Florida Medicaid’s 2026 Community Behavioral Health Fee Schedule sets specific reimbursement rates, unit limits, and billing rules for each covered service.
- Assessments: Fees range from $14.79/15 minutes (brief status exam) to $250.63 (physician psychiatric evaluation). For most assessments, there are a limit of one to two assessments per fiscal year in which the State of Florida operates.
- Psychological Testing: Has a fee level of $17.90/15 minutes and a maximum number of 40 units (or 10 hours) per year.
- Functional Assessments: There are limited function assessments with a fee level of $17.90 for mental health and $15.13 for substance abuse, up to three per year.
- Treatment Plans: A plan development fee is $97.86 and review fees are $48.93. Review fees are limited to four times per year.
- Medication Services: Medication management has a fee of $71.61/event. Medical screening is priced at $44.01. And medication assisted treatment (MAT) is priced at $68.08/week.
- Therapy Services: Rates range from $6.73 to $21.87 per 15 minutes based upon whether it is an individual, family, group or brief therapy service.
- On-Site Behavioral Services: On-site therapy is priced at $19.09, on-site behavior management is priced at $10.09, and on-site therapeutic support is priced at $4.04/15 minutes.
- Community Support Services: Psychosocial rehabilitation is priced at $9.08 per 15 minutes, clubhouse services are priced at $5.04 per 15 minutes, and day services are priced at $12.61/hour.
- FACT Services: The Florida Assertive Community Treatment service is priced at $31.55/day and can be billed once per day.
Overview of Florida’s fiscal year and billing context
Florida’s state government and Medicaid programs operate on a fiscal year running from July 1 through June 30. Many service limits and authorization cycles in the Community Behavioral Health (CBH) Fee Schedule reset at the start of each state fiscal year.
Because of this alignment, providers should plan assessment renewals, treatment plan development, and unit caps with the July 1 reset in mind. Always verify the current fee schedule each year; the Agency for Health Care Administration (AHCA) publishes updates in rule 59G‑4.002 and related coverage policies.
Telemedicine policy
Florida Medicaid allows many CBH services to be delivered via telemedicine. The official telemedicine rule (Fla. Admin. Code 59G‑1.057) states that telemedicine involves real‑time, two‑way audio‑video communication between a practitioner and recipient.
Practitioners must be licensed within their scope of practice and must bill using the GT modifier when appropriate. Telemedicine is not reimbursed for simple telephone calls, email or chart reviews.
In the fee schedule tables below, a “Yes” under “Telemedicine” means the service is payable when delivered using telemedicine if all other requirements are met.
Assessment Services: Rates and Annual Limits
Assessments are the backbone of behavioral‑health billing. They establish medical necessity and drive treatment planning. Florida Medicaid pays the lesser of the billed amount or the scheduled maximum.
Providers must not exceed the published rate and should not bill again within the same fiscal year unless a significant change in the recipient’s clinical status justifies a new assessment. Key assessment codes and limits include:
| Service | Code / Modifier | Rate | Annual Limit | Telemedicine |
| Psychiatric Evaluation (Physician) | H2000 HP | $250.63 per evaluation | 2 per SFY | Yes |
| Psychiatric Evaluation (Non-Physician) | H2000 HO | $179.02 per evaluation | 2 per SFY | Yes |
| Brief Behavioral Health Status Exam | H2010 HO | $14.79 per 15 min | 10 units/year; max 2/day | Yes |
| Psychiatric Review of Records | H2000 | $31.03 per review | 2 per SFY | No |
| In-Depth Assessment (New, MH) | H0031 HO | $126.11 | 1 per SFY | No |
| In-Depth Assessment (Established, MH) | H0031 TS | $100.88 | 1 per SFY | No |
| In-Depth Assessment (New, SA) | H0001 HO | $126.11 | 1 per SFY | No |
| In-Depth Assessment (Established, SA) | H0001 TS | $100.88 | 1 per SFY | No |
| Bio-Psychosocial Evaluation (MH) | H0031 HN | $57.28 | 1 per SFY | Yes |
| Bio-Psychosocial Evaluation (SA) | H0001 HN | $57.28 | 1 per SFY | Yes |
Same-Day Restriction: In-Depth vs. Biopsychosocial
A brief behavioral health status exam is not reimbursed on the same day a psychiatric evaluation, bio‑psychosocial evaluation or in‑depth assessment is performed by the same or another practitioner.
In‑depth assessments and bio‑psychosocial evaluations are mutually exclusive on the same day. After an in‑depth assessment, a bio‑psychosocial evaluation is only payable if there is a documented change in clinical status requiring an updated treatment plan.
Psychological Testing & Functional Assessments
Psychological testing and functional assessments fall into a separate category and are often used to support treatment planning and authorization requests.
Psychological testing is billed in 15-minute increments and is subject to an annual cap. For providers performing comprehensive evaluations, this limit may be reached quickly. It is important to track cumulative units per recipient across the fiscal year before scheduling additional sessions.
| Service | Code | Rate | Annual Limit | Telemedicine |
| Psychological Testing | H2019 | $17.90 per 15 min | 40 units (10 hours) | No |
| Limited Functional Assessment (MH) | H0031 | $17.90 per event | 3 per SFY | Yes |
| Limited Functional Assessment (SA) | H0001 | $15.13 per event | 3 per SFY | Yes |
Treatment Plan Development and Review
Treatment plans guide ongoing services and must be signed by the treating practitioner. The billing date is the date the provider authorizes the plan. Limits apply both to providers and to recipients to encourage coordination of care.
| Service | Code / Modifier | Rate | Limit |
| Treatment Plan Development (MH) | H0032 | $97.86 | 1 per provider / SFY; 2 per recipient |
| Treatment Plan Development (SA) | T1007 | $97.86 | 1 per provider / SFY; 2 per recipient |
| Treatment Plan Review (MH) | H0032 TS | $48.93 | 4 per SFY |
| Treatment Plan Review (SA) | T1007 TS | $48.93 | 4 per SFY |
Plan development includes a two-tier limit. A single provider may bill one development per recipient per fiscal year, while the recipient may receive up to two plans in total across all providers. This distinction is important in coordinated care situations where multiple providers are involved.
Medication Management and Related Medical Services
Medication‑related services have various limits and same‑day conflicts. When scheduling, ensure that screenings, verbal interactions, and procedures do not overlap.
| Service | Code / Modifier | Rate | Limit | Telemedicine |
| Medication Management | T1015 | $71.61 per event | Medically necessary | Yes |
| Behavioral Health Medical Screening (MH) | T1023 HE | $44.01 | 2 per SFY | Yes |
| Behavioral Health Medical Screening (SA) | T1023 HF | $44.01 | 2 per SFY | Yes |
| Verbal Interaction (MH) | H0046 | $15.13 | 52 per SFY | Yes |
| Verbal Interaction (SA) | H0047 | $15.13 | 52 per SFY | Yes |
| Medical Procedures (MH) | T1015 HE | $10.09 | 52 per SFY | No |
| Medical Procedures (SA) | T1015 HF | $10.09 | 52 per SFY | No |
| AOD Specimen Collection | H0048 | $10.09 | 52 per SFY | No |
| Medication-Assisted Treatment (MAT) | H0020 | $68.08 per week | 52 per SFY | Yes* |
Billing cautions for medication services:
- Medication management (T1015) may not be billed on the same day as brief group medical therapy (H2010 HQ) or brief individual medical psychotherapy (H2010 HE/HF).
- Behavioral health medical screening cannot be billed on the same day as verbal interaction or medication management services.
- MAT is billed as a flat weekly rate; do not unbundle its components into other codes.
Therapy Services: Individual, Group, Family, and On-Site
Therapy codes account for a large share of CBH volume. Each has specific unit caps and daily limits. Telemedicine is allowed for most individual services.
| Service | Code / Modifier | Rate | Limit | Telemedicine |
| Brief Individual Medical Psychotherapy (MH) | H2010 HE | $15.13 per 15 min | 16 units/year; max 2/day | Yes |
| Brief Individual Medical Psychotherapy (SA) | H2010 HF | $15.13 per 15 min | 16 units/year; max 2/day | Yes |
| Brief Group Medical Therapy | H2010 HQ | $8.73 per 15 min | 18 units/year | No |
| Individual & Family Therapy | H2019 HR | $21.87 per 15 min | 104 units/year; max 4/day | Yes |
| Group Therapy | H2019 HQ | $6.73 per 15 min | 156 units/year | No |
Therapeutic Behavioral On-site Therapy
Therapeutic behavioral on-site therapy (H2019 HO) and behavior management (H2019 HN) share a combined monthly cap of 36 fifteen-minute units.
If a patient receives 20 units of on-site therapy in a month, only 16 units of behavior management remain available before the combined pool is exhausted.
Therapeutic support (H2019 HM) has its own separate monthly cap of 128 units and does not draw from that shared pool.
| Service | Code / Modifier | Rate | Limit |
| On-Site Therapy | H2019 HO | $19.09 per 15 min | 36 units/month (shared) |
| Behavior Management | H2019 HN | $10.09 per 15 min | 36 units/month (shared) |
| Therapeutic Support | H2019 HM | $4.04 per 15 min | 128 units/month |
Community Support and Intensive Services
Community-based services support recipients with higher levels of need, including psychosocial rehabilitation, clubhouse services, day services, and intensive team-based care.
Psychosocial rehabilitation and clubhouse services share a combined annual unit limit. Providers delivering both services to the same recipient should track total usage across both codes.
Behavioral health day services are generally not reimbursed on the same day as psychosocial rehabilitation services.
| Service | Code | Rate | Annual Limit |
| Psychosocial Rehabilitation | H2017 | $9.08 per 15 min | 1,920 units (shared) |
| Clubhouse Services | H2030 | $5.04 per 15 min | 1,920 units (shared) |
| Behavioral Health Day Services (MH) | H2012 | $12.61 per hour | 190 hours |
| Behavioral Health Day Services (SA) | H2012 HF | $12.61 per hour | 190 hours |
| Florida Assertive Community Treatment (FACT) | H0040 | $31.55 per day | Up to SFY days |
Psychosocial rehabilitation (H2017) and clubhouse services (H2030) share the same 1,920-unit annual cap. Every unit billed under H2017 reduces the amount available for H2030, and vice versa. Providers offering both services to the same recipient must track a single combined running total.
Behavioral health day services cannot be billed on the same day as psychosocial rehabilitation services. These services are mutually exclusive per service date.
Florida Assertive Community Treatment (FACT)
FACT is the most intensive community-based service on the schedule at $31.55 per day, billed once daily up to 365 or 366 days per fiscal year.
FACT services are governed by policy 59G-4.127 and require specific program certification. Only FACT-certified teams should bill under H0040. Billing is limited to one unit per day, up to the number of days in the state fiscal year.
Telemedicine-Eligible CBH Services (2026)
Florida Medicaid allows telemedicine delivery for many Community Behavioral Health (CBH) services under Rule 59G-1.057, subject to program guidance and provider requirements.
Telemedicine eligibility does not override coverage limitations. Services must still meet medical-necessity criteria and remain within applicable unit and frequency limits, regardless of the delivery method.
Key Takeaways And Compliance Tips
- Plan around the fiscal year. Most annual unit limits reset each July 1. Avoid scheduling assessments or treatment plan renewals too early or too late in the fiscal year.
- Use the correct code and modifier. Many services have nearly identical descriptions (e.g., H2010 HE vs. H2010 HF) but different modifiers for mental health versus substance abuse. Confirm both the procedure code and modifier before billing.
- Watch same‑day conflicts. Florida Medicaid generally will not pay two overlapping services on the same date—for example, an in‑depth assessment and a bio‑psychosocial evaluation, or medication management and individual psychotherapy. Build these checks into your billing workflow.
- Telemedicine is widely available but not universal. Services with a “Yes” indicator may be delivered via telemedicine if they meet the rule’s real‑time audio‑video requirements. Telephone‑only or asynchronous communications are not reimbursed.
- Bill within the maximum allowable amount. Medicaid will pay the lower of your billed charge or the fee schedule amount. Do not bill above the schedule rate and always verify you are using the most current fee schedule.
Conclusion
The 2026 Community Behavioral Health Fee Schedule builds on prior years by continuing established service categories and rates. The information above has been verified against AHCA’s official 2025 fee schedule and related policies, which remain in effect for 2026.
Providers should reference the most current AHCA publications each fiscal year and remain attentive to unit limits, same‑day restrictions, and telemedicine requirements. Planning care around the July 1 fiscal year reset and adhering to these guidelines helps ensure compliant billing and uninterrupted reimbursement.
