Out-of-State Enrollments
NOTE: This information will be updated with the implementation of the new provider enrollment system, which is scheduled for April 2026. To stay informed about the transition effort, sign up for Florida Medicaid Health Care Alerts.
Florida Medicaid will reimburse out-of-state providers who provide services to an eligible Medicaid recipient under the following circumstances:
- An emergency arising from an accident or illness that occurs while the recipient is out of state
- The recipient's health will be endangered if the care and services are postponed until returning to Florida
- The child is a non-Title-IV-E Florida foster or adoption subsidy child living out of state and is covered under the Florida Medicaid program; or
- Florida Medicaid determines, on the basis of medical advice, that the needed medical services or necessary supplementary resources are more readily available in another state and prior authorizes the out-of-state services.
To enroll, the out-of-state provider must submit the following documents to Florida Medicaid Provider Enrollment, P.O. Box 7070, Tallahassee, FL 32314-7070:
- Completed Florida Medicaid Out-of-State Provider Enrollment Application
- The appropriate Florida Medicaid Provider Agreement, Institutional Medicaid Provider Agreement, or Non-Institutional Provider Agreement
- Copy of professional license
- Claim form
- Documentation that the claim meets one of the criteria above
If the service was eligible for reimbursement, the provider will be enrolled retroactively for the dates on which the services were provided.
The following out-of-state providers must enroll using the online Florida Medicaid Online Enrollment Application Wizard
- Durable medical equipment and supplies entities enrolling as Medicare Crossover-Only providers.
- Fully licensed physicians in Florida that interpret diagnostic testing results from an out-of-state location through telecommunications and information technology.
- Independent laboratories certified under the Clinical Laboratory Improvement Amendments.
- Medical supply and durable medical equipment (DME) providers and pharmacies that supply items that are not otherwise available from providers located within Florida (Requires prior approval to enroll from the State of Florida, Agency for Health Care Administration).
- Providers can directly email PharmacyPolicy@ahca.myflorida.com to find out if they are the sole source of limited distribution drugs not available from other providers enrolled in Florida Medicaid
Additional Resources
AHCA Adopted Rules
Adopted Rules - Florida Medicaid Forms
Adopted Rules - Provider Enrollment Policy
Florida Medicaid Contact Information Sheet
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