Fla. Admin. Code R. 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 Schedules Effective January 1, 2025:
1. (a) Assistive Care Services Fee Schedule
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18271"https://www.flrules.org/Gateway/reference.asp?No=Ref-18271.
2. (b) Behavior Analysis Fee Schedule
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18300"https://www.flrules.org/Gateway/reference.asp?No=Ref-18300.
3. (c) Behavioral Health Overlay Services Fee Schedule
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18352"https://www.flrules.org/Gateway/reference.asp?No=Ref-18352.
4. (d) Birth Center Fee Schedule
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18302"https://www.flrules.org/Gateway/reference.asp?No=Ref-18302.
5. (e) Community-Based Substance Abuse County Match Fee Schedule
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18304"https://www.flrules.org/Gateway/reference.asp?No=Ref-18304.
6. (f) Community Behavioral Health Services Fee Schedule
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18364"https://www.flrules.org/Gateway/reference.asp?No=Ref-18364.
7. (g) County Health Department Certified Match Program Fee Schedule
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18305"https://www.flrules.org/Gateway/reference.asp?No=Ref-18305.
8. (h) Dental General Fee Schedule
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18306"https://www.flrules.org/Gateway/reference.asp?No=Ref-18306.
9. (i) Durable Medical Equipment and Medical Supply Services Provider Fee Schedule for All Medicaid Recipients
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18307"https://www.flrules.org/Gateway/reference.asp?No=Ref-18307.
10. (j) Early Intervention Services Fee Schedule
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18308"https://www.flrules.org/Gateway/reference.asp?No=Ref-18308.
11. (k) Family Home Health Aide Services Fee Schedule
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18309"https://www.flrules.org/Gateway/reference.asp?No=Ref-18309.
12. (l) Hearing Services Fee Schedule
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18310"https://www.flrules.org/Gateway/reference.asp?No=Ref-18310.
13. (m) Home Health Visit Services Fee Schedule
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18311"https://www.flrules.org/Gateway/reference.asp?No=Ref-18311.
14. (n) Licensed Midwife Fee Schedule
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18313"https://www.flrules.org/Gateway/reference.asp?No=Ref-18313.
15. (o) Medicaid Certified School Match Program Fee Schedule
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18314"https://www.flrules.org/Gateway/reference.asp?No=Ref-18314.
16. (p) Medical Foster Care Services Fee Schedule
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18315"https://www.flrules.org/Gateway/reference.asp?No=Ref-18315.
17. (q) Occupational Therapy Services Fee Schedule
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18354"https://www.flrules.org/Gateway/reference.asp?No=Ref-18354.
18. (r) Personal Care Services Fee Schedule
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18317"https://www.flrules.org/Gateway/reference.asp?No=Ref-18317.
19. (s) Physical Therapy Fee Schedule
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18365"https://www.flrules.org/Gateway/reference.asp?No=Ref-18365.
20. (t) Physician Pediatric Surgery Fee Schedule
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18319"https://www.flrules.org/Gateway/reference.asp?No=Ref-18319.
21. (u) Prescribed Drugs Immunization Fee Schedule
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18322"https://www.flrules.org/Gateway/reference.asp?No=Ref-18322.
22. (v) Private Duty Nursing Services Fee Schedule
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18324"https://www.flrules.org/Gateway/reference.asp?No=Ref-18324.
23. (w) Radiology Fee Schedule
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18325"https://www.flrules.org/Gateway/reference.asp?No=Ref-18325.
24. (x) Regional Perinatal Intensive Care Center (RPICC) Neonatal Services Fee Schedule
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18326"https://www.flrules.org/Gateway/reference.asp?No=Ref-18326.
25. (y) Regional Perinatal Intensive Care Center (RPICC) Obstetrical Services Fee Schedule
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18327"https://www.flrules.org/Gateway/reference.asp?No=Ref-18327.
26. (z) Respiratory Therapy Services Fee Schedule
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18328"https://www.flrules.org/Gateway/reference.asp?No=Ref-18328.
27. (aa) Speech-Language Pathology Services Fee Schedule
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18362"https://www.flrules.org/Gateway/reference.asp?No=Ref-18362.
28. (bb) Transportation Services Fee Schedule
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18332"https://www.flrules.org/Gateway/reference.asp?No=Ref-18332.
29. (cc) Visual Services Fee Schedule
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18333"https://www.flrules.org/Gateway/reference.asp?No=Ref-18333.
(4) Florida Medicaid Fee Schedules Effective July 1, 2025:
1. (a) Independent Laboratory Fee Schedule
  HYPERLINK "https://flrules.org/Gateway/reference.asp?No=Ref-18822"https://flrules.org/Gateway/reference.asp?No=Ref-18822.
2. (b) Practitioner Fee Schedule
  HYPERLINK "https://flrules.org/Gateway/reference.asp?No=Ref-18628"https://flrules.org/Gateway/reference.asp?No=Ref-18628.
3. (c) Practitioner Laboratory Fee Schedule
  HYPERLINK "https://flrules.org/Gateway/reference.asp?No=Ref-18823"https://flrules.org/Gateway/reference.asp?No=Ref-18823.
4. (d) Prescribed Pediatric Extended Care Services Fee Schedule
  HYPERLINK "https://flrules.org/Gateway/reference.asp?No=Ref-18630"https://flrules.org/Gateway/reference.asp?No=Ref-18630.
(5) Florida Medicaid Fee Schedule Effective July 8, 2025:
Specialized Therapeutic Services Fee Schedule
HYPERLINK "https://flrules.org/Gateway/reference.asp?No=Ref-18631"https://flrules.org/Gateway/reference.asp?No=Ref-18631.
(6) Florida Medicaid Fee Schedules Effective October 1, 2025:
1. (a) Independent Laboratory Fee Schedule
  HYPERLINK "https://flrules.org/Gateway/reference.asp?No=Ref-18824"https://flrules.org/Gateway/reference.asp?No=Ref-18824.
2. (b) Practitioner Fee Schedule
  HYPERLINK "https://flrules.org/Gateway/reference.asp?No=Ref-18935"https://flrules.org/Gateway/reference.asp?No=Ref-18935.
3. (c) Practitioner Laboratory Fee Schedule
  HYPERLINK "https://flrules.org/Gateway/reference.asp?No=Ref-18825"https://flrules.org/Gateway/reference.asp?No=Ref-18825.
4. (d) Targeted Case Management Services Fee Schedule
  HYPERLINK "https://flrules.org/Gateway/reference.asp?No=Ref-18820"https://flrules.org/Gateway/reference.asp?No=Ref-18820.
(7) Florida Medicaid Billing Codes Effective January 1, 2025:
1. (a) County Health Department Billing Codes
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18334"https://www.flrules.org/Gateway/reference.asp?No=Ref-18334.
2. (b) Federally Qualified Health Center Billing Codes
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18335"https://www.flrules.org/Gateway/reference.asp?No=Ref-18335.
3. (c) Hospice Services Billing Codes
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18336"https://www.flrules.org/Gateway/reference.asp?No=Ref-18336.
4. (d) Hospital Outpatient Services Billing Codes
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18337"https://www.flrules.org/Gateway/reference.asp?No=Ref-18337.
5. (e) Intermediate Care Facility for Individuals with Intellectual Disabilities Services Billing Codes
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18338"https://www.flrules.org/Gateway/reference.asp?No=Ref-18338.
6. (f) Nursing Facility Services Billing Codes
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18358"https://www.flrules.org/Gateway/reference.asp?No=Ref-18358.
7. (g) Rural Health Clinic Billing Codes
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18341"https://www.flrules.org/Gateway/reference.asp?No=Ref-18341.
8. (h) Statewide Inpatient Psychiatric Program Services Billing Codes
  HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18359"https://www.flrules.org/Gateway/reference.asp?No=Ref-18359.
(8) Florida Medicaid Billing Codes Effective July 1, 2025:
Prescribed Drugs Physician Administered Billing Codes
HYPERLINK "https://flrules.org/Gateway/reference.asp?No=Ref-18629"https://flrules.org/Gateway/reference.asp?No=Ref-18629

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, 10-21-24, 8-24-25, 1-18-26.