The purpose of the amendment to Rule 59G-4.002, Florida Administrative Code, (F.A.C.), is to update fee schedules and billing codes 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 fee schedules and billing codes 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 10, 2020 from 10:30 a.m. 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: [e-mail]. 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: [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/fee_schedules.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 11, 2020. 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 Web site at http://ahca.myflorida.com/Medicaid/review/index.shtml.

(3) Florida Medicaid Fee Schedules Effective January 1, 2020 2019:

(a) Ambulatory Surgical Center Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10603.

(b) Assistive Care Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10604.

(c) Behavior Analysis Fee Schedule

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

(d)(c)Behavioral Health Overlay Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10605.

(e)(d) Birth Center Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10606.

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

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10607.

(g)(f) Community-Based Substance Abuse County Match Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10608.

(h)(g) Community Behavioral Health Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10609.

(i)(h) County Health Department Certified Match Program Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10610.

(j)(i) Dental General Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10611.

(k)(j) Durable Medical Equipment and Medical Supply Services Provider Fee Schedule for All Medicaid Recipients

https://www.flrules.org/Gateway/reference.asp?No=Ref-________10612.

(l)(k) Early Intervention Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-________10613.

(m)(l) Hearing Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-________10614.

(n)(m) Home Health Visit Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10615.

(o)(n) Independent Laboratory Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10616.

(p)(o) Licensed Midwife Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10617.

(q)(p) Medicaid Certified School Match Program Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10618.

(r)(q) Medical Foster Care Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10619.

(s)(r) Mental Health Targeted Case Management Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10620.

(t)(s) Occupational Therapy Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10621.

(u)(t) Outpatient Laboratory Fee Schedule (Formerly titled Physician and Outpatient Laboratory Fee Schedule)

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10622.

(v)(u) Personal Care Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10623.

(v) Physician Therapy Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-10624.

(w) Physical Therapy Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10625.

(x) Physician Pediatric Surgery Fee Schedule

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

(y)(x) Practitioner Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10626.

(z)(y) Practitioner Laboratory Fee Schedule (Formerly titled Physician and Outpatient Laboratory Fee Schedule)

https://www.flrules.org/Gateway/reference.asp?No=Ref-________10627.

(aa)(z) Prescribed Drugs Immunization Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-________10628.

(bb)(aa) Prescribed Drugs Oncology Physician Administered Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-________10629.

(cc)(bb) Prescribed Drugs Physcian Administered Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-________10630.

(dd)(cc) Prescribed Pediatric Extended Care Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10631.

(ee)(dd) Private Duty Nursing Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10632.

(ff)(ee) Radiology Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10633.

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

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10634.

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

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10635.

(ii)(hh) Respiratory Therapy Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10636.

(jj)(ii) Specialized Therapeutic Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10637.

(kk)(jj) Speech-Language Pathology Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10638.

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

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10639.

(mm)(ll) Transportation Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10640.

(nn)(mm) Visual Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10641.

(4) Florida Medicaid Fee Schedules Effective January 1, 2018

Behavior Analysis Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-09186.

(4)(5) Florida Medicaid Billing Codes Effective January 1, 2020 2019:

(a) County Health Department Billing Codes

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10642.

(b) Federally Qualified Health Center Billing Codes

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10643.

(c) Hospice Services Billing Codes

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10644.

(d) Hospital Outpatient Services Billing Codes

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10645.

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

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10646.

(f) Nursing Facility Services Billing Codes

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10647.

(g) Rural Health Clinic Billing Codes

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10648.

(h) Statewide Inpatient Psychiatric Program Services Billing Codes

https://www.flrules.org/Gateway/reference.asp?No=Ref-_______10649.

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, 2-8-18, 5-7-18, 1-7-19, 7-17-19,_______.