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Crossover-only Enrollment 

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. 

Medicare Crossover-only Enrollment
Florida Medicaid may pay the coinsurance and deductible portion of a Medicare claim for medical assistance and related services rendered to dually-eligible Medicaid recipients only to an individual or entity who has a provider agreement in effect with the Agency. Providers can enroll as a Medicare Crossover-only provider for payment and claim processing purposes only. See 409.907(5)(d), F.S.

Applicants cannot (1) be currently sanctioned, (2) have been involuntarily terminated within the last three years, except for reason of inactivity, or (3) have voluntarily terminated without repaying any overpayments or entering into an approved repayment agreement, where applicable, by Medicare or Medicaid in this or any other state.

 

 

The following provider types may apply as a Medicare Crossover-only Provider:

 

Medicare Crossover-only Provider Enrollment Requirement

Eligible provider types seeking crossover-only enrollment can apply online via the Online Enrollment Wizard. The following documents are required to be uploaded along with the application:

  • Medicare Crossover-only Provider Agreement
  • Proof of Electronic Funds Transfer (EFT), voided check, or bank letter.
  • A copy of the Medicare Approval Letter.
  • An Explanation of Medicare Benefits (EOMB) showing a paid claim with a date of service within thirty (30) days prior to the application submission.
  • A copy of all applicable Federal, State, or local licenses.
  • Proof of accreditation, if required in the Coverages and Limitations Handbook for the requested provider type.
  • Proof of certification, if required in the Coverages and Limitations Handbook for the requested provider type.

All individuals declared on the provider application are subject to background screening. Refer to Background Screening for more information.

Applicants must meet all Florida Medicaid provider enrollment criteria including requirements as described in the Coverage and Limitations Handbook for the requested provider type. One exception is Medicare crossover-only DME providers are exempt from the requirement to maintain an in-state business location.

 

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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