The purpose of the amendment to Rule 59G-4.002 is to incorporate by reference the Florida Medicaid Provider Reimbursement Schedules, _____________. The amendment updates the Florida Medicaid provider fee schedules.  

  •  

    AGENCY FOR HEALTH CARE ADMINISTRATION

    Medicaid

    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 incorporate by reference the Florida Medicaid Provider Reimbursement Schedules, ________. The amendment updates the Florida Medicaid provider fee schedules.

    SUBJECT AREA TO BE ADDRESSED: Medicaid Provider Reimbursement Schedules.

    An additional area to be addressed during the workshop will be the potential regulatory impact the amendment to Rule 59G-4.002, F.A.C., 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: Tuesday, October 1, 2013, 3:00 p.m. 4:00 p.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 DEVELOPMENT AND A COPY OF THE PRELIMINARY DRAFT 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 workshop at: http://ahca.myflorida.com/Medicaid/review/index.shtml

     

    THE PRELIMINARY TEXT OF THE PROPOSED RULE DEVELOPMENT 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:

    Advanced Registered Nurse Practitioner Fee Schedule, Effective July 1, 2012 January 1, 2011

    Advanced Registered Nurse Practitioner Fee Schedule, Effective January 1, 2013 2012

    Advanced Registered Nurse Practitioner Fee Schedule, Effective July 1, 2013

    Birthing Center Fee Schedule, Effective July 1, 2012 January 1, 2011

    Birthing Center Fee Schedule, Effective January 1, 2013 2012

    Birthing Center Fee Schedule, Effective July 1, 2013

    Chiropractic Services Fee Schedule, Effective July 1, 2012 January 1, 2011

    Chiropractic Services Fee Schedule, Effective January 1, 2013 2012

    Chiropractic Services Fee Schedule, Effective July 1, 2013

    Dental General Fee Schedule, Effective January 1, 2011

    Dental General Fee Schedule, Effective July 1, 2012 2011

    Dental General Fee Schedule, Effective January 1, 2013 2012

    Dental General Fee Schedule, Effective July 1, 2013

    Dental Injectables Fee Schedule, Effective July 1, 2012 January 1, 2011

    Dental Injectables Fee Schedule, Effective January 1, 2013 2012

    Dental Injectables Fee Schedule, Effective July 1, 2013

    Dental Oral/Maxillofacial Surgery Fee Schedule, Effective July 1, 2012 January 1, 2011

    Dental Oral/Maxillofacial Surgery Fee Schedule, January 1, 2013 2012

    Dental Oral/Maxillofacial Surgery Fee Schedule, July 1, 2013

    Hearing Services Fee Schedule, Effective July 1, 2012 January 1, 2011

    Hearing Services Fee Schedule, Effective January 1, 2013 2012

    Hearing Services Fee Schedule, Effective July 1, 2013

    Licensed Midwife Fee Schedule, Effective July 1, 2012 January 1, 2011

    Licensed Midwife Fee Schedule, Effective January 1, 2013 2012

    Licensed Midwife Fee Schedule, Effective July 1, 2013

    Optometric Optometry Services Fee Schedule, Effective July 1, 2012 January 1, 2011

    Optometric Services Fee Schedule, Effective January 1, 2013 2012

    Optometric Services Fee Schedule, Effective July 1, 2013

    Outpatient Hospital Laboratory Fee Schedule, Effective January 1, 2013 2010

    Physician Anesthesia Fee Schedule, Effective July 1, 2012 January 1, 2011

    Physician Anesthesia Fee Schedule, Effective January 1, 2013 2012

    Physician Anesthesia Fee Schedule, Effective July 1, 2013

    Physician Assistant Fee Schedule, Effective July 1, 2012 January 1, 2011

    Physician Assistant Fee Schedule, Effective January 1, 2013 2012

    Physician Assistant Fee Schedule, Effective July 1, 2013

    Physician Durable Medical Equipment Fee Schedule, Effective July 1, 2013

    Physician Evaluation and Management Fee Schedule, Effective July 1, 2012 January 1, 2011

    Physician Evaluation and Management Fee Schedule, Effective January 1, 2013 2012

    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

    Physician Immunization Fee Schedule, Effective July 1, 2012 October 1, 2011

    Physician Immunization Fee Schedule, Effective January 1, 2013 2012

    Physician Immunization Fee Schedule, Effective July 1, 2013

    Physician Laboratory Services Fee Schedule, Effective July 1, 2012 January 1, 2011

    Physician Laboratory Services Fee Schedule, Effective January 1, 2013 2012

    Physician Laboratory Services Fee Schedule, Effective July 1, 2013

    Physician Medical Fee Schedule, Effective July 1, 2012 January 1, 2011

    Physician Medical Fee Schedule, Effective January 1, 2013 2012

    Physician Medical Fee Schedule, Effective July 1, 2013

    Physician Pediatric Surgery Fee Schedule, Effective July 1, 2012 January 1, 2011

    Physician Pediatric Surgery Fee Schedule, Effective January 1, 2013 2012

    Physician Pediatric Surgery Fee Schedule, Effective July 1, 2013

    Physician Primary Care Rate Increase Fee Schedule, Effective January 1, 2013

    Physician Primary Care Rate Increase Fee Schedule, Effective July 1, 2013

    Physician Radiology Services Fee Schedule, Effective July 1, 2012 January 1, 2011

    Physician Radiology Services Fee Schedule, Effective January 1, 2013 2012

    Physician Radiology Services Fee Schedule, Effective July 1, 2013

    Physician Surgical Fee Schedule, Effective July 1, 2012 January 1, 2011

    Physician Surgical Fee Schedule, Effective January 1, 2013 2012

    Physician Surgical Fee Schedule, Effective July 1, 2013

    Podiatry Services Fee Schedule, Effective July 1, 2012 January 1, 2011

    Podiatry Fee Schedule, Effective January 1, 2013 2012

    Podiatry Fee Schedule, Effective July 1, 2013

    Regional Perinatal Intensive Care Center (RPICC) Neonatal Services Fee Schedule, Effective July 1, 2012 January 1, 2011

    Regional Perinatal Intensive Care Center (RPICC) Neonatal Services Fee Schedule, Effective January 1, 2013 2012

    Regional Perinatal Intensive Care Center (RPICC) Neonatal Services Fee Schedule, Effective July 1, 2013

    Regional Perinatal Intensive Care Centers (RPICC) Obstetrical Services Fee Schedule, Effective July 1, 2012 January 1, 2011

    Regional Perinatal Intensive Care Centers (RPICC) Obstetrical Services Fee Schedule, Effective January 1, 2013 2012

    Regional Perinatal Intensive Care Centers (RPICC) Obstetrical Services Fee Schedule, Effective July 1, 2013

    Registered Nurse First Assistant Fee Schedule, Effective July 1, 2012 January 1, 2011

    Registered Nurse First Assistant Fee Schedule, Effective January 1, 2013 2012

    Registered Nurse First Assistant Fee Schedule, Effective July 1, 2013

    Visual Services Fee Schedule, Effective July 1, 2012 January 1, 2011; and

    Visual Services Fee Schedule, Effective January 1, 2013 2012

    Visual Services Fee Schedule, Effective July 1, 2013

    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, ___________.

Document Information

Subject:
Medicaid Provider Reimbursement Schedules. An additional area to be addressed during the workshop will be the potential regulatory impact the amendment to Rule 59G-4.002 will have as provided for under sections 120.54 and 120.541, Florida Statutes.
Purpose:
The purpose of the amendment to Rule 59G-4.002 is to incorporate by reference the Florida Medicaid Provider Reimbursement Schedules, _____________. The amendment updates the Florida Medicaid provider fee schedules.
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 workshop at: http://ahca.myflorida.com/Medicaid/review/index.shtml.
Related Rules: (1)
59G-4.002. Medicaid Provider Reimbursement Schedule