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Adopted Rules - Reimbursement Policies

Adopted Rules

Reimbursement Policies

Note: Selecting the rule name hyperlink will redirect you to the Florida Administrative Register’s (FAR) website. The FAR website will display the rule history, along with any recent notices and reference material on the rule. Selecting the PDF hyperlink under reference material will retrieve the most recently promulgated reference material associated with the rule.

Rule NumberRule NameEffective DateFAR Notice
59G-5.110 Direct Reimbursement to Recipients [ pdf 19.7 kB ] 6/2/2016FAR
59G-13.086Developmental Disabilities Individual Budgeting Waiver Disposable Incontinence Medical Supplies[ application/pdf ]10/19/2015FAR
59G-13.081 Developmental Disabilities Individual Budgeting Waiver Services Provider Rate Table [ excel 55.7 kB ] 1/4/2024FAR
59G-6.031 Enhanced Ambulatory Patient Grouping Reimbursement Methodology for Hospital Outpatient Services and Ambulatory Surgical Centers [ pdf 213.7 kB ] 12/25/2018FAR
59G-13.102Familial Dysautonomia Waiver Disposable Incontinence Medical Supplies Fee Schedule and Minimum Quality Standards[ application/pdf ]06/7/2012FAR
59G-13.080 Home and Community-Based Services Waivers [ pdf 53.9 kB ] 12/3/2008FAR
59G-4.001 Medicaid Providers Who Bill on the CMS-1500 [ pdf 8.7 MB ] 12/3/2008FAR
59G-4.003 Medicaid Providers Who Bill on the UB-04 [ pdf 9.3 MB ] 2/25/2009FAR
59G-6.090 Payment Methodology for County Health Departments [ pdf 116.5 kB ] 2/27/2020FAR
59G-6.080Payment Methodology for Federally Qualified Health Center and Rural Health Center Services[ application/msword ]5/23/2016FAR
59G-6.040 Payment Methodology for ICF/MR-DD Services in Publicly Owned and Publicly Operated Facilities [ pdf 9.5 kB ] 11/21/2004FAR
59G-6.020 Payment Methodology for Inpatient Hospital Services [ pdf 481.2 kB ] 7/12/2018FAR
59G-6.010 Payment Methodology for Nursing Home Services [ pdf 197.4 kB ] 9/14/2021FAR
59G-6.030 Payment Methodology for Outpatient Hospital Services [ pdf 292.2 kB ] 6/26/2017FAR
59G-6.045 Payment Methodology for Services in Facilities Not Publicly Owned and Not Publicly Operated [ pdf 173.4 kB ] 10/24/2021FAR
59G-4.251 Prescribed Drugs Reimbursement Methodology [ pdf 149 kB ] 12/20/2021FAR
59G-4.002Provider Reimbursement Schedules and Billing Codes10/21/2024FAR
59G-1.001 Purpose [ pdf 8.8 kB ] 4/29/1993FAR
59G-6.025 Reimbursement Methodology for Cancer Hospitals [ pdf 273.2 kB ] 5/13/2019FAR
59G-6.005 Reimbursement Methodology for Services Provided by Medical School Faculty [ pdf 119.2 kB ] 8/15/2021FAR

Historical Medicaid Reimbursement Schedules