Florida

At A Glance
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MEDICAID REIMBURSEMENT

  • Live Video: Yes
  • Store-and-Forward: No
  • Remote Patient Monitoring: No
  • Audio Only: No

PRIVATE PAYER LAW

  • Law Exists: Yes
  • Payment Parity: No

PROFESSIONAL REQUIREMENTS

  • Licensure Compacts: CC, NLC
  • Consent Requirements: No

STATE RESOURCES

  1. Medicaid Program: Florida Medicaid
  2. Administrator: Florida Dept. of Children and Families
  3. Regional Telehealth Resource Center: Southeast Telehealth Resource Center

COVID-19

Last updated 02/11/2022

Audio Only Delivery

Medicaid 1915(c) Waiver: Appendix K Developmental Disabilities Individual Budgeting (iBudget) Waiver

STATUS: Active, extended until 6 months after the conclusion of the public health emergency (see combined waiver)

Medicaid 1915(c) Waiver: Appendix K Florida Long-Term Care Program

STATUS: Active, extended until 6 months after the conclusion of the public health emergency (see combined waiver)

Medicaid 1915(c) Waiver: Appendix K Model Waiver and Familial Dysautonomia

STATUS: Active, extended until 6 months after the conclusion of the public health emergency (see combined waiver)

Last updated 02/11/2022

Cross State Licensing

Medicaid: Telehealth FAQs

STATUS: Active

Department of Health: Telehealth FAQs

STATUS: Active

Florida Board of Medicine: Updates for health care providers regarding expiration of emergency orders

STATUS: Active

Last updated 02/11/2022

Easing Consent Requirements

No Reference Found

Last updated 02/11/2022

Easing Prescribing Requirements

Department of Health: Telehealth FAQs

STATUS: Active

Florida Board of Medicine: Updates for health care providers regarding expiration of emergency orders

STATUS: Active

Department of Children and Families: Emergency Rule for Substance Abuse Program and MAT Treatment

STATUS: Effective November 25, 2021 and expires 90 days later

Last updated 02/11/2022

Miscellaneous

Medicaid 1915(c) Waiver: Appendix K Developmental Disabilities Individual Budgeting Waiver, Florida Long Term Care Program, Model Waiver, and Familial Dysautonomia Waiver

STATUS: Active, extends current waivers 6 months after the conclusion of the public health emergency

HB 5001: Appropriations – includes telehealth

STATUS: Enacted

Florida State of Emergency Expired June 26, 2021

SOURCE: Governor’s EO-21-94; FDOH Declaration

Last updated 02/11/2022

Originating Site

No Reference Found

Last updated 02/11/2022

Private Payer

No Reference Found

Last updated 02/11/2022

Provider Type

Medicaid: Telehealth FAQs

STATUS: Active

Department of Health: Telehealth FAQs

STATUS: Active

Last updated 02/11/2022

Service Expansion

No Reference Found

Medicaid

Last updated 02/11/2022

Consent Requirements

No Reference Found

Last updated 02/11/2022

Definitions

Telemedicine is “the use of telecommunication and information technology to provide clinical care to individuals at a distance, and to transmit the information needed to provide that care.”

SOURCE: FL Dept. of Health, Child Protection Team Program, Program Handbook, p.65 (Jun. 28, 2019).  FL Admin Code 64C-8-001(6). (Accessed Feb. 2022).

Telemedicine – The practice of health care delivery by a practitioner who is located at a site other than the site where a recipient is located for the purposes of evaluation, diagnosis, or treatment.

SOURCE: FL Admin Code 59G-1.057. (Accessed Feb. 2022).

Last updated 02/11/2022

Email, Phone & Fax

No reimbursement for telephone, chart review, electronic mail messages or facsimile transmissions.

SOURCE: FL Admin Code 59G-1.057. (Accessed Feb. 2022).

Last updated 02/11/2022

Live Video

POLICY

FL Medicaid reimburses for real time, two-way, interactive telemedicine.

Providers must include the GT modifier.

SOURCE: FL Admin Code 59G-1.057. (Accessed Feb. 2022).

ELIGIBLE SERVICES/SPECIALTIES

Florida Medicaid reimburses the practitioner who is providing the evaluation, diagnosis, or treatment recommendation located at a site other than where the recipient is located.

SOURCE: FL Admin Code 59G-1.057. (Accessed Feb. 2022).

Child Protective Team (CPT) Services

Real-time CPT telemedicine services for the evaluation of children suspected to be abused or neglected has been implemented in rural or remote areas.

SOURCE: FL Dept. of Health, Child Protection Team Program, Program Handbook, p. 24 (Jun. 28, 2019).  (Accessed Feb. 2022).

ELIGIBLE PROVIDERS

Telemedicine is available for use by all providers of Florida Medicaid services that are enrolled in or registered with the Florida Medicaid program and who are licensed within their scope of practice to perform the service.

SOURCE: FL Admin Code 59G-1.057. (Accessed Feb. 2022).

Child Protective Team (CPT) Services

Real-time CPT telemedicine services for the evaluation of children suspected to be abused or neglected has been implemented in rural or remote areas.  Only CPT medical providers approved as CMS medical providers and are specifically trained to do telemedicine exams can perform exams at the hub site.  Only registered nurses trained to assist in telemedicine exams can participate in the CPT medical exam at the remote site. All persons at remote site must act under the direct supervision of the telemedicine physician or physician extender.

SOURCE: FL Dept. of Health, Child Protection Team Program, Program Handbook, p. 24 (Jun. 28, 2019).  (Accessed Feb. 2022).

ELIGIBLE SITES

No Reference Found

GEOGRAPHIC LIMITS

No Reference Found

FACILITY/TRANSMISSION FEE

No Reference Found

Last updated 02/11/2022

Miscellaneous

Substance Abuse Services

Prior to initiating services utilizing telehealth, providers shall submit detailed procedures outlining which services they intend to provide. Providers delivering any services by telehealth are responsible for the quality of the equipment and technology employed and are responsible for its safe use. Providers utilizing telehealth equipment and technology must be able meet or exceed the prevailing standard of care. Service providers must meet the following additional requirements:

  • Must be capable of two-way, real-time electronic communication, and the security of the technology must be in accordance with applicable federal confidentiality regulations 45 CFR §164.312;
  • The interactive telecommunication equipment must include audio and high-resolution video equipment which allows the staff providing the service to clearly understand and view the individual receiving services;
  • Clinical screenings, assessments, medication management, and counseling are the only services allowable through telehealth; and
  • Telehealth services must be provided within the state of Florida except for those licensed for outpatient, intervention, and prevention.

SOURCE: FL Admin Code Sec. 65D-30.004.  (Accessed Feb. 2022).

Children’s Medical Services

There is a webpage dedicated to explaining what telemedicine services are to families.

SOURCE: FL Children’s Medical Services:  Special Services for children with special needs.  Telemedicine Services. (Accessed Feb. 2022).

No reimbursement for equipment used to provide telemedicine services.

SOURCE: FL Admin Code 59G-1.057. (Accessed Feb. 2022).

Telehealth Minority Maternity Care Pilot Programs

 By July 1, 2022, the department shall establish a telehealth minority maternity care pilot program in Duval County and Orange County which uses telehealth to expand the capacity for positive maternal health outcomes in racial and ethnic minority populations. The department shall direct and assist the county health departments in Duval County and Orange County to implement the programs. The pilot programs shall adopt the use of telehealth or coordinate with prenatal home visiting programs to provide services and education to eligible pregnant women up to the last day of their postpartum periods and provide training to participating health care practitioners and other perinatal professionals.

SOURCE: FL Statute 383.2163. (Accessed Feb. 2022).

School-Based Mental Health Assistance Allocation

The mental health assistance allocation is created to provide funding to assist school districts in establishing or expanding school-based mental health care. Before the distribution of the allocation, the school district must develop and submit a detailed plan outlining the local program and planned expenditures to the district school board for approval. The plans must include elements related to Contracts or interagency agreements with one or more local community behavioral health providers or providers of Community Action Team services to provide a behavioral health staff presence and services at district schools. Services may include, but are not limited to, mental health screenings and assessments, individual counseling, family counseling, group counseling, psychiatric or psychological services, trauma-informed care, mobile crisis services, and behavior modification. These behavioral health services may be provided on or off the school campus and may be supplemented by telehealth.

SOURCE: FL Statute 1011.62. (Accessed Feb. 2022).

Last updated 02/11/2022

Out of State Providers

No Reference Found

Last updated 02/11/2022

Overview

FL Medicaid reimburses for real time interactive telemedicine according to administrative code, however there is no indication of reimbursement in any Medicaid Manual.  No reference was found in regards to reimbursement for store-and-forward or remote patient monitoring.

Last updated 02/11/2022

Remote Patient Monitoring

POLICY

No Reference Found

CONDITIONS

No Reference Found

PROVIDER LIMITATIONS

No Reference Found

OTHER RESTRICTIONS

No Reference Found

Last updated 02/11/2022

Store and Forward

POLICY

No Reference Found

ELIGIBLE SERVICES/SPECIALTIES

No Reference Found

GEOGRAPHIC LIMITS

No Reference Found

TRANSMISSION FEE

No Reference Found

Private Payer

Last updated 02/11/2022

Definitions

“Telehealth” means the use of synchronous or asynchronous telecommunications technology by a telehealth provider to provide health care services, including, but not limited to, assessment, diagnosis, consultation, treatment, and monitoring of a patient; transfer of medical data; patient and professional health-related education; public health services; and health administration. The term does not include audio-only telephone calls, e-mail messages, or facsimile transmissions.

SOURCE: FL Statute 456.47. (Accessed Feb. 2022).

Last updated 02/11/2022

Parity

SERVICE PARITY

Insurers and providers must mutually agree on payment rates and payment methodologies for telehealth delivered services.

SOURCE: FL Statute 641.31 (45). & 627.42396. (Accessed Feb. 2022).

PAYMENT PARITY

Any contract provision that distinguishes between payment rates or payment methodologies for services provided through telehealth and the same services provided without the use of telehealth must be initialed by the telehealth provider.

SOURCE: FL Statute 641.31. & 641.42396. (Accessed Feb. 2022).

Last updated 02/11/2022

Requirements

Contracts between health insurers or health maintenance organizations and telehealth providers must be voluntary and must establish mutually acceptable payment rates or payment methodologies for services provided through telehealth.  Any contract provision that distinguishes between payment rates or payment methodologies for services provided through telehealth and the same service provided without telehealth must be initialed by the telehealth provider.

SOURCE: FL Statute 641.31 (45). & 627.42396. (Accessed Feb. 2022).

Professional Requirements

Last updated 02/11/2022

Consent Requirements

No Reference Found

Last updated 02/11/2022

Cross State Licensing

A health care professional not licensed in this state may provide health care services to a patient located in this state using telehealth if the health care professional registers with the applicable board, or the department if there is no board, and provides health care services within the applicable scope of practice established by Florida law or rule.

See law for specific provider requirements.

An out-of-state provider must have professional liability coverage or financial responsibility that includes coverage for telehealth services provided to patients not located in the provider’s home state.  A health care professional registered under this section may not open an office or provide in-person services.  The Department is required to publish all registrants on its website with specific requirements outlined in the law.

SOURCE: FL Statute 456.47 & Florida Board of Medicine (Accessed Feb. 2022).

Last updated 02/11/2022

Definitions

“Telehealth” means the use of synchronous or asynchronous telecommunications technology by a telehealth provider to provide health care services, including, but not limited to, assessment, diagnosis, consultation, treatment, and monitoring of a patient; transfer of medical data; patient and professional health-related education; public health services; and health administration. The term does not include audio-only telephone calls, e-mail messages, or facsimile transmissions.

SOURCE: FL Statute 456.47. (Accessed Feb. 2022).

“Telehealth” means the mode of providing care, treatment, or services by a Florida qualified professional, as defined under subsection 397.311(34), F.S., within the scope of his or her practice, through the use of clinical and medical information exchanged from one site to another via electronic communication. Telehealth does not include the provision of health services only through an audio only telephone, email messages, text messages, facsimile transmission, U.S. mail or other parcel service, or any combination thereof.

SOURCE: FL Admin Code 65D-30.002. (Accessed Feb. 2022).

Children’s Medical Services

“Telemedicine” means “the use of telecommunication and information technology to provide clinical care to individuals at a distance and to transmit the information needed to provide that care.

SOURCE: FL Admin Code 64C-8.001. (Accessed Feb. 2022).

Last updated 02/11/2022

Licensure Compacts

Member of the Nurses Licensure Compact.

SOURCE:  Current NLC States & Status.  Nurse Licensure Compact. (Accessed Feb. 2022).

Member of the Counseling Compact.

SOURCE: Counseling Compact Map. (Accessed Feb. 2022).

* See Compact websites for implementation and license issuing status and other related requirements.

Last updated 02/11/2022

Miscellaneous

HB 5001 makes appropriations to certain telehealth programs and pilots.

SOURCE: FL State Senate. HB 5001 (Mar. 19, 2020). (Accessed Feb. 2022).

 

Last updated 02/11/2022

Online Prescribing

A telehealth provider may use telehealth to perform a patient evaluation. If a telehealth provider conducts a patient evaluation sufficient to diagnose and treat the patient, the telehealth provider is not required to research a patient’s medical history or conduct a physical examination of the patient before using telehealth to provide health care services to the patient.

A telehealth provider may not use telehealth to prescribe a controlled substance unless the controlled substance is prescribed for the following:

  1. The treatment of a psychiatric disorder;
  2. Inpatient treatment at a hospital licensed under chapter 395;
  3. The treatment of a patient receiving hospice services as defined in s. 400.601; or
  4. The treatment of a resident of a nursing home facility as defined in s. 400.021.

SOURCE: FL Statute 456.47 (Accessed Feb. 2022).

Last updated 02/11/2022

Professional Boards Standards

Health Professional Telehealth Practice Standards and Related Requirements

SOURCE: FL Statute 456.47. (Accessed Feb. 2022).