Florida Medicaid
Complete guide to Florida Medicaid enrollment, MCO contracting, and billing requirements
Enrollment Time
60-90 Days
MCOs
5 Plans
Timely Filing
90 Days
Model
Managed Care
Florida Medicaid Overview
Florida Medicaid operates through the Managed Medical Assistance (MMA) program, with managed care plans serving most beneficiaries. The program includes comprehensive medical, behavioral health, and dental services.
Managed Medical Assistance (MMA)
Most beneficiaries including children and families
Long-Term Care (LTC)
Elderly and disabled populations
Enrollment Process
Florida Medicaid Provider Enrollment
Step-by-Step Process
- Enroll with Florida Medicaid through the Agency for Health Care Administration (AHCA)
- Complete online provider enrollment application
- Submit required documentation (licenses, NPI, tax documents)
- Pass background screening requirements
- Contract with individual MCOs after Medicaid enrollment
Timeline
- • Florida Medicaid enrollment: 30-60 days
- • MCO credentialing: 60-90 days per plan
- • Total: 90-150 days from start to billing
Required Documentation
- • Florida professional license
- • DEA registration (if applicable)
- • NPI (Type 1 and/or Type 2)
- • W-9 or tax documentation
- • Malpractice insurance
- • Level 2 background screening clearance
Florida Medicaid MCOs
Aetna Better Health of Florida
Florida Community Care
Humana Healthy Horizons
Molina Healthcare of Florida
Simply Healthcare Plans
Tip: Most providers contract with 3-4 MCOs to maximize patient access. Plan availability varies by region in Florida.
Behavioral Health Services
Florida Medicaid Behavioral Health Coverage
Behavioral health services are covered through the MCOs in Florida Medicaid. Specialized BH services may require additional authorization.
Covered BH Services
- • Outpatient therapy (individual, group, family)
- • Psychiatric services and medication management
- • Intensive outpatient programs (IOP)
- • Partial hospitalization programs (PHP)
- • Residential treatment (with authorization)
- • Substance abuse treatment services
- • Crisis stabilization services
BH Provider Requirements
- • Florida behavioral health license (LCSW, LMHC, LMFT, psychologist)
- • Facilities must be licensed by DCF or appropriate agency
- • SUD programs require SAMH licensure
- • Background screening Level 2 clearance
Important Contacts
AHCA (Agency for Health Care Admin)
Provider Enrollment
1-866-809-0390
Medicaid Helpline
1-877-254-1055
Provider Portal
Florida Medicaid PortalBackground Screening
AHCA Screening Unit
1-888-419-3456
Level 2 Screening
Required for all Medicaid providers