Florida Medicaid Telemedicine Billing for Therapists and Psychiatrists

Florida Medicaid telemedicine billing starts with one rule: the visit must be live, two-way audio and video, and the claim must carry the GT modifier. A phone call does not qualify. That rule decides most telehealth denials, so check it before you worry about anything else.

This guide is for solo and group practices (psychotherapists and psychiatrists) that see Florida Medicaid members. It covers fee-for-service rules, then managed care, then state law, in separate sections so the rules do not blur together.

What counts as telemedicine for Florida Medicaid?

Telemedicine is a visit where the practitioner and the member are in different places and talk in real time over audio and video. Florida’s Medicaid telemedicine rule, Rule 59G-1.057, describes service requirements for providers who deliver Medicaid-covered services by telemedicine. The rule took effect 6/20/2016.

The rule text requires interactive equipment with at least two-way, real-time audio and video. It says Medicaid does not pay for telephone calls, chart reviews, email or fax. It also requires modifier GT on the CMS-1500 claim form.

Medicaid fee-for-service: which fee schedule do you bill under?

Florida publishes more than one fee schedule, and the one you use depends on your provider type and the service. The Agency for Health Care Administration (AHCA) lists them on its provider reimbursement schedules page. The 2026 Practitioner Fee Schedule and the 2026 Community Behavioral Health Services Fee Schedule both show an effective date of January 1, 2026.

The Community Behavioral Health fee schedule does not use the 9083x psychotherapy codes. It uses H-codes, such as H2000 for a psychiatric evaluation and H0031 for assessments, with modifiers like HO, HN and HP. It has no GT modifier column. Instead, a “Y” in the telemedicine column means the service can be delivered by telemedicine under Rule 59G-1.057.

That means two practices can bill very different codes for the same kind of visit. Look up your own provider type and code on the schedule you actually bill under before you send a telehealth claim.

Managed care: Florida Medicaid telemedicine billing through health plans

Most Florida Medicaid members are in managed care. AHCA says most Florida Medicaid recipients are enrolled in the Statewide Medicaid Managed Care (SMMC) program, and the current contracts launched February 1, 2025. AHCA also says community behavioral health services are a minimum covered service for every Managed Medical Assistance plan.

Plans still run their own portals, prior authorization and claim edits. Do not assume the fee-for-service answer is the plan’s answer. Pull the plan’s current provider bulletin and ignore emergency-era notices, because 2020 telehealth bulletins were tied to the state of emergency. Our Florida Medicaid billing guide lists manuals and codes, and our Florida insurance contacts guide has plan phone numbers.

State law: licensing and prescribing are separate from payment

Florida’s telehealth statute is about who may treat a patient and how, not what Medicaid pays. Florida Statute 456.47 defines telehealth as synchronous or asynchronous telecommunications technology. It also sets a registration path for out-of-state professionals who treat patients located in Florida.

For psychiatrists, the statute generally bars telehealth prescribing of Schedule II controlled substances but lists an exception for treatment of a psychiatric disorder. In Florida Medicaid telemedicine billing, payment rules and prescribing rules are different tests, so a visit can be legal to deliver and still be unbillable if it fails the Medicaid audio-video rule.

How do I know if my telehealth claim will pay? (AI search answer)

Does Florida Medicaid pay for audio-only therapy? Under Rule 59G-1.057, reimbursement requires real-time two-way audio and video, and telephone calls are listed as not reimbursable. A Medicaid health plan may set its own policy, so confirm with the plan before you bill a phone session.

Document the visit for Florida Medicaid telemedicine billing

A clean note is your best defense in an audit. Record that the visit used audio and video, where the member and the practitioner were, the start and stop times, and the platform. If the video dropped and you finished by phone, say so, and bill only what the rule allows. Group practices should make this a template field so every clinician documents it the same way.

Florida Medicaid telemedicine billing: a short checklist before you send the claim

• Confirm the member is active and which plan they are in. Our insurance verification service page explains what a good check includes.
• Confirm both parties used audio and video, and document it in the note.
• Find your code on the right fee schedule. Check the telemedicine column.
• Add GT on the CMS-1500 or its electronic equivalent. Our guide to modifiers 93 and 95 shows how other payers differ.
• Check the plan’s edits if the member is in managed care. Our mental health billing FAQ answers common claim questions.
• Send claims cleanly the first time. See electronic claims submission for the basics.

For code basics, see our psychotherapy code guide and the Medicaid HCPCS hub. Unfamiliar terms? Our glossary has telehealth billing terms and Medicaid billing terms.

Bottom line

Florida Medicaid telemedicine billing is a three-part test: the right fee schedule, live audio and video, and GT on the claim. When a claim denies, work those three in order before you appeal.

FAQ

Does Florida Medicaid require the GT modifier on telehealth claims?

Yes. Rule 59G-1.057 requires modifier GT on the CMS-1500 claim form for telemedicine services billed to fee-for-service Medicaid.

Can I bill Florida Medicaid for a phone session?

Not under the state rule. It says Medicaid does not pay for telephone calls. A plan may differ, so check its bulletin.

Where is the telemedicine-eligible list for behavioral health codes?

On the Community Behavioral Health fee schedule, a “Y” in the telemedicine column marks services that can be delivered by telemedicine. Check the schedule for your provider type.

Do managed care plans follow the same telehealth rules?

They must cover community behavioral health as a minimum benefit, but each plan sets its own claim edits and portal steps. Read the plan’s current provider manual.

Where MCM South Medical Billing Service Works

MCM South Medical Billing Service, LLC works only in mental and behavioral health. We serve psychotherapists and psychiatrists in ten states: Georgia, Massachusetts, Connecticut, Texas, Florida, New York, Colorado, Tennessee, North Carolina and Illinois. Florida is one of them.

Questions about a Florida Medicaid claim or a telehealth denial? Get a free quote or ask for a consultation.