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Florida Administrative Code

Fla. Admin. Code R. 59G-4.002 (2026)

Provider Reimbursement Schedules and Billing Codes

✓ current as of September 2026
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(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:

(a) Assistive Care Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-18271.

(b) Behavior Analysis Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-18300.

(c) Behavioral Health Overlay Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-18352.

(d) Birth Center Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-18302.

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

https://www.flrules.org/Gateway/reference.asp?No=Ref-18304.

(f) Community Behavioral Health Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-18364.

(g) County Health Department Certified Match Program Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-18305.

(h) Dental General Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-18306.

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

https://www.flrules.org/Gateway/reference.asp?No=Ref-18307.

(j) Early Intervention Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-18308.

(k) Family Home Health Aide Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-18309.

(l) Hearing Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-18310.

(m) Home Health Visit Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-18311.

(n) Licensed Midwife Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-18313.

(o) Medicaid Certified School Match Program Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-18314.

(p) Medical Foster Care Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-18315.

(q) Occupational Therapy Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-18354.

(r) Personal Care Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-18317.

(s) Physical Therapy Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-18365.

(t) Physician Pediatric Surgery Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-18319.

(u) Prescribed Drugs Immunization Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-18322.

(v) Private Duty Nursing Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-18324.

(w) Radiology Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-18325.

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

https://www.flrules.org/Gateway/reference.asp?No=Ref-18326.

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

https://www.flrules.org/Gateway/reference.asp?No=Ref-18327.

(z) Respiratory Therapy Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-18328.

(aa) Speech-Language Pathology Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-18362.

(bb) Transportation Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-18332.

(cc) Visual Services Fee Schedule

https://www.flrules.org/Gateway/reference.asp?No=Ref-18333.

(4) Florida Medicaid Fee Schedules Effective July 1, 2025:

(a) Independent Laboratory Fee Schedule

https://flrules.org/Gateway/reference.asp?No=Ref-18822.

(b) Practitioner Fee Schedule

https://flrules.org/Gateway/reference.asp?No=Ref-18628.

(c) Practitioner Laboratory Fee Schedule

https://flrules.org/Gateway/reference.asp?No=Ref-18823.

(d) Prescribed Pediatric Extended Care Services Fee Schedule

https://flrules.org/Gateway/reference.asp?No=Ref-18630.

(5) Florida Medicaid Fee Schedule Effective July 8, 2025:

Specialized Therapeutic Services Fee Schedule

https://flrules.org/Gateway/reference.asp?No=Ref-18631.

(6) Florida Medicaid Fee Schedules Effective October 1, 2025:

(a) Independent Laboratory Fee Schedule

https://flrules.org/Gateway/reference.asp?No=Ref-18824.

(b) Practitioner Fee Schedule

https://flrules.org/Gateway/reference.asp?No=Ref-18935.

(c) Practitioner Laboratory Fee Schedule

https://flrules.org/Gateway/reference.asp?No=Ref-18825.

(d) Targeted Case Management Services Fee Schedule

https://flrules.org/Gateway/reference.asp?No=Ref-18820.

(7) Florida Medicaid Billing Codes Effective January 1, 2025:

(a) County Health Department Billing Codes

https://www.flrules.org/Gateway/reference.asp?No=Ref-18334.

(b) Federally Qualified Health Center Billing Codes

https://www.flrules.org/Gateway/reference.asp?No=Ref-18335.

(c) Hospice Services Billing Codes

https://www.flrules.org/Gateway/reference.asp?No=Ref-18336.

(d) Hospital Outpatient Services Billing Codes

https://www.flrules.org/Gateway/reference.asp?No=Ref-18337.

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

https://www.flrules.org/Gateway/reference.asp?No=Ref-18338.

(f) Nursing Facility Services Billing Codes

https://www.flrules.org/Gateway/reference.asp?No=Ref-18358.

(g) Rural Health Clinic Billing Codes

https://www.flrules.org/Gateway/reference.asp?No=Ref-18341.

(h) Statewide Inpatient Psychiatric Program Services Billing Codes

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

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.

Effective: 1/18/2026.