Medicaid Provider Reimbursement Schedule

 

AGENCY FOR HEALTH CARE ADMINISTRATION
Medicaid

RULE NO.: RULE TITLE:
59G-4.002: Medicaid Provider Reimbursement Schedule

NOTICE 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. 38, No. 22, June 1, 2012 issue of the Florida Administrative Weekly.

The following changes have been made to the proposed rule.

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

59G-4.002 Medicaid Provider Reimbursement Schedule.

(1) Medicaid providers who provide the following services and their billing agents who submit claims on behalf of an enrolled Medicaid provider must be in compliance with the provisions of the Florida Medicaid Provider Reimbursement Schedule 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. Rule 59G-4.002 incorporates by reference changes to the Florida Medicaid Provider Reimbursement Schedule for the following services: practitioner procedure codes and fees, effective January 1, 2011, practitioner procedure codes and fees, effective January 1, 2012, fees for general dental services, effective July 1, 2011, physician immunization fees, effective April 1, 2011, and physician immunization fees, effective October 1, 2011.

(2) The following fee schedules are incorporated by reference: Advanced Registered Nurse Practitioner Fee Schedule, Effective January 1, 2011 and January 1, 2012; Birthing Center Fee Schedule, Effective January 1, 2011 and January 1, 2012; Chiropractic Services Fee Schedule, Effective January 1, 2011 and January 1, 2012; Dental General Fee Schedule, Effective January 1, 2011, July 1, 2011, and January 1, 2012; Dental Oral/Maxillofacial Surgery Fee Schedule, Effective January 1, 2011 and January 1, 2012; Dental Injectables Fee Schedule, Effective January 1, 2011 and January 1, 2012; Hearing Services Fee Schedule, Effective January 1, 2011 and January 1, 2012; Licensed Midwife Fee Schedule, Effective January 1, 2011 and January 1, 2012; Optometry Services Fee Schedule, Effective January 1, 2011 and January 1, 2012; Outpatient Hospital Laboratory Services Fee Schedule, Effective January 1, 2010; Physician Anesthesia Fee Schedule, Effective January 1, 2011 and January 1, 2012; Physician Assistant Fee Schedule, Effective January 1, 2011 and January 1, 2012; Physician Evaluation and Management Fee Schedule, Effective January 1, 2011 and January 1, 2012; Physician Immunization Fee Schedule, Effective January 1, 2011, April 1, 2011, October 1, 2011, and January 1, 2012; Physician Laboratory Services Fee Schedule, Effective January 1, 2011 and January 1, 2012; Physician Medical Fee Schedule, Effective January 1, 2011 and January 1, 2012; Physician Pediatric Fee Schedule, Effective January 1, 2011 and January 1, 2012; Physician Radiology Services Fee Schedule, Effective January 1, 2011 and January 1, 2012; Physician Surgical Fee Schedule, Effective January 1, 2011 and January 1, 2012; Podiatry Services Fee Schedule, Effective January 1, 2011 and January 1, 2012; Regional Perinatal Care Centers (RPICC) Neonatal Services Fee Schedule, Effective January 1, 2011 and January 1, 2012; Regional Perinatal Care Centers (RPICC) Obstetrical Services Fee Schedule, Effective January 1, 2011 and January 1, 2012; Registered Nurse First Assistant Fee Schedule, Effective January 1, 2011 and January 1, 2012; and Visual Services Fee Schedule, Effective January 1, 2011 and January 1, 2012.

The fee schedules Florida Medicaid Provider Reimbursement Schedule are is available from the Medicaid fiscal agent’s Web site at www. mymedicaid-florida.com. Select Public Information for Providers, then Provider Support, and then Fee Schedules. Paper copies of the fee schedules reimbursement schedule may be obtained by calling the Provider Contact Center at [phone] 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,_________.