Last updated 06/14/2023
Consent Requirements
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Last updated 06/14/2023
Definitions
Telemedicine is the practice of health care delivery by a practitioner who is in a site other than the site where a recipient is located, using interactive telecommunications equipment that minimally includes real time, two-way interactive communication between a recipient and a practitioner using audio and video equipment.
SOURCE: FL Medicaid, Alert, Ending of Federal Public Health Emergency: Updated Co-Payment and Telemedicine Guidance for Medical and Behavioral Health Providers, May 4, 2023, (Accessed Jun. 2023).
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 Jun. 2023).
Substance Abuse Services
“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 Jun. 2023).
Children’s Medical Services
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 Admin Code 64C-8-001(6). (Accessed Jun. 2023).
Last updated 06/14/2023
Email, Phone & Fax
Florida Medicaid will cover telehealth services in accordance with the Agency’s promulgated Telemedicine rule and will no longer cover audio-only telehealth services.
SOURCE: FL Medicaid, Alert, Ending of Federal Public Health Emergency: Updated Co-Payment and Telemedicine Guidance for Medical and Behavioral Health Providers, May 4, 2023, (Accessed Jun. 2023).
No reimbursement for telephone, chart review, electronic mail messages or facsimile transmissions.
SOURCE: FL Admin Code 59G-1.057. (Accessed Jun. 2023).
Last updated 06/14/2023
Live Video
POLICY
During the federal PHE, the Agency provided expansive coverage for telemedicine services. Effective May 11, 2023, Florida Medicaid will cover telehealth services in accordance with the Agency’s promulgated Telemedicine rule and will no longer cover audio-only telehealth services. Florida Medicaid will continue to cover store-and-forward and remote patient monitoring services.
As a reminder, Statewide Medicaid Managed Care (SMMC) plans may provide more expansive coverage than what is in Agency rule, including telemedicine and waiving co-payments. However, SMMC plans may not be more restrictive than Agency rule.
SOURCE: FL Medicaid, Alert, Ending of Federal Public Health Emergency: Updated Co-Payment and Telemedicine Guidance for Medical and Behavioral Health Providers, May 4, 2023, (Accessed Jun. 2023).
FL Medicaid reimburses for real time, two-way, interactive telemedicine.
Providers must include the GT modifier.
SOURCE: FL Admin Code 59G-1.057. (Accessed Jun. 2023).
Statewide Medicaid Managed Care Telemedicine/Teledentistry policy available. Provides reimbursement requirements of plans for telemedicine and teledentistry.
SOURCE: FL Agency for Health Care Administration, Statewide Medicaid Managed Care Telemedicine/Teledentistry, Aug. 2018, (Accessed Jul. 2023).
ELIGIBLE SERVICES/SPECIALTIES
List of eligible community behavioral health services is provided in Provider Alert. See alert for procedure codes, modifiers and telemedicine modifiers.
SOURCE: FL Medicaid, Alert, Community Behavioral Health Telemedicine-Eligible Services, May 12, 2023, (Accessed Jun. 2023).
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 Jun. 2023).
Alcohol and/or drug screenings can be delivered with a telehealth place of service.
SOURCE: FL Medicaid Alert, Screening, Brief Intervention, and Referral to Treatment (SBIRT) Continuing Medical Education (CME) Opportunity for Providers, Apr. 13, 2023, (Accessed Jun. 2023).
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 Jun. 2023).
ELIGIBLE SITES
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GEOGRAPHIC LIMITS
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FACILITY/TRANSMISSION FEE
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Last updated 06/14/2023
Miscellaneous
Substance Abuse Services – Telehealth
Providers shall maintain policies and procedures outlining how they will provide services through telehealth as described in subsection 65D-30.003(1), F.A.C.
Providers delivering services through telehealth shall provide the service to the same extent the service would be delivered if provided through an in-person service delivery with a provider.
Providers delivering any services by telehealth are responsible for the quality of the equipment and technology employed. Providers 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 (2)-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;
SOURCE: FL Admin Code Sec. 65D-30.004. (Accessed Jun. 2023).
No reimbursement for equipment used to provide telemedicine services.
SOURCE: FL Admin Code 59G-1.057. (Accessed Jun. 2023).
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 Jun. 2023).
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 Jun. 2023).
Last updated 06/14/2023
Out of State Providers
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Last updated 06/14/2023
Overview
FL Medicaid reimburses for real time interactive telemedicine according to administrative code, however there is no indication of reimbursement in any Medicaid Manual. A recently released Medicaid notice to clarify Medicaid policy post-COVID public health emergency states that FL Medicaid will continue to cover store-and-forward and remote patient monitoring services, but will no longer cover audio-only telehealth services.
Last updated 06/14/2023
Remote Patient Monitoring
POLICY
Florida Medicaid will continue to cover store-and-forward and remote patient monitoring services.
SOURCE: FL Medicaid, Alert, Ending of Federal Public Health Emergency: Updated Co-Payment and Telemedicine Guidance for Medical and Behavioral Health Providers, May 4, 2023, (Accessed Jun. 2023).
Statewide Medicaid Managed Care Telemedicine/Teledentistry, which includes remote patient monitoring, policy available. Provides reimbursement requirements of plans for telemedicine and teledentistry.
SOURCE: FL Agency for Health Care Administration, Statewide Medicaid Managed Care Telemedicine/Teledentistry, Aug. 2018, (Accessed Jul. 2023).
CONDITIONS
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PROVIDER LIMITATIONS
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OTHER RESTRICTIONS
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Last updated 06/14/2023
Store and Forward
POLICY
Florida Medicaid will continue to cover store-and-forward and remote patient monitoring services.
SOURCE: FL Medicaid, Alert, Ending of Federal Public Health Emergency: Updated Co-Payment and Telemedicine Guidance for Medical and Behavioral Health Providers, May 4, 2023, (Accessed Jun. 2023).
Statewide Medicaid Managed Care Telemedicine/Teledentistry, which includes store-and-forward, policy available. Provides reimbursement requirements of plans for telemedicine and teledentistry.
SOURCE: FL Agency for Health Care Administration, Statewide Medicaid Managed Care Telemedicine/Teledentistry, Aug. 2018, (Accessed Jul. 2023).
ELIGIBLE SERVICES/SPECIALTIES
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GEOGRAPHIC LIMITS
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TRANSMISSION FEE
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