Florida Medicaid Telemedicine Billing: 3 Essential Checks
Florida Medicaid telemedicine billing pays for a visit delivered by real-time, two-way audio and video, and the fee-for-service claim must carry the GT modifier. A phone call does not qualify. Run three checks before every claim and you avoid the denials that cost practices the most.
The rule behind Florida Medicaid telemedicine billing
Florida Medicaid telemedicine billing is governed by Rule 59G-1.057 of the Florida Administrative Code. The rule text says Medicaid pays for telemedicine delivered through interactive equipment with audio and video that allows two-way, real-time communication. It does not pay for telephone calls, chart reviews, email or fax. For fee-for-service claims, the practitioner at the remote site bills with modifier GT on the CMS-1500 claim form. The rule was adopted in 2016 and took effect June 20, 2016.
| Check | What to confirm |
|---|---|
| 1. Fee schedule | The code appears on the schedule for your provider type |
| 2. Live audio and video | Two-way, real-time, and documented in the note |
| 3. Modifier | GT on fee-for-service claims, or whatever the managed care plan requires |
Check 1: find the code on the right fee schedule
Florida Medicaid telemedicine billing starts with the code, so open the Agency for Health Care Administration (AHCA) fee schedules page. It lists a Practitioner Fee Schedule and a Community Behavioral Health Services Fee Schedule, each with an updated version effective January 1, 2026. Community behavioral health services are billed on their own schedule, so a code that works for a practitioner may not be on it. Look up each code you bill, note any telemedicine marker or modifier listed for it, and keep a copy of the schedule you used.
Check 2: live audio and video, documented
The visit has to meet the rule and the note has to prove it. The Center for Connected Health Policy (CCHP), a non-profit that tracks telehealth law, reports on its Florida page (updated June 18, 2026) that Florida Medicaid stopped covering audio-only telehealth on May 11, 2023. Record that video and audio were both used, where the member and clinician were, the start and stop times, and the platform. If the video drops and you finish by phone, write that down and bill only what the rule allows. Our guide to insurance verification helps you catch plan type before the visit.
Check 3: the modifier and the claim
The last step in Florida Medicaid telemedicine billing is the claim line. On fee-for-service claims, GT tells Medicaid the service was a live telemedicine visit. Add it to the line, not just the note. For managed care members, ask the plan for its edits before you bill, since plans set their own claim rules. Review your clean claim rate each month to see whether telehealth lines are failing.
How do you bill a Florida Medicaid telehealth therapy visit?
To complete Florida Medicaid telemedicine billing for a therapy visit, confirm the member’s eligibility and plan, hold the visit by live two-way audio and video, find the code on the correct fee schedule, add modifier GT for fee-for-service, and document the platform and times. Submit the CMS-1500 or its electronic equivalent once, cleanly. Our eligibility verification guide covers the first step.
How the rules differ by payer type
Private payers
Commercial plans are not bound by the Medicaid rule. Each sets its own telehealth policy, so check the plan before you bill and use the insurance companies contact directory to find the right provider line.
Medicare and Medicaid
This post covers Florida Medicaid only. Medicare has its own telehealth rules. Within Florida Medicaid, most members are enrolled in the Statewide Medicaid Managed Care (SMMC) program, according to AHCA, and the current SMMC 3.0 contracts began February 1, 2025. CCHP says managed care plans may offer broader telehealth coverage than the state rule, but not narrower. Check each plan’s current provider bulletin and ignore emergency-era notices from 2020, which no longer apply. Read the remittance advice and use the CARC and RARC code guide to see why a telehealth line denied.
State rules
Payment and prescribing are separate tests. Under section 456.47 of the Florida Statutes, telehealth providers generally cannot prescribe Schedule II controlled substances remotely, with exceptions that include treating a psychiatric disorder. The same statute sets a registration path for out-of-state professionals who treat Florida patients. Psychiatrists should confirm their own prescribing and registration duties with counsel.
What to do Monday morning
- Audit your Florida Medicaid telemedicine billing: pull 20 recent claims and check each for GT and a note that records video and audio.
- Download the current Practitioner and Community Behavioral Health fee schedules and compare your top codes.
- Ask each managed care plan you bill for its current telehealth policy in writing.
- Add a one-line telehealth template to your notes: platform, locations, start and stop times.
The short version: Florida Medicaid telemedicine billing
Florida Medicaid telemedicine billing comes down to three checks: the right fee schedule, live two-way audio and video, and modifier GT on fee-for-service claims. Managed care plans set their own edits. Prescribing law is a separate question from payment.
How MCM South helps
MCM South Medical Billing Service, LLC bills exclusively for mental and behavioral health, for psychotherapists and psychiatrists in solo and medium-size practices. We bill out-of-network claims for clients and work with Medicaid and private payers in our ten served states, Florida included. If telehealth denials are piling up, ask us to look at your claims.
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Related reading
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FAQ
Is modifier GT required on Florida Medicaid telehealth claims?
For fee-for-service claims, yes. The rule says providers must include modifier GT on the CMS-1500 claim form. Managed care plans may have their own modifier rules, so ask the plan.
Does Florida Medicaid pay for therapy by phone?
Not under the state rule, which excludes telephone calls and requires audio and video. CCHP reports that audio-only telehealth coverage ended May 11, 2023. A plan cannot offer less than the rule, though it may offer more, so confirm with the plan.
How do I know if a behavioral health code can be billed by telemedicine?
Check the Community Behavioral Health Services Fee Schedule and the AHCA provider alert for the code and any listed modifier. Do not assume a practitioner-schedule rule applies to a community behavioral health code.
Do managed care plans follow the same telehealth rules?
They must meet the state rule at minimum, but each plan sets its own portals, authorizations and claim edits. Check the plan’s current provider bulletin before you bill.
Where MCM South works
MCM South Medical Billing Service, LLC works with psychotherapists and psychiatrists in our ten currently served states: Georgia, Massachusetts, Connecticut, Texas, Florida, New York, Colorado, Tennessee, North Carolina and Illinois. We serve solo and medium-size practices that bill mental and behavioral health. Founder Michael Williams has worked with insurance payers in all 50 states. Browse the state and regional billing guides for rules that vary by state, or see our billing services.
This post is operational guidance for billing, not legal advice. Rules change, so confirm with the payer or your counsel.
