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Florida Medicaid Provider Minimum Wage Fee Schedule Increases

  • The 2022 General Appropriations Act provided the Agency with funding to supplement provider rates and fee schedules for the sole purpose of increasing wages of direct care employees of Medicaid Providers to at least $15 per hour. This appropriation is a targeted increase and not an overall increase for all providers, nor does it provide additional reimbursement to pay for staff already receiving $15 per hour.
  • The Agency’s Actuarial Services vendor, Milliman, at the direction of the Agency, provided the estimated impact that a $15 per hour minimum wage for direct care employees would have on costs for healthcare providers. This study was the source the legislature utilized for the appropriation.
  • The Milliman analysis provided the Agency with an estimated percent impact of an increased minimum wage for direct care employees broken down by NAICS (North American Industry Classification System) codes. The Agency then created a crosswalk that mapped the corresponding NAICS code and percent increase to provider fee schedule and appropriation category.
  • The Florida Legislature appropriated specific amounts for Medicaid services:
    • $5,958,207 was appropriated to increase wages for fee-for-service hospital services
    • $13,832,192 was appropriated to increase wages for fee-for-service nursing home services
    • $34,991,119 was appropriated to increase wages for fee-for-service ICF/IID services
    • $30,218,138 was appropriated to increase wages for all other fee-for-service categories (fee schedules)
  • The remaining appropriation is for the Prepaid Health plans to pass through to providers the $15 minimum wage increase for services provided under the Statewide Medicaid Managed Care program.  Health plans will increase payments to providers by the same increment as was applied in the updated fee schedules for those providers whose reimbursement by health plans is equal to the fee-for-service reimbursement.
    • For services under the Long-Term Care (LTC) Program that are not listed on a fee schedule, the Prepaid Health plans are responsible to increase reimbursement for these services to account for the $15 minimum wage increase.
Appropriation Category Appropriation Annualized Appropriation Total Appropriation
203: Hospital Inpatient Services $4,940,128 $- $4,940,128
207: Hospital Outpatient Services $1,018,079 $- $1,018,079
208: Other Fee-for-Service Hospice $840,002 $279,986 $1,119,988
209: Personal Care Services $14,670,065 $- $14,670,065
210: Physician and Health Care Practitioner Services $14,083,964 $- $14,083,964
211: Prepaid Health Plans $67,678,874 $22,559,625 $90,238,499
217: Assistive Care Services $344,121 $- $344,121
220: Intermediate Care Facilities/Developmentally Disabled Community $34,991,119 $- $34,991,119
222: Prepaid Health Plan/Long Term Care $135,900,000 $45,300,000 $181,200,000
221: Nursing Home Care $10,374,277 $3,457,915 $13,832,192
222: Prepaid Health Plan/Long Term Care - Nursing Home Care $201,566,143 $67,185,264 $268,751,407
Total Appropriation for Minimum Wage Increase $486,406,772 $138,782,790 $625,189,562

Fee Schedule Increases
The Medicaid Fee-for-Service (FFS) Fee Schedules listed below have received an increase for the sole purpose of raising wages of direct care employees of Medicaid providers, including 1099 employees, who provide services under the Florida Medicaid Program to at least $15.00 per hour. The FFS fee schedule increases below will be live in the Florida Medicaid Management Information System (FMMIS) in the near future. All fee schedule increases on the table below, except for Federally Qualified Health Centers and Rural Health Clinics, will be effective retroactively for dates of service on or after July 1, 2022. The increased rates for Federally Qualified Health Centers and Rural Health Clinics will be effective October 1, 2022.

Medicaid Provider Minimum Wage Appropriations
Fee-for-Service Fee Schedule Increases
Fee Schedule % Increase Applied Link to Updated Fee Schedule
Assistive Care Services Fee Schedule 9.10% Assistive Care Services Fee Schedule
Behavioral Health Overlay Services 0.88% Behavioral Health Overlay Services
Birthing Center Fee Schedule 1.28% Birthing Center Fee Schedule
Child Health Targeted Case Management 0.59% Child Health Targeted Case Management
Community Behavioral Health Services 0.88% Community Behavioral Health Services
Dental Fee Schedule 0.44% Dental Fee Schedule
FQHC Billing Codes & RHC Billing Codes 1.47% FQHC Billing Codes & RHC Billing Codes
Hearing Services Fee Schedule 0.71% Hearing Services Fee Schedule
Home Health Visit Services Fee Schedule 3.33% Home Health Visit Services Fee Schedule
Independent Laboratory Fee Schedule 0.37% Independent Laboratory Fee Schedule
Licensed Midwives Fee Schedule 1.28% Licensed Midwives Fee Schedule
Medical Foster Care Services Fee Schedule 13.39% Medical Foster Care Services Fee Schedule
Mental Health Targeted Case Management 0.59% Mental Health Targeted Case Management Fee Schedule
Occupational Therapy Services Fee Schedule 0.71% Occupational Therapy Services Fee Schedule
Personal Care Services Fee Schedule 15.45% Personal Care Services Fee Schedule
Physical Therapy Fee Schedule 0.71% Physical Therapy Fee schedule
Practitioner Fee Schedule 0.95% Practitioner Fee Schedule
Practitioner Laboratory Fee Schedule 0.37% Practitioner Laboratory Fee Schedule
Prescribed Pediatric Extended Care Services 13.39% Prescribed Pediatric Extended Care Services Fee Schedule
Private Duty Nursing Services Fee Schedule 3.33% Private Duty Nursing Services Fee Schedule
Radiology Fee Schedule 1.28% Radiology Fee Schedule
Respiratory Therapy Services Fee Schedule 1.28% Respiratory Therapy Services Fee Schedule
Specialized Therapeutic Services 0.88% Specialized Therapeutic Services
Speech-Language Pathology Services 0.71% Speech-Language Pathology Services Fee Schedule
Transportation Services Fee Schedule 1.44% Transportation Services Fee Schedule
Visual Services Fee Schedule 1.15% Visual Services Fee Schedule
 

Nursing Home Rate Increases
The Agency for Health Care Administration (Agency) has adjusted Medicaid nursing home rates for State Fiscal Year 2022-23. Additionally, the Agency has increased the nursing homes rates as directed in the 2022-23 General Appropriations Act for the purpose of raising wages of all employees of Medicaid Nursing Home providers, including 1099 employees, to at least $15.00 per hour. The final nursing home rates can be accessed here, on the Medicaid Program Finance page on the Agency’s website.

These rates will be implemented in the Florida Medicaid Management Information System (FMMIS) in the near future. Once implemented in FMMIS, Medicaid nursing home rates for 2022-23 will be effective retroactively for dates of service on or after October 1, 2022.
 

Hospice Rate Increases
The Agency for Health Care Administration (Agency) has adjusted Medicaid Hospice rates for room and board and level of care for State Fiscal Year 2022-23. Additionally, the Agency has increased the hospice rates as directed in the 2022-23 General Appropriations Act for the purpose of raising wages for direct care employees, including 1099 employees, of Medicaid hospice providers to at least $15.00 per hour. These rates will be implemented in the Florida Medicaid Management Information System (FMMIS) in the near future and will be effective retroactively for dates of service on or after October 1, 2022.

The final Medicaid hospice rates can be accessed on the Agency’s website at the links below:
 

Hospital, ASC, and ICF Rate Increases
The Agency has adjusted the institutional FFS rates below for sole purpose of raising wages of direct care employees of Medicaid providers including 1099 employees who provide services under the Florida Medicaid Program to at least $15.00 per hour.  These rates are effective July 1, 2022.

Medicaid Provider Minimum Wage Appropriations
Fee-for-Service Institutional Rate Increases
Fee-for-Service Institutional Rates Link to Updated Reimbursement Rates
Hospital and Ambulatory Surgical Centers (ASC) Inpatient and Outpatient Services Hospital and ASC Inpatient and Outpatient Services Fee-for-Service Rates
ICF/IID Fee-for-Service Rates ICF/IID Fee-for-Service Rates
 

Medicaid Fee-For-Service Fee Schedules NOT Receiving an Increase
The following fee schedules will NOT receive an increase related to the minimum wage requirement. Florida Medicaid providers who bill exclusively under the fee schedules listed below are not required to sign the supplemental wage agreement.