This quick reference guide provides information about common application deficiencies and resolutions specifically for Florida Medicaid Behavior Analysis provider enrollment.

Missing or Incomplete Non-Institutional Medicaid Provider Agreement

The Non-Institutional Medicaid Provider Agreement is available on the Enrollment Forms page.

A Registered Behavior Technician (RBT), Assistant Behavior Analyst (ABA), or Lead Analyst will sign their agreement to submit with their Florida Medicaid application. An employer cannot sign for the applicant.

A Behavior Analysis Group is required to have each principal of the provider sign the agreement. For this purpose, principals include partners or shareholders of five (5) percent or more, officers, directors, managers, financial records custodian, medical records custodian, subcontractors, and individuals holding signing privileges on the depository account, and other affiliated persons.

A Chief Executive Officer (CEO) or president may sign the agreement in place of all principals of the group.

Missing or Incomplete Proof of Tax ID

Florida Medicaid applicants must submit proof from the Internal Revenue Service (IRS) showing the disclosed Tax IDs belong to the respective applicants. Applicants cannot enroll with another person’s or an employer’s, Tax ID.
Acceptable forms of proof include:

• IRS Letter 47c
• IRS Form SS-4
• IRS W-9
• Social Security Number (SSN) Card

Non-citizens require authorization from the Department of Homeland Security (DHS) in order to work in the United States. If you are a non-citizen, submit evidence of employment authorization from the DHS.

It is essential to ensure that the name on the application and the license match exactly with the name on the tax document.

Provider Contact Information

Florida Medicaid Behavior Analysis providers must have a specified address, phone number, and email unique to their application. If a provider works with multiple group providers, the rendering provider must make one update only via the Florida Medicaid Provider Web Portal. To update this information, providers should access their account via Secure Web Portal and follow the instructions as displayed below:

1. To update the provider’s contact information, go to the Secure Web Portal and click on Demographic Maintenance.

2. Click on Location Name Address and then click on SVC LOCATION:

3. Enter unique information in the E-mail and Phone number fields below. Then click save in the bottom right corner.

Florida Medicaid requires that Behavior Analysis rendering providers have a unique email address and phone number. When completing the online application, the rendering provider’s email and phone number must be entered in the Service Location panel. Applicants should refrain from placing the group’s contact information in this panel.

Notice Regarding Use of Social Security Number (SSN)

As a part of the Florida Medicaid provider enrollment application, it is mandatory for all individuals listed on the provider enrollment application to furnish their SSN to the Agency for Health Care Administration (Agency), pursuant to Part 455, Subpart B of the Code of Federal Regulations. Failure to furnish an SSN validates denial of enrollment with Florida Medicaid. The SSN is used to secure the proper identification of persons for whom the Agency is responsible for making a return, statement, or other document in accordance with the Internal Revenue Code, and to assist in the administration of the Florida Medicaid program.

Notice Regarding Use of National Provider Identifier

Behavior Analysis providers must provide an NPI (National Provider Identifier) as a condition of enrollment with Florida Medicaid.

In accordance with the federal requirement, all rendering, ordering, prescribing, or attending providers enrolled in Florida Medicaid must have an NPI on file with the Agency. This includes all behavior analysis providers, provider type 39, enrolled with Florida Medicaid, and all provider type 39 specialties; Lead Analysts (specialty type 392), Assistant Behavior Analysts (specialty type 391), Registered Behavior Technicians (specialty type 390), and Behavior Analysis Groups (specialty type 393).

The NPI is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA. You can find out more about the CMS requirement for an NPI here: National Provider Identifier Standard (NPI). 

Please refer to the NPI Quick Reference Guide under Provider Services for additional information on NPI requirements.
 

Missing Results for the Fingerprint-based Criminal Background Check

Florida Medicaid applicants must submit a complete set of their fingerprints to obtain a state and national criminal background check.

Applicants must utilize the Care Provider Background Screening Clearinghouse (Clearinghouse) to request, schedule, and track fingerprint results. Information about the Clearinghouse is available on the Background Screening page.

An applicant must create an account in the Clearinghouse for Florida Medicaid and process all background screenings (screenings) on that account for Provider Enrollment to receive the screening results. The Clearinghouse site has helpful training materials to assist with creating an account and scheduling a screening.

Applicants who have been screened for employment or enrollment in another program still require an eligible screening for their current application.

A new screening must be scheduled if an applicant has no screening in the Clearinghouse or screening with no photo.

Applicants with an Eligible status screening with a photo in the Clearinghouse can request an Agency Review for Florida Medicaid and do not need to submit new fingerprints at this moment.

Missing Certification or License

Individuals enrolling in the Behavior Analysis program must submit the appropriate proof of a designation as a behavior technician, assistant, analyst, or group as detailed below.

390 Registered Behavior Technician

In addition to the information in the Florida Medicaid Provider Enrollment Application Guide, below is additional information that will be useful in completing the enrollment applications.

• Proof of certification must include one of the following:
  • Behavior Analyst Certification Board (BACB) designation as a Registered Behavior Technician (RBT), or;
  • A color copy from the BACB website (www.bacb.com) showing the applicant’s RBT registration.
  • The copy must be in color.
    • Black and white scans or copies will be rejected.
    • The name on the application and the name on the BACB credentialing document must match exactly.
  • Must link to a Medicaid-enrolled Behavior Analysis Group.

391 Assistant Behavior Analyst

Additional information that will be useful in completing the enrollment applications.

• Proof of certification must include:
  • Behavior Analyst Certification Board designation as a Board Certified Assistant Behavior Analyst (BCaBA)
  • Must link to a Medicaid-enrolled Behavior Analysis Group.

392 Lead Analyst

Additional information that will be useful in completing the enrollment applications.

• Proof of certification must include one of the following:
  • Behavior Analyst Certification Board designation as a Board Certified Behavior Analyst (BCBA)
  • Behavior Analyst Certification Board designation as a Board Certified Behavior Analyst Doctoral (BCBA-D)
  • Florida Certified Behavior Analyst (FL-CBA)
  • Florida Licensed Clinical Social Worker
  • Florida Licensed Mental Health Counselor
  • Florida Licensed Marriage and Family Therapist
  • Florida Licensed Psychologist
  • Florida Licensed School Psychologist
• Must link to a Medicaid-enrolled Behavior Analysis Group (if enrolling as a Sole Proprietor Enrolling as a Member of a Group).
• A site visit is required if enrolling as a Sole Proprietor.

393 Behavior Analysis Group

Additional information that will be useful in completing the enrollment applications.

• Behavior Analysis groups must have at least one Lead Analyst as a group member.
• Group members must be enrolled in Medicaid as a Registered Behavior Technician, Assistant Behavior Analyst, or Lead Analyst.
• For billing purposes, each Behavior Analysis group must submit a list of treating providers within the group.
• Each of the group’s treating providers must be individually enrolled in the Florida Medicaid program to be linked to the group in the Medicaid system.
• A site visit is required.

For More Information

The Agency has established a web page for Behavior Analysis and Behavior Health services.

• Behavior Analysis Services Information page
• Medical and Behavioral Health Coverage Policy page
• Behavioral Health and Health Facilities page
• Health Care Clinics page

Additional Resources
AHCA Adopted Rules
Adopted Rules - Florida Medicaid Forms
Adopted Rules - Provider Enrollment Policy
Florida Medicaid Contact Information Sheet
Support
Training

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