Florida Medicaid’s Covered Services and HCBS Waivers
Medicaid reimburses for reproductive services to provide diagnostic and therapeutic procedures relating to the reproductive system, including obstetrical and family planning services.
Medicaid reimburses for reproductive services including:
- One prenatal visit that includes a Healthy Start prenatal risk screening
- Up to ten visits, per recipient, for prenatal care
- Testing for sexually transmitted diseases in accordance with section 384.31, Florida Statutes and Rule 64D-3.042, Florida Administrative Code
- Tobacco use screening, smoking cessation counseling, and treatment
- Supplies, medications, and treatments
- One delivery every 280 days, per recipient
- Repair during or following pregnancy
- One recovery service per home birth
- One newborn assessment, per recipient
- Up to two postpartum visits within 90 days following delivery, per recipient
- Up to four additional prenatal visits, per recipient experiencing a high-risk pregnancy
- One neonatology consultation per specialty referral, per recipient
- Surgical excision during pregnancy
- Fetal invasive services
- Fetoscopic laser therapy for treatment of twin-to-twin transfusion syndrome performed by providers with a maternal-fetal medicine subspecialty
- Induction of labor
- Cesarean section
- Family planning visits
- One new patient visit, per recipient
- One established patient visit every 365 days, per recipient
- Counseling visits
- One supply visit per month, per recipient
- Human immunodeficiency virus counseling visits
- Up to two preventive visits per lifetime, per recipient
- Up to four visits per year, per recipient with acknowledged behavioral risks
- Laboratory tests
- Sexually transmitted disease treatment and follow-up
- Essure® (non-incisional surgical procedure)
- Tubal ligation
These services are one of the minimum covered services for all Managed Medical Assistance plans serving Medicaid enrollees.
Florida Medicaid recipients requiring medically necessary reproductive services.
Information on Medicaid health plans and services is available on the Statewide Medicaid Managed Care webpage.
The Florida Medicaid coverage policies, fee schedules, and Rule are available on the Agency Website.