and their billing agents who submit claims on behalf of an enrolled Medicaid provider must be in compliance with all applicable fee schedules, which are incorporated by reference below: for the following services: advanced registered nurse practitioner, birth center, chiropractic, general dental, hearing, licensed midwife, optometric, outpatient hospital laboratory, physician, physician assistant, podiatry, registered nurse first assistant, and visual.
(2) The following fee schedules are incorporated by reference:
(a) Advanced Registered Nurse Practitioner Fee Schedule, Effective July 1, 2012 January 1, 2011
(b) Advanced Registered Nurse Practitioner Fee Schedule, Effective January 1, 2013 2012
(c) Advanced Registered Nurse Practitioner Fee Schedule, Effective July 1, 2013
(d) Birthing Center Fee Schedule, Effective July 1, 2012 January 1, 2011
(e) Birthing Center Fee Schedule, Effective January 1, 2013 2012
(f) Birthing Center Fee Schedule, Effective July 1, 2013
(g) Chiropractic Services Fee Schedule, Effective July 1, 2012 January 1, 2011
(h) Chiropractic Services Fee Schedule, Effective January 1, 2013 2012
(i) Chiropractic Services Fee Schedule, Effective July 1, 2013
Dental General Fee Schedule, Effective January 1, 2011
(j) Dental General Fee Schedule, Effective July 1, 2012 2011
(k) Dental General Fee Schedule, Effective January 1, 2013 2012
(l) Dental General Fee Schedule, Effective July 1, 2013
(m) Dental Injectables Fee Schedule, Effective July 1, 2012 January 1, 2011
(n) Dental Injectables Fee Schedule, Effective January 1, 2013 2012
(o) Dental Injectables Fee Schedule, Effective July 1, 2013
(p) Dental Oral/Maxillofacial Surgery Fee Schedule, Effective July 1, 2012 January 1, 2011
(q) Dental Oral/Maxillofacial Surgery Fee Schedule, January 1, 2013 2012
(r) Dental Oral/Maxillofacial Surgery Fee Schedule, July 1, 2013
(s) Hearing Services Fee Schedule, Effective July 1, 2012 January 1, 2011
(t) Hearing Services Fee Schedule, Effective January 1, 2013 2012
(u) Hearing Services Fee Schedule, Effective July 1, 2013
(v) Licensed Midwife Fee Schedule, Effective July 1, 2012 January 1, 2011
(w) Licensed Midwife Fee Schedule, Effective January 1, 2013 2012
(x) Licensed Midwife Fee Schedule, Effective July 1, 2013
(y) Optometric Optometry Services Fee Schedule, Effective July 1, 2012 January 1, 2011
(z) Optometric Services Fee Schedule, Effective January 1, 2013 2012
(aa) Optometric Services Fee Schedule, Effective July 1, 2013
(bb) Outpatient Hospital Laboratory Fee Schedule, Effective January 1, 2013 2010
(cc) Physician Anesthesia Fee Schedule, Effective July 1, 2012 January 1, 2011
(dd) Physician Anesthesia Fee Schedule, Effective January 1, 2013 2012
(ee) Physician Anesthesia Fee Schedule, Effective July 1, 2013
(ff) Physician Assistant Fee Schedule, Effective July 1, 2012 January 1, 2011
(gg) Physician Assistant Fee Schedule, Effective January 1, 2013 2012
(hh) Physician Assistant Fee Schedule, Effective July 1, 2013
(ii) Physician Durable Medical Equipment Fee Schedule, Effective July 1, 2013
(jj) Physician Evaluation and Management Fee Schedule, Effective July 1, 2012 January 1, 2011
(kk) Physician Evaluation and Management Fee Schedule, Effective January 1, 2013 2012
(ll) Physician Evaluation and Management Fee Schedule, Effective July 1, 2013
Physician Immunization Fee Schedule, Effective January 1, 2011
Physician Immunization Fee Schedule, Effective April 1, 2011
(mm) Physician Immunization Fee Schedule, Effective July 1, 2012 October 1, 2011
(nn) Physician Immunization Fee Schedule, Effective January 1, 2013 2012
(oo) Physician Immunization Fee Schedule, Effective July 1, 2013
(pp) Physician Laboratory Services Fee Schedule, Effective July 1, 2012 January 1, 2011
(qq) Physician Laboratory Services Fee Schedule, Effective January 1, 2013 2012
(rr) Physician Laboratory Services Fee Schedule, Effective July 1, 2013
(ss) Physician Medical Fee Schedule, Effective July 1, 2012 January 1, 2011
(tt) Physician Medical Fee Schedule, Effective January 1, 2013 2012
(uu) Physician Medical Fee Schedule, Effective July 1, 2013
(vv) Physician Pediatric Surgery Fee Schedule, Effective July 1, 2012 January 1, 2011
(ww) Physician Pediatric Surgery Fee Schedule, Effective January 1, 2013 2012
(xx) Physician Pediatric Surgery Fee Schedule, Effective July 1, 2013
(yy) Physician Primary Care Rate Increase Fee Schedule, Effective January 1, 2013
(zz) Physician Primary Care Rate Increase Fee Schedule, Effective July 1, 2013
(aaa) Physician Radiology Services Fee Schedule, Effective July 1, 2012 January 1, 2011
(bbb) Physician Radiology Services Fee Schedule, Effective January 1, 2013 2012
(ccc) Physician Radiology Services Fee Schedule, Effective July 1, 2013
(ddd) Physician Surgical Fee Schedule, Effective July 1, 2012 January 1, 2011
(eee) Physician Surgical Fee Schedule, Effective January 1, 2013 2012
(fff) Physician Surgical Fee Schedule, Effective July 1, 2013
(ggg) Podiatry Services Fee Schedule, Effective July 1, 2012 January 1, 2011
(hhh) Podiatry Fee Schedule, Effective January 1, 2013 2012
(iii) Podiatry Fee Schedule, Effective July 1, 2013
(jjj) Regional Perinatal Intensive Care Center (RPICC) Neonatal Services Fee Schedule, Effective July 1, 2012 January 1, 2011
(kkk) Regional Perinatal Intensive Care Center (RPICC) Neonatal Services Fee Schedule, Effective January 1, 2013 2012
(lll) Regional Perinatal Intensive Care Center (RPICC) Neonatal Services Fee Schedule, Effective July 1, 2013
(mmm) Regional Perinatal Intensive Care Centers (RPICC) Obstetrical Services Fee Schedule, Effective July 1, 2012 January 1, 2011
(nnn) Regional Perinatal Intensive Care Centers (RPICC) Obstetrical Services Fee Schedule, Effective January 1, 2013 2012
(ooo) Regional Perinatal Intensive Care Centers (RPICC) Obstetrical Services Fee Schedule, Effective July 1, 2013
(ppp) Registered Nurse First Assistant Fee Schedule, Effective July 1, 2012 January 1, 2011
(qqq) Registered Nurse First Assistant Fee Schedule, Effective January 1, 2013 2012
(rrr) Registered Nurse First Assistant Fee Schedule, Effective July 1, 2013
(sss) Visual Services Fee Schedule, Effective July 1, 2012 January 1, 2011; and
(ttt) Visual Services Fee Schedule, Effective January 1, 2013 2012
(uuu) Visual Services Fee Schedule, Effective July 1, 2013
(2) The fee schedules are available from the Medicaid fiscal agent’s Web site at http://mymedicaid-florida.com. Select Public Information for Providers, then Provider Support, and then Fee Schedules. Paper copies of the fee schedules may be obtained by calling the Provider Services Contact Center at 1-800-289-7799 and selecting Option 7.
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, ___________.
NAME OF PERSON ORIGINATING PROPOSED RULE: Fred Lawrence
NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Elizabeth Dudek
DATE PROPOSED RULE APPROVED BY AGENCY HEAD: January 16, 2014
DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: September 16, 2013
Document Information
- Comments Open:
- 2/27/2014
- Summary:
- The current amendment to Rule 59G-4.002, incorporates by reference the Florida Medicaid Provider Reimbursement Schedules including changes to the following: 1) practitioner procedure codes and fees, effective July 1, 2012; 2) practitioner procedure codes and fees, effective January 1, 2013; 3) practitioner procedure codes and fees, effective July 1, 2013; and 4) addition of physician primary care rate increase fee schedule, effective January 1, 2013 and July 1, 2013.
- Purpose:
- The purpose of the amendment to Rule 59G-4.002 is to record effective dates for practitioner codes and fees.
- Rulemaking Authority:
- 409.919 FS.
- Law:
- 409.902, 409.905, 409.906, 409.907, 409.908, 409.912, 409.913 FS.
- Contact:
- Fred Lawrence, Medicaid Services, 2727 Mahan Drive, Mail Stop 20, Tallahassee, Florida 32308-5407, telephone: 850-412-4208, e-mail: fred.lawrence@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. Comments will be received until 5:00 p.m. on Friday, March 28, 2014.
- Related Rules: (1)
- 59G-4.002. Medicaid Provider Reimbursement Schedule