Beginning August 1, 2012,
reimbursement for procedure codes 99201-99215 is limited to two per month for
general services.  This affects the following provider types and
specialties: provider types 25, 26, 29 and 30 with a specialty code of 009
(Family Practice), 011 (General Practice), 012 (Preventive Medicine), 018
(Internal Medicine), 045 (Public Health), 075 (Adult Primary Care), 077
(College Health Nurse), 080 (Family Nurse).
Exemption to this limit
automatically applies to the following:

• Recipients under the age of 21
• A pregnancy-related diagnosis code associated with
  the visit
• Visits provided in county health departments,
  federally qualified health clinics or rural health clinics
• The rendering provider has another specialty on
  their enrollment file

Claims with documentation may
be submitted for consideration to your local Medicaid area office to override
the limit for the following diagnoses:

• End-stage cirrhosis and ascites (requiring
  adjustments to diuretic medications and check of potassium levels)
• Diabetes with complications of peripheral neuropathy
  resulting in infected foot ulcer (requires frequent visits for antibiotics,
  debridement)
• Pneumonia and comorbidities (to monitor treatment
  response)
• New onset of syncope (evaluation, review of studies
  and follow-up)

The Agency for Health Care
Administration (Agency) may consider additional diagnoses to exempt from the
limit.

Send your claims with
documentation describing the medical necessity of the visit to your local
Medicaid area office addressed with “Attention: Exceptional Claim
Process.”  Contact information for the Medicaid area offices can be found
at http://www.mymedicaid-florida.com/.
The Agency wishes to thank you for your
continued care of our Medicaid recipients.  Your cooperation in this
effort is appreciated.