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:	10/21/2024
	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, 10-21-24.
	References in this version:	Ref-16990 Practitioner Laboratory Fee Schedule 1.1.2023 Ref-16991 Prescribed Drugs Immunization Fee Schedule 10.1.2023 Ref-16992 Assistive Care Services Fee Schedule 2024 Ref-16993 Behavior Analysis Fee Schedule 2024 Ref-16994 Behavioral Health Overlay Services Fee Schedule 2024 Ref-16995 Birth Center Fee Schedule 2024 Ref-16996 Community-Based Substance Abuse County Match Fee Schedule 2024 Ref-16997 Community Behavioral Health Services Fee Schedule 2024 Ref-16998 County Health Department Certified Match Program Services Fee Schedule 2024 Ref-16999 Dental General Fee Schedule 2024 Ref-17000 Durable Medical Equipment and Medical Supply Services Provider Fee Schedule for All Medicaid Recipients 2024 Ref-17001 Early Intervention Services Fee Schedule 2024 Ref-17002 Hearing Services Fee Schedule 2024 Ref-17003 Home Health Visit Services Fee Schedule 2024 Ref-17004 Independent Laboratory Fee Schedule 2024 Ref-17005 Licensed Midwife Fee Schedule 2024 Ref-17006 Medicaid Certified School Match Program Fee Schedule 2024 Ref-17007 Medical Foster Care Services Fee Schedule 2024 Ref-17008 Occupational Therapy Services Fee Schedule 2024 Ref-17009 Personal Care Services Fee Schedule 2024 Ref-17010 Physical Therapy Fee Schedule 2024 Ref-17011 Physician Pediatric Surgery Fee Schedule 2024 Ref-17012 Practitioner Fee Schedule 2024 Ref-17013 Practitioner Laboratory Fee Schedule 2024 Ref-17014 Prescribed Drugs Immunization Fee Schedule 2024 Ref-17015 Prescribed Pediatric Extended Care Services Fee Schedule 2024 Ref-17016 Private Duty Nursing Services Fee Schedule 2024 Ref-17017 Radiology Fee Schedule 2024 Ref-17027 Regional Perinatal Intensive Care Center (RIPCC) Neonatal Services Fee Schedule 2024 Ref-17028 Regional Perinatal Intensive Care Center (RIPCC) Obstetrical Services Fee Schedule 2024 Ref-17029 Respiratory Therapy Services Fee Schedule 2024 Ref-17030 Specialized Therapeutic Services Fee Schedule 2024 Ref-17031 Speech-Language Pathology Services Fee Schedule 2024 Ref-17032 Targeted Case Management Services Fee Schedule 2024 Ref-17033 Transportation Services Fee Schedule 2024 Ref-17034 Visual Services Fee Schedule 2024 Ref-17035 County Health Department Billing Codes 2024 Ref-17036 Federally Qualified Health Center Billing Codes 2024 Ref-17037 Hospice Services Billing Codes 2024 Ref-17038 Hospital Outpatient Services Billing Codes 2024 Ref-17039 Intermediate Care Facility for Individuals with Intellectual Disabilities Services Billing Codes 2024 Ref-17040 Nursing Facility Services Billing Codes 2024 Ref-17041 Prescribed Drugs Physician Administered Billing Codes 2024 Ref-17042 Rural Health Clinic Billing Codes 2024 Ref-17043 Statewide Inpatient Psychiatric Program Services Billing Codes 2024

History of this Rule since Jan. 6, 2006

Section	Description	ID	Publish Date

Final 59G-4.002	Provider Reimbursement Schedules and Billing Codes	28828126	Effective: 10/21/2024
Public Hearing 59G-4.002	The Agency is rescheduling the original August 5, 2024, hearing published in Vol. 50/134 on July 10, 2024, for the purpose of discussing Florida .... August 19, 2024, from 1:00 p.m. – 2:00 p.m. Agency for Health Care Administration, 2727 Mahan Drive, Building ....	28624038	8/8/2024 Vol. 50/155
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.	28531888	7/10/2024 Vol. 50/134
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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