Statutes, codes, and regulations
Florida Administrative Code
Department 59 - AGENCY FOR HEALTH CARE ADMINISTRATIONDivision 59G - Medicaid
Chapter 59G-4 - MEDICAID POLICY
Section 59G-4.002 - Provider Reimbursement Schedules and Billing Codes

Fla. Admin. Code R. 59G-4.002

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Current through Reg. 50, No. 235-239, December 10, 2024
Section 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 website at http://ahca.myflorida.com/Medicaid/review/index.shtml.
(3) Florida Medicaid Fee Schedule Effective January 1, 2023: Practitioner Laboratory Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-16990.

(4) Florida Medicaid Fee Schedule Effective October 1, 2023: Prescribed Drugs Immunization Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-16991.

(5) Florida Medicaid Fee Schedules Effective January 1, 2024:
(a) Assistive Care Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-16992.

(b) Behavior Analysis Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-16993.

(c) Behavioral Health Overlay Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-16994.

(d) Birth Center Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-16995.

(e) Community-Based Substance Abuse County Match Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-16996.

(f) Community Behavioral Health Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-16997.

(g) County Health Department Certified Match Program Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-16998.

(h) Dental General Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-16999.

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

https://www.flrules.org/Gateway/reference.asp?No=Ref-17000.

(j) Early Intervention Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-17001.

(k) Hearing Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-17002.

(l) Home Health Visit Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-17003.

(m) Independent Laboratory Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-17004.

(n) Licensed Midwife Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-17005.

(o) Medicaid Certified School Match Program Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-17006.

(p) Medical Foster Care Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-17007.

(q) Occupational Therapy Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-17008.

(r) Personal Care Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-17009.

(s) Physical Therapy Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-17010.

(t) Physician Pediatric Surgery Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-17011.

(u) Practitioner Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-17012.

(v) Practitioner Laboratory Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-17013.

(w) Prescribed Drugs Immunization Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-17014.

(x) Prescribed Pediatric Extended Care Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-17015.

(y) Private Duty Nursing Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-17016.

(z) Radiology Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-17017.

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

https://www.flrules.org/Gateway/reference.asp?No=Ref-17027.

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

https://www.flrules.org/Gateway/reference.asp?No=Ref-17028.

(cc) Respiratory Therapy Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-17029.

(dd) Specialized Therapeutic Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-17030.

(ee) Speech-Language Pathology Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-17031.

(ff) Targeted Case Management Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-17032.

(gg) Transportation Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-17033.

(hh) Visual Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-17034.

(6) Florida Medicaid Billing Codes Effective January 1, 2024:
(a) County Health Department Billing Codes

https://www.flrules.org/Gateway/reference.asp?No=Ref-17035.

(b) Federally Qualified Health Center Billing Codes

https://www.flrules.org/Gateway/reference.asp?No=Ref-17036.

(c) Hospice Services Billing Codes

https://www.flrules.org/Gateway/reference.asp?No=Ref-17037.

(d) Hospital Outpatient Services Billing Codes

https://www.flrules.org/Gateway/reference.asp?No=Ref-17038.

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

https://www.flrules.org/Gateway/reference.asp?No=Ref-17039.

(f) Nursing Facility Services Billing Codes

https://www.flrules.org/Gateway/reference.asp?No=Ref-17040.

(g) Prescribed Drugs Physician Administered Billing Codes

https://www.flrules.org/Gateway/reference.asp?No=Ref-17041.

(h) Rural Health Clinic Billing Codes

https://www.flrules.org/Gateway/reference.asp?No=Ref-17042.

(i) Statewide Inpatient Psychiatric Program Services Billing Codes

https://www.flrules.org/Gateway/reference.asp?No=Ref-17043.

(6) This rule is in effect for five years from its effective date.

Fla. Admin. Code Ann. R. 59G-4.002

Rulemaking Authority 409.919 FS. Law Implemented 409.902, 409.905, 409.906, 409.907, 409.908, 409.912, 409.913 FS.

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, Amended by Florida Register Volume 42, Number 110, June 7, 2016 effective 6/20/2016, Amended by Florida Register Volume 43, Number 109, June 6, 2017 effective 6/22/2017, Amended by Florida Register Volume 44, Number 015, January 23, 2018 effective 2/8/2018, Amended by Florida Register Volume 44, Number 080, April 24, 2018 effective 5/7/2018, Amended by Florida Register Volume 44, Number 249, December 26, 2018 effective 1/7/2019, Amended by Florida Register Volume 45, Number 128, July 2, 2019 effective 7/17/2019, Amended by Florida Register Volume 46, Number 232, December 1, 2020 effective 12/15/2020, Amended by Florida Register Volume 47, Number 178, September 14, 2021 effective 9/29/2021, Amended by Florida Register Volume 48, Number 139, July 19, 2022 effective 8/2/2022, Amended by Florida Register Volume 49, Number 244, December 19, 2023 effective 12/31/2023, Amended by Florida Register Volume 50, Number 197, October 8, 2024 effective 10/21/2024.

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, 12-15-20, 9-29-21, 8-2-22, 12-31-23.