Florida Medicaid reimbursement rates
41,202 current fee-for-service and managed-care rates from Florida Medicaid, across 110 services and 3 programs, normalized by code, provider level and unit. Each links to one of 128 official source documents.
Last retrieved 2026-10-02. History back to 2012-06-07.
- Current rates
- 41,202
- Services
- 110
- Programs
- 3
- Lines with a plan rule
- 6of 22 service lines
By industry
Applied behavior analysis (ABA)Florida rates, labor costs and changesBehavioral healthFlorida rates, labor costs and changesHome healthFlorida rates, labor costs and changesHome care & personal careFlorida rates, labor costs and changesPrivate duty nursingFlorida rates, labor costs and changesSkilled nursing facilitiesFlorida rates, labor costs and changesHospiceFlorida rates, labor costs and changesIntellectual & developmental disabilitiesFlorida rates, labor costs and changesOutpatient therapy (PT, OT, speech)Florida rates, labor costs and changes
Florida rates by service
The median current rate for each service, like-for-like by unit. Follow a service to compare it with every other state.
| Service | Line | Median rate | Unit | Per hour | Variants |
|---|---|---|---|---|---|
| ABA assessment by a behavior analyst | ABA / autism services | $105.82 | — | $76.20 | 4 |
| ABA assessment support by a technician | ABA / autism services | $12.19 | 15 min | $48.76 | 1 |
| ABA assessment with 2+ technicians (severe behavior) | ABA / autism services | $12.19 | 15 min | $48.76 | 1 |
| ABA parent and caregiver training | ABA / autism services | $19.05 | 15 min | $76.20 | 3 |
| ABA therapy with 2+ technicians (severe behavior) | ABA / autism services | $12.19 | 15 min | $48.76 | 1 |
| ABA therapy with plan changes by an analyst | ABA / autism services | $17.27 | 15 min | $69.08 | 2 |
| Behavior analysis services (disability system) | ABA / autism services | $14.91 | 15 min | $59.64 | 24 |
| Group ABA therapy led by a technician | ABA / autism services | $6.58 | 15 min | $26.32 | 5 |
| Group ABA therapy led by an analyst | ABA / autism services | $8.58 | 15 min | $34.32 | 5 |
| One-on-one ABA therapy by a technician | ABA / autism services | $12.26 | 15 min | $49.04 | 1 |
| Addiction (substance use) counseling | Behavioral health | $15.00 | per quarter unit | — | 1 |
| Assertive Community Treatment (ACT) team | Behavioral health | $31.55 | day | — | 1 |
| Behavioral health day treatment | Behavioral health | $12.61 | hour | $12.61 | 2 |
| Behavioral health residential facility (non-hospital) | Behavioral health | $196.21 | day | — | 2 |
| Behavioral health services (fee schedule) | Behavioral health | $10.09 | one time | — | 1 |
| Clubhouse psychosocial rehabilitation (bundled rate) | Behavioral health | $5.04 | per quarter hour | — | 1 |
| Comprehensive community support services | Behavioral health | $15.00 | per quarter unit | — | 1 |
| Medication administration (behavioral health) | Behavioral health | $10.09 | one time | — | 3 |
| Mental health assessment (non-physician) | Behavioral health | $24.47 | per evaluation | — | 24 |
| Mental health counseling | Behavioral health | $8.97 | one time | $56.02 | 20 |
| Mental health service plan development | Behavioral health | $73.40 | one time | — | 4 |
| Opioid treatment program weekly bundle | Behavioral health | $68.08 | weekly rate | — | 1 |
| Outpatient psychotherapy and diagnostic evaluation | Behavioral health | $66.76 | per quarter hour | $107.16 | 35 |
| Peer support (behavioral health) | Behavioral health | $6.10 | per quarter hour | — | 2 |
| Psychiatric residential treatment (daily) | Behavioral health | $689.47 | — | — | 1 |
| Psychological and developmental testing | Behavioral health | $17.90 | per quarter hour | — | 1 |
| Psychosocial rehabilitation | Behavioral health | $9.08 | per quarter hour | — | 1 |
| Skills training and development | Behavioral health | $5.03 | 15 min | $20.10 | 2 |
| Therapeutic behavioral services | Behavioral health | $10.09 | per quarter hour | $27.30 | 5 |
| Therapeutic behavioral services (daily rate) | Behavioral health | $33.02 | day | — | 1 |
| Therapeutic foster care (child) | Behavioral health | $136.94 | day | — | 3 |
| FQHC / RHC visit (PPS or APM rate) | Clinics (FQHC/RHC) | $173.52 | visit | — | 935 |
| Dental services | Dental | $64.87 | — | — | 233 |
| Durable medical equipment | Equipment & supplies | $101.96 | — | $42.92 | 577 |
| Enteral and parenteral nutrition | Equipment & supplies | $1.63 | day | — | 23 |
| Medical supplies | Equipment & supplies | $3.98 | — | — | 845 |
| Orthotics and prosthetics | Equipment & supplies | $203.99 | — | $42.92 | 698 |
| Case management / support coordination | Other home & community services | $91.70 | unit | — | 15 |
| Emergency response system installation | Other home & community services | $276.63 | unit | — | 1 |
| Emergency response system monitoring | Other home & community services | $44.26 | unit | — | 1 |
| Home modifications (accessibility) | Other home & community services | $857.54 | unit | — | 2 |
| Medical foster care (medically complex child) | Other home & community services | $60.59 | day | — | 3 |
| Nursing assessment | Other home & community services | $8.16 | 15 min | $32.64 | 18 |
| Nursing respite (RN or LPN) | Other home & community services | $97.99 | day | $23.62 | 24 |
| Prescribed pediatric extended care (medical day care) | Other home & community services | $174.25 | day | $47.76 | 2 |
| Respite care (daily) | Other home & community services | $58.82 | 15 min | $14.30 | 36 |
| Self-direction coaching / supports broker | Other home & community services | $183.37 | month | — | 9 |
| Home health aide visit | Home health | $18.04 | visit | — | 9 |
| Home health nurse visit (RN or LPN) | Home health | $27.06 | visit | — | 6 |
| Hospice continuous home care (hourly) | Hospice | $65.04 | hour | $65.04 | 91 |
| Hospice end-of-life visit add-on (per hour) | Hospice | $16.26 | 15 min | $65.04 | 91 |
| Hospice general inpatient care (daily) | Hospice | $1,132.04 | day | — | 91 |
| Hospice inpatient respite (daily) | Hospice | $530.15 | day | — | 91 |
| Hospice room and board in a nursing home | Hospice | $286.24 | day | — | 92 |
| Hospice room and board in an ICF/IID | Hospice | $628.98 | day | — | 137 |
| Hospice routine home care (daily) | Hospice | $183.62 | day | — | 182 |
| Inpatient DRG pricing input (outlier, cost ratio, stay) | Hospital inpatient | $1.00 | ratio | — | 717 |
| Inpatient DRG relative weight | Hospital inpatient | $1.78 | weight | — | 1342 |
| Inpatient hospital stay (DRG base rate) | Hospital inpatient | $3,474.74 | discharge | — | 358 |
| Inpatient payment adjustment factor | Hospital inpatient | $1.00 | factor | — | 3042 |
| Inpatient psychiatric stay (per day) | Hospital inpatient | $287.00 | day | — | 3 |
| Inpatient rate add-on (education, wage, directed payment) | Hospital inpatient | $0.00 | average per-discharge | — | 716 |
| EAPG relative weight (outpatient hospital or surgery center) | Hospital outpatient | $0.3364 | weight | — | 666 |
| Outpatient hospital add-on payment | Hospital outpatient | $0.00 | service | — | 385 |
| Outpatient hospital conversion factor (APC/EAPG) | Hospital outpatient | $434.62 | EAPG weight (base rate per relative weight) | — | 385 |
| Outpatient payment adjustment factor | Hospital outpatient | $1.00 | factor | — | 385 |
| Behavior support services (disability waiver) | IDD services | $431.84 | unit | — | 6 |
| Community integration / community access (IDD) | IDD services | $4.27 | 15 min | $17.08 | 18 |
| Day habilitation / day program (IDD) | IDD services | $409.51 | hour | $12.59 | 24 |
| ICF/IID stay (daily rate) | IDD services | $756.54 | day | — | 549 |
| In-home and community living supports (IDD) | IDD services | $7.66 | 15 min | $30.64 | 6 |
| Intensive behavioral residential supports | IDD services | $504.90 | day | — | 60 |
| Prevocational services | IDD services | $409.51 | hour | $12.59 | 24 |
| Residential habilitation / group home supports | IDD services | $332.76 | day | — | 181 |
| Supported employment (job coaching) | IDD services | $9.63 | 15 min | $19.46 | 18 |
| Clinical lab tests | Lab & pathology | $10.64 | — | — | 6255 |
| Nursing home daily rate component (facility-specific) | Nursing facility | $23.64 | day | — | 8728 |
| Nursing home stay (daily rate) | Nursing facility | $299.44 | day | — | 819 |
| Swing-bed stay (hospital bed used for nursing-home care) | Nursing facility | $295.26 | — | — | 8 |
| Early intervention services for infants and toddlers | Other | $37.50 | 30-minute unit | $75.00 | 25 |
| Home health aide or nurse aide care (hourly) | Personal care & attendant | $12.50 | /hr | $13.85 | 18 |
| Personal care (daily rate) | Personal care & attendant | $15.58 | day | — | 1 |
| Personal care / attendant care (hourly) | Personal care & attendant | $57.39 | 15 min | $19.32 | 38 |
| Vaccines and immune globulins | Pharmacy | $86.23 | — | — | 78 |
| Private duty nursing (hourly shifts) | Private duty nursing | $8.16 | /hr | $28.36 | 28 |
| Waiver nursing (RN or LPN, by the 15 minutes) | Private duty nursing | $7.09 | per 15- | $28.36 | 43 |
| Anesthesia conversion factor | Physician & professional | $14.50 | per 15 minutes of anesthesia time (time/15 x amount) | — | 1 |
| Payment percentage for non-physician practitioners | Physician & professional | $80.00 | percent of allowable | — | 1 |
| Physician and practitioner services (fee schedule) | Physician & professional | $283.15 | — | $79.37 | 9865 |
| Practitioner payment adjustment (percent or set amount) | Physician & professional | $16.00 | percent increase | — | 7 |
| Imaging and radiology | Radiology | $56.01 | — | — | 1723 |
| Nutrition counseling (dietitian) | Therapy (PT/OT/speech) | $13.27 | 15 min | $53.08 | 6 |
| Occupational therapy | Therapy (PT/OT/speech) | $17.96 | 15 min | $71.84 | 14 |
| Occupational therapy evaluation | Therapy (PT/OT/speech) | $54.38 | — | — | 36 |
| Other therapy services | Therapy (PT/OT/speech) | $17.19 | 15 min | $68.76 | 1 |
| Physical therapy | Therapy (PT/OT/speech) | $17.96 | 15 min | $71.84 | 13 |
| Physical therapy evaluation | Therapy (PT/OT/speech) | $54.38 | — | — | 36 |
| Respiratory therapy at home | Therapy (PT/OT/speech) | $17.96 | 15 min | $71.84 | 6 |
| Respiratory therapy evaluation | Therapy (PT/OT/speech) | $54.38 | — | — | 7 |
| Speech-generating device evaluation | Therapy (PT/OT/speech) | $91.82 | — | — | 1 |
| Speech-generating device therapy | Therapy (PT/OT/speech) | $45.03 | — | — | 2 |
| Speech-language evaluation | Therapy (PT/OT/speech) | $54.38 | — | — | 35 |
| Speech-language therapy | Therapy (PT/OT/speech) | $17.96 | — | $71.84 | 10 |
| Swallowing and feeding evaluation | Therapy (PT/OT/speech) | $54.58 | — | — | 4 |
| Swallowing and feeding therapy | Therapy (PT/OT/speech) | $58.11 | — | — | 3 |
| Air ambulance transport | Transportation | $1,116.61 | — | — | 2 |
| Ambulance mileage | Transportation | $4.47 | per air mile | — | 2 |
| Ground ambulance transport | Transportation | $203.05 | — | — | 6 |
| Eyeglasses and contact lenses | Vision & hearing | $15.17 | — | — | 85 |
| Hearing aids and hearing services | Vision & hearing | $231.62 | — | — | 39 |
Most-compared billing codes in Florida
Where Florida ranks among states for codes published widely. Rank 1 = highest rate.
| Code | Service | Florida | All-state median | Rank |
|---|---|---|---|---|
| 10004 | Physician and practitioner services (fee schedule) | $29.87 | $35.52 | 15 of 19 |
| 10005 | Physician and practitioner services (fee schedule) | $49.87 | $60.63 | 14 of 19 |
| 10006 | Physician and practitioner services (fee schedule) | $34.01 | $39.90 | 14 of 19 |
| 10007 | Physician and practitioner services (fee schedule) | $62.34 | $76.74 | 14 of 19 |
| 10008 | Physician and practitioner services (fee schedule) | $36.63 | $46.94 | 15 of 19 |
| 10009 | Physician and practitioner services (fee schedule) | $73.76 | $93.03 | 14 of 19 |
| 10010 | Physician and practitioner services (fee schedule) | $51.17 | $65.32 | 14 of 19 |
| 10021 | Physician and practitioner services (fee schedule) | $37.92 | $49.77 | 16 of 19 |
| 10030 | Physician and practitioner services (fee schedule) | $91.96 | $119.43 | 15 of 19 |
| 10035 | Physician and practitioner services (fee schedule) | $56.99 | $70.26 | 15 of 19 |
| 10036 | Physician and practitioner services (fee schedule) | $28.95 | $35.41 | 15 of 19 |
| 10060 | Physician and practitioner services (fee schedule) | $100.01 | $76.16 | 3 of 19 |
| 10061 | Physician and practitioner services (fee schedule) | $171.19 | $129.16 | 3 of 19 |
| 10080 | Physician and practitioner services (fee schedule) | $185.43 | $78.73 | 3 of 19 |
| 10081 | Physician and practitioner services (fee schedule) | $280.35 | $127.86 | 2 of 19 |
| 10120 | Physician and practitioner services (fee schedule) | $79.49 | $77.44 | 9 of 19 |
| 10121 | Physician and practitioner services (fee schedule) | $133.52 | $135.29 | 11 of 19 |
| 10140 | Physician and practitioner services (fee schedule) | $89.88 | $86.45 | 8 of 19 |
| 10160 | Physician and practitioner services (fee schedule) | $71.18 | $69.52 | 9 of 19 |
| 10180 | Physician and practitioner services (fee schedule) | $222.16 | $148.10 | 2 of 19 |
| 11000 | Physician and practitioner services (fee schedule) | $18.96 | $24.52 | 16 of 19 |
| 11001 | Physician and practitioner services (fee schedule) | $10.11 | $12.36 | 16 of 19 |
| 11004 | Physician and practitioner services (fee schedule) | $392.51 | $437.21 | 13 of 19 |
| 11005 | Physician and practitioner services (fee schedule) | $538.76 | $573.02 | 12 of 19 |
| 11006 | Physician and practitioner services (fee schedule) | $485.25 | $542.16 | 13 of 19 |
| 11008 | Physician and practitioner services (fee schedule) | $190.15 | $206.56 | 12 of 19 |
| 11010 | Physician and practitioner services (fee schedule) | $194.05 | $225.24 | 14 of 19 |
| 11011 | Physician and practitioner services (fee schedule) | $206.13 | $229.46 | 13 of 19 |
| 11012 | Physician and practitioner services (fee schedule) | $286.55 | $326.26 | 13 of 19 |
| 11042 | Physician and practitioner services (fee schedule) | $103.13 | $50.80 | 3 of 19 |
| 11043 | Physician and practitioner services (fee schedule) | $186.26 | $134.21 | 3 of 19 |
| 11044 | Physician and practitioner services (fee schedule) | $156.38 | $182.12 | 14 of 19 |
| 11055 | Physician and practitioner services (fee schedule) | $10.65 | $14.80 | 16 of 19 |
| 11056 | Physician and practitioner services (fee schedule) | $15.33 | $20.38 | 16 of 19 |
| 11057 | Physician and practitioner services (fee schedule) | $19.74 | $26.13 | 16 of 19 |
| 11102 | Physician and practitioner services (fee schedule) | $25.74 | $32.23 | 14 of 19 |
| 11103 | Physician and practitioner services (fee schedule) | $14.94 | $18.65 | 15 of 19 |
| 11104 | Physician and practitioner services (fee schedule) | $32.18 | $40.43 | 14 of 19 |
| 11105 | Physician and practitioner services (fee schedule) | $17.46 | $22.05 | 14 of 19 |
| 11106 | Physician and practitioner services (fee schedule) | $38.84 | $49.21 | 14 of 19 |
Managed care in Florida
46 plans on record, 0 state-directed payment records, 5,071 published capitation cells.
Who sets the rate, line by line →Recent rate changes and notices
Frequently asked questions
Where does Florida publish its Medicaid fee schedules?
Florida publishes rates across 128 official documents (fee schedules, rate notices and bulletins). Every rate on this page links to its source document.
How many Medicaid rates does Florida publish?
41,202 rates are current across 110 services and 3 programs, with 330,074 versions on record since 2012-06-07.
Do Florida Medicaid managed-care plans pay the fee schedule?
For 6 of 22 service lines, plan contracts or state law set a rule plans must follow (a floor, a state-set rate or a required pass-through). For the rest, plans negotiate. See the managed-care page for each line's rule and citation.
Other states
Your Florida rate cardYour codes, what Florida pays, what plans must pay, and every change in 2026.