Purpose


The purpose of the amendment to Rule 59G-4.003, F.A.C., is to incorporate by reference the Florida Medicaid Provider Reimbursement Handbook UB-04, June 2012. The handbook contains policies and instructions related to claims for reimbursement by certain, identified provider types. The policies and instructions are applicable to claims submitted on the UB-04 paper claim form, and to claims submitted electronically. The revisions contemplated include the following: additional billing instructions specifically for Nursing Facilities, Intermediate Care Facilities, and State Mental Hospitals; updated references for the new Medicaid fiscal agent; and updated prior-authorization requirements for certain diagnostic imaging procedures.