AGENCY FOR HEALTH CARE ADMINISTRATION
MedicaidRule No.: RULE TITLE
59G-4.160: Outpatient Hospital ServicesNOTICE OF CHANGE
Notice is hereby given that the following changes have been made to the proposed rule in accordance with subparagraph 120.54(3)(d)1., F.S., published in Vol. 36 No. 21, May 28, 2010 issue of the Florida Administrative Weekly.
The amendment to Rule 59G-4.160, Outpatient Hospital Services, incorporates by reference in rule the Florida Medicaid Hospital Services Coverage and Limitations Handbook, January 2010. A notice of change was published in the Vol. 36, No. 26, July 2, 2010 issue of the Florida Administrative Weekly. The following changes have been made to the handbook referenced in the Vol. 36, No. 26, July 2, 2010 issue of the Florida Administrative Weekly.
CHAPTER 2
Page 2-2 Medicaid Reimbursement: Delete the following paragraph:
In the outpatient hospital setting, the federal Emergency Medical Treatment and Labor Act (EMTALA) screening is reimbursed the Medicaid established technical component of $24, not the line item rate. This service is identified by revenue code 0451 and HCPCS 99281.
APPENDIX B: 045X EMERGENCY ROOM
Page B-7 0450 General Classification: The following bullets are changed to read:
● Use General Classification code 0450 when recipients require emergency room care beyond the EMTALA emergency medical screening services. Code 0450 cannot be used in conjunction with 0451(99281).
● All other appropriate and covered outpatient revenue codes can be billed with 0450 to reflect services rendered to the patient during the course emergency room treatment.
Page B-8 0451(99281) EMTALA Emergency Medical Screening Services (Effective 7/1/96).
The following bullet is changed to read:
● Report the EMTALA Medical Screening code 0451 (99281) when, following the screening and exam, no further emergency room care or treatment is necessary. If ancillary services are necessary to determine whether or not emergency care or further treatment is required, report the ancillary charges using the appropriate revenue center codes in conjunction with code 0451 (99281). Note that 0451(99281) cannot be used in conjunction with 0450.
The following bullet is deleted:
● The federal EMTALA screening is reimbursed the Medicaid established technical component of $24, not the line item rate.
