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Florida Medicaid

August 2019 Outpatient Hospital Services Coverage Policy Agency for Health Care Administration August 2019 Florida Medicaid Florida Medicaid Outpatient Hospital Services Coverage Policy August 2019 i Table of Contents Introduction .. 1 Florida Medicaid Policies .. 1 Statewide Medicaid Managed Care Plans .. 1 Legal Authority .. 1 Definitions .. 1 Eligible Recipient .. 2 General Criteria .. 2 Who Can Receive .. 2 Coinsurance and Copayment .. 2 Eligible Provider .. 2 General Criteria .. 2 Who Can Provide .. 2 Coverage Information .. 2 General Criteria .. 2 Specific Criteria .. 2 Early and Periodic Screening, Diagnosis, and Treatment .. 4 Exclusion .. 4 General Non-Covered Criteria .. 4 Specific Non-Covered Criteria.

Florida Medicaid recipients requiring medically necessary outpatient hospital services. Some services may be subject to additional coverage criteria as specified in section 4.0. If a service is limited to recipients under the age of 21 years, it is specified in section 4.0. Otherwise, the service is covered for recipients of all ages.

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