59G-4.002 : Provider Reimbursement Schedules and Billing Codes - Florida Administrative Rules, Law, Code, Register

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Rule Title: Provider Reimbursement Schedules and Billing Codes
Department:	AGENCY FOR HEALTH CARE ADMINISTRATION	Add to MyFLRules Favorites
Division:	Medicaid
Chapter:	MEDICAID POLICY

Latest version of the final adopted rule presented in Florida Administrative Code (FAC):

	Effective Date:	12/31/2023
	History Notes:	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, 12-15-20, 9-29-21, 8-2-22, 12-31-23.
	References in this version:	Ref-14539 Behavior Analysis Fee Schedule Ref-14543 Community-Based Substance Abuse County Match Fee Schedule Ref-14545 County Health Department Certified Match Program Fee Schedule Ref-14547 Durable Medical Equipment and Medical Supply Services Provider Fee Schedule for All Medicaid Recipients Ref-14548 Early Intervention Services Fee Schedule Ref-14553 Medicaid Certified School Match Program Fee Schedule Ref-14559 Physician Pediatric Surgery Fee Schedule Ref-14562 Prescribed Drugs Immunization Fee Schedule Ref-14566 Regional Perinatal Intensive Care Center (RPICC) Neonatal Services Fee Schedule Ref-14567 Regional Perinatal Intensive Care Center (RPICC) Obstetrical Services Fee Schedule Ref-16089 Assistive Care Services Fee Schedule 2022 JULY Ref-16090 Behavioral Health Overlay Services Fee Schedule 2022 JULY Ref-16091 Birth Center Fee Schedule 2022 JULY Ref-16092 Community Behavioral Health Services Fee Schedule 2022 JULY Ref-16093 Dental General Fee Schedule 2022 JULY Ref-16094 Hearing Services Fee Schedule 2022 JULY Ref-16095 Home Health Visit Services Fee Schedule 2022 JULY Ref-16096 Independent Laboratory Fee Schedule JULY 2022 Ref-16097 Licensed Midwife Fee Schedule 2022 JULY Ref-16098 Medical Foster Care Services Fee Schedule 2022 JULY Ref-16099 Occupational Therapy Fee Schedule 2022 JULY Ref-16100 Personal Care Services Fee Schedule 2022 JULY Ref-16101 Physical Therapy Services Fee Schedule 2022 JULY Ref-16102 Practitioner Fee Schedule 2022 JULY Ref-16103 Practitioner Laboratory Fee Schedule 2022 JULY Ref-16104 Prescribed Pediatric Extended Care Services Fee Schedule 2022 JULY Ref-16105 Private Duty Nursing Services Fee Schedule 2022 JULY Ref-16106 Radiology Fee Schedule 2022 JULY Ref-16107 Respiratory Therapy Services Fee Schedule 2022 JULY Ref-16108 Specialized Therapeutic Services Fee Schedule 2022 JULY Ref-16109 Speech-Language Pathology Services Fee Schedule 2022 JULY Ref-16110 Targeted Case Management Services Fee Schedule 2022 JULY Ref-16111 Transportation Services Fee Schedule 2022 JULY Ref-16112 Visual Services Fee Schedule 2022 JULY Ref-16113 Assistive Care Services Fee Schedule 2023 Ref-16114 Behavior Analysis Fee Schedule 2023 Ref-16115 Behavioral Health Overlay Services Fee Schedule 2023 Ref-16116 Birth Center Fee Schedule 2023 Ref-16117 Community-Based Substance Abuse County Match Fee Schedule 2023 Ref-16118 Community Behavioral Health Services Fee Schedule 2023 Ref-16119 Dental General Fee Schedule 2023 Ref-16120 Durable Medical Equipment and Medical Supply Services Provider Fee Schedule for All Medicaid Recipients 2023 Ref-16121 Early Intervention Services Fee Schedule 2023 Ref-16122 Hearing Services Fee Schedule 2023 Ref-16123 Home Health Visit Services Fee Schedule 2023 Ref-16124 Independent Laboratory Fee Schedule 2023 Ref-16125 Licensed Midwife Fee Schedule 2023 Ref-16126 Medicaid Certified School Match Program Fee Schedule 2023 Ref-16127 Medical Foster Care Services Fee Schedule 2023 Ref-16128 Occupational Therapy Services Fee Schedule 2023 Ref-16129 Personal Care Services Fee Schedule 2023 Ref-16130 Physical Therapy Services Fee Schedule 2023 Ref-16131 Physician Pediatric Surgery Fee Schedule 2023 Ref-16132 Practitioner Fee Schedule 2023 Ref-16133 Practitioner Laboratory Fee Schedule 2023 Ref-16134 Prescribed Drugs Immunization Fee Schedule 2023 Ref-16135 Prescribed Pediatric Extended Care Services Fee Schedule 2023 Ref-16136 Private Duty Nursing Services Fee Schedule 2023 Ref-16137 Radiology Fee Schedule 2023 Ref-16138 Regional Perinatal Intensive Care Center (RIPCC) Neonatal Services Fee Schedule 2023 Ref-16139 Regional Perinatal Intensive Care Center (RIPCC) Obstetrical Services Fee Schedule 2023 Ref-16140 Respiratory Therapy Services Fee Schedule 2023 Ref-16141 Specialized Therapeutic Services Fee Schedule 2023 Ref-16142 Speech-Language Pathology Services Fee Schedule 2023 Ref-16143 Targeted Case Management Services Fee Schedule 2023 Ref-16144 Transportation Services Fee Schedule 2023 Ref-16145 Visual Services Fee Schedule 2023 Ref-16147 County Health Department Billing Codes 2023 Ref-16148 Federally Qualified Health Center Billing Codes 2023 Ref-16149 Hospice Services Billing Codes 2023 Ref-16150 Hospital Outpatient Services Billing Codes 2023 Ref-16151 Intermediate Care Facility for Individuals with Intellectual Disabilities Services Billing Codes 2023 Ref-16152 Nursing Facility Billing Codes 2023 Ref-16153 Prescribed Drugs Physician Administered Billing Codes 2023 Ref-16154 Rural Health Clinic Billing Codes 2023 Ref-16155 Statewide Inpatient Psychiatric Program Services Billing Codes 2023 Ref-16157 County Health Department Certified Match Program Fee Schedule_2023

History of this Rule since Jan. 6, 2006

Section	Description	ID	Publish Date

Correction 59G-4.002	Provider Reimbursement Schedules and Billing Codes	28256699	4/11/2024 Vol. 50/72
Development 59G-4.002	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. The amendment revises the Florida Medicaid provider fee schedules ....	28222652	4/2/2024 Vol. 50/65
Final 59G-4.002	Provider Reimbursement Schedules and Billing Codes	27852694	Effective: 12/31/2023
Change 59G-4.002	Provider Reimbursement Schedules and Billing Codes	27727661	11/2/2023 Vol. 49/214
Proposed 59G-4.002	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.	27449271	8/16/2023 Vol. 49/159
Development 59G-4.002	The purpose of the amendment to Rule 59G-4.002 is to update fee schedules and billing codes in the existing rule. The amendment revises the Florida Medicaid provider fee schedules and billing codes.	27008018	3/31/2023 Vol. 49/63
Development 59G-4.002	The purpose of the amendment to Rule 59G-4.002 is to update fee schedules and billing codes in the existing rule. The amendment revises the Florida Medicaid provider fee schedules and billing codes.	26939051	3/21/2023 Vol. 49/55
Final 59G-4.002	Provider Reimbursement Schedules and Billing Codes	26076721	Effective: 08/02/2022
Correction 59G-4.002	Provider Reimbursement Schedules and Billing Codes	26014253	6/28/2022 Vol. 48/125
Proposed 59G-4.002	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.	25877289	5/19/2022 Vol. 48/98
Development 59G-4.002	The purpose of the amendment to Rule 59G-4.002 is to update fee schedules and billing codes in the existing rule. The amendment revises the Florida Medicaid provider fee schedules and billing codes.	25674171	3/17/2022 Vol. 48/53
Final 59G-4.002	Provider Reimbursement Schedules and Billing Codes	25004483	Effective: 09/29/2021
Proposed 59G-4.002	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.	24742098	7/12/2021 Vol. 47/133
Development 59G-4.002	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.	24431213	4/19/2021 Vol. 47/75
Final 59G-4.002	Provider Reimbursement Schedules and Billing Codes	23946310	Effective: 12/15/2020
Variances 59G-4.002	On August 11, 2020, the Agency for Health Care Administration, received a petition for Variance from or Waiver of Rules 59G-13.081 and 59G-4.002 from Petitioner, C.R. Florida Administrative Code Rule 59G-13.081 incorporates ....	23900623	11/18/2020 Vol. 46/225
Change 59G-4.002	Provider Reimbursement Schedules and Billing Codes	23785290	10/21/2020 Vol. 46/206
Proposed 59G-4.002	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.	23584306	8/28/2020 Vol. 46/169
Variances 59G-4.002	Variance from or Waiver of Rules 59G-13.081 and 59G-4.002 from Petitioner, C.R. Florida Administrative Code Rule 59G-13.081 incorporates by reference into rule the Florida Medicaid Developmental Disabilities Individual Budgeting ....	23527464	8/13/2020 Vol. 46/158
Development 59G-4.002	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.	22856806	1/24/2020 Vol. 46/16
Final 59G-4.002	Provider Reimbursement Schedules and Billing Codes	22077217	Effective: 07/17/2019
Proposed 59G-4.002	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.	21750036	4/17/2019 Vol. 45/75
Final 59G-4.002	Provider Reimbursement Schedules and Billing Codes	21294039	Effective: 01/07/2019
Development 59G-4.002	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.	21304030	12/28/2018 Vol. 44/251
Proposed 59G-4.002	The purpose of the amendment to Rule 59G-4.002, Florida Administrative Code, (F.A.C.), is to update fee schedules and billing codes.	21106635	10/31/2018 Vol. 44/213
Development 59G-4.002	The purpose of the amendment to Rule 59G-4.002, Florida Administrative Code, (F.A.C.), is to update fee schedules and billing codes. The amendment revises the January 1, 2018 Practitioner Fee Schedule, Practitioner Laboratory ....	20571486	6/22/2018 Vol. 44/122
Final 59G-4.002	Provider Reimbursement Schedules and Billing Codes	20333157	Effective: 05/07/2018
Change 59G-4.002	Provider Reimbursement Schedules and Billing Codes	20221898	3/27/2018 Vol. 44/60
Proposed 59G-4.002	The purpose of the amendment to Rule 59G-4.002, Florida Administrative Code, (F.A.C.), is to update fee schedule information in the existing rule.	20103461	2/23/2018 Vol. 44/38
Development 59G-4.002	The purpose of the amendment to Rule 59G-4.002, Florida Administrative Code, (F.A.C.), is to update the fee schedule information in the existing rule.	20056610	2/12/2018 Vol. 44/29
Final 59G-4.002	Provider Reimbursement Schedules and Billing Codes	19983181	Effective: 02/08/2018
Change 59G-4.002	Provider Reimbursement Schedules and Billing Codes	19881234	12/27/2017 Vol. 43/248
Public Hearing 59G-4.002	The Agency is scheduling an additional hearing for the purpose of discussing Provider Reimbursement Schedules and Billing Codes. December 21, 2017 from 2:00 p.m. to 2:30 p.m. Agency for Health Care Administration, 2727 Mahan Drive, Building ....	19837002	12/14/2017 Vol. 43/240
Proposed 59G-4.002	The purpose of the amendment to Rule 59G-4.002, Florida Administrative Code, (F.A.C.), is to update fee schedule information in the existing rule.	19754940	11/20/2017 Vol. 43/224
Development 59G-4.002	The purpose of the amendment to Rule 59G-4.002, Florida Administrative Code, (F.A.C.), is to update fee schedule information in the existing rule. The amendment adds the Respiratory Therapy Services Fee Schedule and revises ....	19461418	9/28/2017 Vol. 43/188
Final 59G-4.002	Provider Reimbursement Schedules and Billing Codes	19052757	Effective: 06/22/2017
Proposed 59G-4.002	The purpose of the amendment to Rule 59G-4.002 is to incorporate by reference the Florida Medicaid provider reimbursement schedules and billing codes.	18798617	4/4/2017 Vol. 43/65
Development 59G-4.002	The purpose of the amendment to Rule 59G-4.002 is to incorporate by reference the Florida Medicaid provider reimbursement schedules and billing codes. The amendment records effective dates for reimbursement schedules for ....	18062193	9/29/2016 Vol. 42/190
Final 59G-4.002	Provider Reimbursement Schedules and Billing Codes	17625111	Effective: 06/20/2016
Change 59G-4.002	Medicaid Provider Reimbursement Schedules	17508614	5/9/2016 Vol. 42/90
Change 59G-4.002	Medicaid Provider Reimbursement Schedules	17478059	4/29/2016 Vol. 42/84
Hearing 59G-4.002	Medicaid Provider Reimbursement Schedules	17300355	3/17/2016 Vol. 42/53
Hearing 59G-4.002	Medicaid Provider Reimbursement Schedules	17123427	2/5/2016 Vol. 42/24
Proposed 59G-4.002	The purpose of the amendment to Rule 59G-4.002 is to incorporate by reference the Florida Medicaid provider reimbursement schedules and billing codes.	17029531	1/13/2016 Vol. 42/08
Withdrawal 59G-4.002	Medicaid Provider Reimbursement Schedules	16732420	11/5/2015 Vol. 41/216
Proposed 59G-4.002	The purpose of the amendment to Rule 59G-4.002 is to incorporate by reference the Florida Medicaid provider reimbursement schedules and billing codes.	16708364	11/2/2015 Vol. 41/213
Development 59G-4.002	The purpose of the amendment to Rule 59G-4.002 is to incorporate by reference the Florida Medicaid Provider Reimbursement Schedules. The amendment records effective dates for reimbursement schedules and the addition of two ....	14603367	5/22/2014 Vol. 40/100
Final 59G-4.002	Medicaid Provider Reimbursement Schedules	14521693	Effective: 05/21/2014
Proposed 59G-4.002	The purpose of the amendment to Rule 59G-4.002 is to record effective dates for practitioner codes and fees.	14240005	2/27/2014 Vol. 40/40
Development 59G-4.002	The purpose of the amendment to Rule 59G-4.002 is to incorporate by reference the Florida Medicaid Provider Reimbursement Schedules, _____________. The amendment updates the Florida Medicaid provider fee schedules.	13513087	9/16/2013 Vol. 39/180
Final 59G-4.002	Medicaid Provider Reimbursement Schedules	13195412	Effective: 07/16/2013
Change 59G-4.002	Medicaid Provider Reimbursement Schedule	13011985	5/16/2013 Vol. 39/96
Change 59G-4.002	Medicaid Provider Reimbursement Schedule	12653861	2/18/2013 Vol. 39/33
Public Hearing 59G-4.002	The Agency is scheduling a hearing in Tallahassee, FL for the purpose of discussing the Florida Medicaid provider reimbursement fee schedules. .... Wednesday, December 19, 2012 from 3:00 p.m. to 4:00 p.m. Agency for Health Care Administration, 2727 Mahan Drive, Building ....	12377314	12/12/2012 Vol. 38/89
Change 59G-4.002	Medicaid Provider Reimbursement Schedule	11966616	9/7/2012 Vol. 38/36
Proposed 59G-4.002	The proposed rule amends Rule 59G-4.002, F.A.C. The purpose of the rule amendment is to record effective dates for practitioner procedure codes and fees. The rule amendment also excludes injectable medications from the ....	11563484	6/1/2012 Vol. 38/22
Development 59G-4.002	The amendment to Rule 59G-4.002, F.A.C., incorporates by reference the Florida Medicaid Provider Reimbursement Schedule, January 1, 2011. The reimbursement schedule contains the procedure codes and maximum fees that are ....	10108096	7/15/2011 Vol. 37/28
Development 59G-4.002	The amendment to Rule 59G-4.002, F.A.C., incorporates by reference the Florida Medicaid Provider Reimbursement Schedule, January 1, 2011. The reimbursement schedule contains the procedure codes and maximum fees that are ....	9995770	6/10/2011 Vol. 37/23
Final 59G-4.002	Medicaid Provider Reimbursement Schedule	9608740	Effective: 01/31/2011
Proposed 59G-4.002	The amendment to Rule 59G-4.002, F.A.C., incorporates by reference the Florida Medicaid Provider Reimbursement Schedule, January 1, 2010. The amendment to Rule 59G-4.002, F.A.C., will permit the Agency to implement revisions ....	9242177	10/15/2010 Vol. 36/41
Development 59G-4.002	The amendment to Rule 59G-4.002, F.A.C., incorporates by reference the Florida Medicaid Provider Reimbursement Schedule, January 1, 2010. The reimbursement schedule contains the procedure codes and maximum fees that are ....	8886769	7/23/2010 Vol. 36/29
Final 59G-4.002	Medicaid Provider Reimbursement Schedule	8224841	Effective: 02/11/2010
Proposed 59G-4.002	The amendment to Rule 59G-4.002, F.A.C., incorporates by reference the Florida Medicaid Provider Reimbursement Schedule, March 2009. The effect of the amendment to Rule 59G-4.002, F.A.C., will permit the Agency to implement ....	7885535	11/6/2009 Vol. 35/44
Final 59G-4.002	Medicaid Provider Reimbursement Schedule	7036979	Effective: 04/28/2009
Development 59G-4.002	Rule 59G-4.002, F.A.C., incorporates by reference the Florida Medicaid Provider Reimbursement Schedule, March 2009. The reimbursement schedule contains the procedure codes and maximum fees that are effective March 2009 for ....	6828235	2/27/2009 Vol. 35/08
Proposed 59G-4.002	Rule 59G-4.002, F.A.C., incorporates by reference the Florida Medicaid Provider Reimbursement Schedule, July 2008. The reimbursement schedule contains the procedure codes and maximum fees that are effective July 2008 for ....	6741808	2/6/2009 Vol. 35/05
Development 59G-4.002	Rule 59G-4.002, F.A.C., incorporates by reference the Florida Medicaid Provider Reimbursement Schedule, July 2008. The reimbursement schedule contains the procedure codes and maximum fees that are effective July 2008 for ....	6249339	10/10/2008 Vol. 34/41
Final 59G-4.002	Medicaid Provider Reimbursement Schedule	6174358	Effective: 09/29/2008
Proposed 59G-4.002	The amendment to Rule 59G-4.002, F.A.C., incorporates by reference the Florida Medicaid Provider Reimbursement Schedule, January 2008. The reimbursement schedule contains the procedure codes and maximum fees that are effective ....	5737858	6/13/2008 Vol. 34/24
Development 59G-4.002	Rule 59G-4.002, F.A.C., incorporates by reference the Florida Medicaid Provider Reimbursement Schedule, January 2008. The reimbursement schedule contains the procedure codes and maximum fees that are effective January 2008 ....	5296508	2/29/2008 Vol. 34/09
Final 59G-4.002	Medicaid Provider Reimbursement Schedule	4372195	Effective: 07/25/2007
Proposed 59G-4.002	The amendment to Rule 59G-4.002, F.A.C., incorporates by reference the Florida Medicaid Provider Reimbursement Schedule, January 2007. The reimbursement schedule contains the procedure codes and maximum fees that are effective ....	4062377	4/27/2007 Vol. 33/17
Final 59G-4.002	Medicaid Provider Reimbursement Schedule	3915519	Effective: 03/27/2007
Development 59G-4.002	Rule 59G-4.002 incorporates by reference the Florida Medicaid Provider Reimbursement Schedule, January 2007. The reimbursement schedule contains the procedure codes and maximum fees that are effective January 2007 for the ....	3807655	2/23/2007 Vol. 33/08
Proposed 59G-4.002	The purpose of this rule amendment is to incorporate by reference Update July 2006 to the Florida Medicaid Provider Reimbursement Schedule. The update contains the fees for the reinstated hearing, optometric, visual, and ....	3378721	1/12/2007 Vol. 33/02
Development 59G-4.002	The purpose of this rule amendment is to incorporate by reference Update July 2006 to the Florida Medicaid Provider Reimbursement Schedule. The update contains the fees for the reinstated hearing, optometric, visual, and ....	3130110	11/3/2006 Vol. 32/44
Final 59G-4.002	Medicaid Provider Reimbursement Schedule	3051152	Effective: 10/11/2006
Proposed 59G-4.002	The purpose of this rule amendment is to incorporate by reference errata January 2006 to the Florida Medicaid Provider Reimbursement Schedule. The errata contain corrections to the Hearing Services Fee Schedule, Podiatry ....	470564	7/7/2006 Vol. 32/27
Development 59G-4.002	The purpose of this rule amendment is to incorporate by reference errata January 2006 to the Florida Medicaid Provider Reimbursement Schedule. The errata contain corrected fees for the Hearing Services Fee Schedule and ....	344173	5/19/2006 Vol. 32/20
Final 59G-4.002	Medicaid Provider Reimbursement Schedule	1845345	Effective: 04/16/2006
Proposed 59G-4.002	The amendment to Rule 59G-4.002, F.A.C., incorporates by reference the Florida Medicaid Provider Reimbursement Schedule, January 2006. The reimbursement schedule contains the procedure codes and maximum fees that are effective ....	34549	1/20/2006 Vol. 32/03

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