I used to have to research information on Medicaid in different states for a past employer. One of the great things about working with any state's traditional Medicaid program is that all policies and procedures are publicly available on that state's website. Some state's websites are easier to navigate and find information on than others, of course, but it's all out there in some fashion.
I looked at the Florida Medicaid website and found that the Practitioner Fee Schedule has a column on it for whether any given CPT code requires prior authorizations. That should be a good resource for you. I'm including that link below and also a few additional links below that may be helpful learning and navigating Florida Medicaid.
Fee Schedules (the Practitioner Fee schedule specifically would have the physician codes with the prior authorization column):
Rule 59G-4.002, Provider Reimbursement Schedules and Billing CodesFee ScheduleEffective DateAssistive Care Services Fee ScheduleUpdated Fee Schedule 2023Updated Fee Schedule July 2022Promulgated Fee Schedule 2022Behavior Analysis Fee ScheduleUpdated Fe...
ahca.myflorida.com
Program rules (this is where you can find any claims billing rules or other policies):
Rules The Rules Unit is responsible for coordinating and providing support to Florida Medicaid staff related to administrative rules promulgated in the Florida Administrative Code. Emergency Variance/Waiver Petition Below you...
ahca.myflorida.com
Program overview (including how providers can enroll in traditional Medicaid and rules that apply to managed Medicaid in Florida too):
Medicaid is the medical assistance program that provides access to health care for low-income families and individuals. Medicaid also assists the elderly and people with disabilities with the costs of nursing facility care and other medical and long-t...
ahca.myflorida.com
Hope this helps!
