Florida Medicaid Behavioral Health Billing: Manuals, Codes and Payers
Florida Medicaid publishes behavioral health rates in fee schedules from the Agency for Health Care Administration (AHCA), and most members are in Statewide Medicaid Managed Care plans. This page lists the sources, the plans, and the codes we could confirm. Checked against state sources on 9/30/26.
Get My Free ConsultationIn this guide
- ✓ AHCA fee schedules for 2026
- ✓ Statewide Medicaid Managed Care plans
- ✓ HCPCS codes in the 2026 fee schedules
- ✓ The Children's Medical Services plan change
Florida Medicaid Billing at a glance
This page covers florida medicaid billing for behavioral health claims: where the state provider manuals and code lists live, and which HCPCS codes apply to psychotherapists and psychiatrists. Rules vary by state and by payer, so confirm current requirements with the state Medicaid agency before you bill.
Use this Florida Medicaid Billing guide as a starting point. Florida Medicaid Billing rules differ by plan, so check whether a claim goes to the state fee-for-service program or to a managed care plan. Keep a copy of the current Florida Medicaid Billing manual your practice follows, and review your Florida Medicaid Billing process whenever the state issues an update.
Florida Medicaid at a glance
State manuals and fee schedules
| Document | What it covers |
|---|---|
| Florida AHCA Medicaid | The state Medicaid agency. |
| AHCA fee schedules | January 1, 2026 schedules for Practitioner, Community Behavioral Health, Behavioral Health Overlay Services and Mental Health Targeted Case Management. |
Managed care plans and payer sites
| Payer | Provider site |
|---|---|
| Sunshine Health | Providers |
| Florida Community Care | Providers |
| Aetna Better Health of Florida | Providers |
| Humana Healthy Horizons in Florida | For providers |
Also named: UnitedHealthcare, Molina and Simply Healthcare Plans. AHCA's own plan-contact list is dated 2021, so confirm the current roster with AHCA.
HCPCS codes we could confirm
AHCA's 2026 fee schedules list H0040 (Florida Assertive Community Treatment), H0031, H2019 (with modifiers HR, HQ, HO, HN and HM), H2017, and H2020 for Behavioral Health Overlay Services (modifier HA, per day). H2015 appears for substance-abuse services only. H2011, H2033 and H0036 appeared only in a plan guide from Aetna. We could not read the Medicaid coverage and limitations handbook.
What is changing
- The Children's Medical Services plan moves from Sunshine Health to Molina on 10/1/2026.
- We could not confirm the 2025 to 2030 plan roster from an AHCA page.
Current as of 9/30/2026. Reconfirm before you bill.
Florida Medicaid billing: frequently asked questions
Where are Florida Medicaid behavioral health rates?
In AHCA's fee schedules, updated January 1, 2026, including Community Behavioral Health and Behavioral Health Overlay Services.
Does Florida use H2020?
The 2026 fee schedules list H2020 for Behavioral Health Overlay Services with modifier HA, per day. Confirm the rules in the schedule.
Who pays Florida Medicaid claims?
Statewide Medicaid Managed Care plans pay most claims. Check the member's plan and that plan's manual.
Where this information comes from
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