Florida Administrative Code
59 - AGENCY FOR HEALTH CARE ADMINISTRATION
59G - Medicaid
Chapter 59G-4 - MEDICAID POLICY
Section 59G-4.002 - Provider Reimbursement Schedules and Billing Codes

Universal Citation: FL Admin Code R 59G-4.002

Current through Reg. 50, No. 249, December 24, 2024

(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.

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, 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.

Disclaimer: These regulations may not be the most recent version. Florida may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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