Florida Medicaid Provider Minimum Wage Fee Schedule Increases

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Florida Medicaid Provider Minimum Wage Fee Schedule Increases

• The 2022 General Appropriations Act provided the Agency with funding to supplement provider rates and fee schedules for the sole purpose of increasing wages of direct care employees of Medicaid Providers to at least $15 per hour. This appropriation is a targeted increase and not an overall increase for all providers, nor does it provide additional reimbursement to pay for staff already receiving $15 per hour.
• The Agency’s Actuarial Services vendor, Milliman, at the direction of the Agency, provided the estimated impact that a $15 per hour minimum wage for direct care employees would have on costs for healthcare providers. This study was the source the legislature utilized for the appropriation.
• The Milliman analysis provided the Agency with an estimated percent impact of an increased minimum wage for direct care employees broken down by NAICS (North American Industry Classification System) codes. The Agency then created a crosswalk that mapped the corresponding NAICS code and percent increase to provider fee schedule and appropriation category.
• The Florida Legislature appropriated specific amounts for Medicaid services:
  • $5,958,207 was appropriated to increase wages for fee-for-service hospital services
  • $13,832,192 was appropriated to increase wages for fee-for-service nursing home services
  • $34,991,119 was appropriated to increase wages for fee-for-service ICF/IID services
  • $30,218,138 was appropriated to increase wages for all other fee-for-service categories (fee schedules)
• The remaining appropriation is for the Prepaid Health plans to pass through to providers the $15 minimum wage increase for services provided under the Statewide Medicaid Managed Care program.  Health plans will increase payments to providers by the same increment as was applied in the updated fee schedules for those providers whose reimbursement by health plans is equal to the fee-for-service reimbursement.
  • For services under the Long-Term Care (LTC) Program that are not listed on a fee schedule, the Prepaid Health plans are responsible to increase reimbursement for these services to account for the $15 minimum wage increase.

Fee Schedule Increases
The Medicaid Fee-for-Service (FFS) Fee Schedules listed below have received an increase for the sole purpose of raising wages of direct care employees of Medicaid providers, including 1099 employees, who provide services under the Florida Medicaid Program to at least $15.00 per hour. The FFS fee schedule increases below will be live in the Florida Medicaid Management Information System (FMMIS) in the near future. All fee schedule increases on the table below, except for Federally Qualified Health Centers and Rural Health Clinics, will be effective retroactively for dates of service on or after July 1, 2022. The increased rates for Federally Qualified Health Centers and Rural Health Clinics will be effective October 1, 2022.

Medicaid Provider Minimum Wage Appropriations Fee-for-Service Fee Schedule Increases

Fee Schedule	% Increase Applied	Link to Updated Fee Schedule
Assistive Care Services Fee Schedule	9.10%	Assistive Care Services Fee Schedule [ 10 kB ]
Behavioral Health Overlay Services	0.88%	Behavioral Health Overlay Services [ 29.5 kB ]
Birthing Center Fee Schedule	1.28%	Birthing Center Fee Schedule [ 92 kB ]
Child Health Targeted Case Management	0.59%	Child Health Targeted Case Management [ 107.6 kB ]
Community Behavioral Health Services	0.88%	Community Behavioral Health Services [ 560.9 kB ]
Dental Fee Schedule	0.44%	Dental Fee Schedule [ 145.7 kB ]
FQHC Billing Codes & RHC Billing Codes	1.47%	FQHC Billing Codes & RHC Billing Codes
Hearing Services Fee Schedule	0.71%	Hearing Services Fee Schedule [ 42.1 kB ]
Home Health Visit Services Fee Schedule	3.33%	Home Health Visit Services Fee Schedule [ 61.5 kB ]
Independent Laboratory Fee Schedule	0.37%	Independent Laboratory Fee Schedule [ 378.2 kB ]
Licensed Midwives Fee Schedule	1.28%	Licensed Midwives Fee Schedule [ 137.1 kB ]
Medical Foster Care Services Fee Schedule	13.39%	Medical Foster Care Services Fee Schedule [ 9.9 kB ]
Mental Health Targeted Case Management	0.59%	Mental Health Targeted Case Management Fee Schedule [ 107.6 kB ]
Occupational Therapy Services Fee Schedule	0.71%	Occupational Therapy Services Fee Schedule [ 43.2 kB ]
Personal Care Services Fee Schedule	15.45%	Personal Care Services Fee Schedule [ 51.9 kB ]
Physical Therapy Fee Schedule	0.71%	Physical Therapy Fee schedule [ 42.9 kB ]
Practitioner Fee Schedule	0.95%	Practitioner Fee Schedule [ 904.5 kB ]
Practitioner Laboratory Fee Schedule	0.37%	Practitioner Laboratory Fee Schedule [ 592.7 kB ]
Prescribed Pediatric Extended Care Services	13.39%	Prescribed Pediatric Extended Care Services Fee Schedule [ 67.2 kB ]
Private Duty Nursing Services Fee Schedule	3.33%	Private Duty Nursing Services Fee Schedule [ 63.3 kB ]
Radiology Fee Schedule	1.28%	Radiology Fee Schedule [ 414.6 kB ]
Respiratory Therapy Services Fee Schedule	1.28%	Respiratory Therapy Services Fee Schedule [ 100.5 kB ]
Specialized Therapeutic Services	0.88%	Specialized Therapeutic Services [ 103.8 kB ]
Speech-Language Pathology Services	0.71%	Speech-Language Pathology Services Fee Schedule [ 39.1 kB ]
Transportation Services Fee Schedule	1.44%	Transportation Services Fee Schedule [ 19.5 kB ]
Visual Services Fee Schedule	1.15%	Visual Services Fee Schedule [ 42.4 kB ]

Nursing Home Rate Increases
The Agency for Health Care Administration (Agency) has adjusted Medicaid nursing home rates for State Fiscal Year 2022-23. Additionally, the Agency has increased the nursing homes rates as directed in the 2022-23 General Appropriations Act for the purpose of raising wages of all employees of Medicaid Nursing Home providers, including 1099 employees, to at least $15.00 per hour. The final nursing home rates can be accessed here, on the Medicaid Program Finance page on the Agency’s website.

These rates will be implemented in the Florida Medicaid Management Information System (FMMIS) in the near future. Once implemented in FMMIS, Medicaid nursing home rates for 2022-23 will be effective retroactively for dates of service on or after October 1, 2022.

Hospice Rate Increases
The Agency for Health Care Administration (Agency) has adjusted Medicaid Hospice rates for room and board and level of care for State Fiscal Year 2022-23. Additionally, the Agency has increased the hospice rates as directed in the 2022-23 General Appropriations Act for the purpose of raising wages for direct care employees, including 1099 employees, of Medicaid hospice providers to at least $15.00 per hour. These rates will be implemented in the Florida Medicaid Management Information System (FMMIS) in the near future and will be effective retroactively for dates of service on or after October 1, 2022.

The final Medicaid hospice rates can be accessed on the Agency’s website at the links below:

• Hospice Room and Board Rates
• Hospice Level of Care Rates

Hospital, ASC, and ICF Rate Increases
The Agency has adjusted the institutional FFS rates below for sole purpose of raising wages of direct care employees of Medicaid providers including 1099 employees who provide services under the Florida Medicaid Program to at least $15.00 per hour.  These rates are effective July 1, 2022.

Medicaid Provider Minimum Wage Appropriations Fee-for-Service Institutional Rate Increases

Medicaid Fee-For-Service Fee Schedules NOT Receiving an Increase
The following fee schedules will NOT receive an increase related to the minimum wage requirement. Florida Medicaid providers who bill exclusively under the fee schedules listed below are not required to sign the supplemental wage agreement.

• Behavior Analysis Fee Schedule [ 259.8 kB ]
• Community-Based Substance Abuse County Match Fee Schedule [ 30.7 kB ]
• County Health Department Certified Match Program Fee Schedule [ 94.5 kB ]
• Durable Medical Equipment and Medical Supply Services Provider Fee Schedule for All Medicaid Recipients [ 1.1 MB ]
• Early Intervention Services Fee Schedule [ 94.4 kB ]
• Medicaid Certified School Match Program Fee Schedule [ 167.9 kB ]
• Physician Pediatric Surgery Fee Schedule [ 146.2 kB ]
• Prescribed Drugs Immunization Fee Schedule [ 188.5 kB ]
• Prescribed Drugs Physician Administered Billing Codes [ 251.3 kB ]
• Regional Perinatal Intensive Care Center (RPICC) Neonatal Services Fee Schedule [ 50 kB ]
• Regional Perinatal Intensive Care Center (RPICC) Obstetrical Services Fee Schedule [ 38.2 kB ]
• Targeted Case Management for Children at Risk of Abuse and Neglect [ 28.9 kB ]