Florida Medicaid Telehealth Billing for Therapists

Last updated: October 9, 2026.

Florida Medicaid telehealth billing starts with the covered service and the current telemedicine rule, 59G-1.057. The rule uses real-time two-way audio and video and excludes telephone conversations. Do not assume a phone-only therapy visit qualifies under that baseline.

Checked October 9, 2026: use AHCA’s adopted general policies index and the current service schedule. Emergency-era announcements or another payer’s modifier guidance are not a reliable basis for today’s Florida Medicaid claim.

Is this exact behavioral health service eligible for telemedicine?

Check the code and modifier together in the 2026 Community Behavioral Health Fee Schedule. Its telemedicine column marks eligible rows with Y. For example, the individual/family therapy row H2019 HR is marked Y; the group therapy row H2019 HQ is not marked Y. Do not infer telemedicine eligibility for every service from one eligible row.

Match the benefit you are billing before applying that example. A plan’s instructions for another service or code set need their own review. If the exact service is unclear, obtain the payer’s written direction before the appointment rather than choosing the closest-looking row after the visit.

FFS GT modifier versus SMMC plan claim instructions

The Florida Medicaid rule specifically directs FFS providers to use GT on the CMS-1500 for qualifying telemedicine services. This does not establish one claim recipe for every SMMC plan. Confirm the responsible plan’s code, modifier, place-of-service and authorization instructions for the service you will deliver.

Ask the plan a concrete question: for this benefit and practitioner type, what fields are required on a video-visit claim? Record the answer and its effective date. Do not import Medicare or commercial requirements for modifier 95 or place of service 02/10 without checking the Florida Medicaid payer’s instructions.

Check provider location and enrollment

The February 2026 enrollment policy addresses providers furnishing telemedicine from Florida and the out-of-state enrollment pathway. A Florida license alone does not settle Medicaid enrollment for a practitioner working elsewhere. Confirm the enrollment requirements for the actual provider location before offering the service.

Use the therapist enrollment guide for Full/Limited and group-linkage questions. For managed care, also confirm plan participation for the organization and clinician. A remote appointment does not erase either approval layer.

Document and verify before billing the remote visit

The Behavioral Health Therapy Services policy includes treatment-plan and daily-note requirements. As a practical workflow, also document the encounter modality and location facts needed to support the payer’s telemedicine requirements. Do not change the modality in the claim when the clinical record describes a different encounter.

• Verify service-date coverage and the responsible medical plan.

• Confirm the exact service is eligible for the planned modality.

• Check enrollment, network and authorization requirements for this encounter.

• Reconcile the documented visit with the payer’s claim instructions before submission.

Continue with eligibility verification and behavioral health claim routing. Keep the video-visit billing instructions with the payer record so the next biller does not have to infer them from an older claim.

Frequently Asked Questions

Is phone-only therapy covered by the Florida Medicaid telemedicine rule?

The cited rule requires real-time two-way audio and video and excludes telephone conversations. Verify any claimed exception through current official payer guidance.

Does every plan use GT?

The state rule specifies GT for qualifying FFS CMS-1500 claims. Confirm SMMC plan claim requirements separately.

Is every H2019 service telemedicine eligible?

No. Check the exact modifier and service row. The 2026 CBH schedule marks H2019 HR with Y, while H2019 HQ is not marked Y.