September 23, 2022

Taxonomy code and requirements for Florida Medicaid claims

As of March 1, 2022, the Agency for Health Care Administration (AHCA) requires billing and rendering providers to include the following information on your claims. Ensure your information matches the current provider enrollment information on file with AHCA or your claims will deny beginning Oct. 1, 2022.

  • National Provider Identification (NPI) number for both billing and rendering provider
    • This is the NPI enrolled (limited/fully) with Florida Medicaid
  • Taxonomy Code for both billing provider and rendering provider
    • This is the taxonomy code appropriate to the services provided and to your enrolled provider type and specialty
  • Address with ZIP+4 code
    • This is the provider's street address and ZIP+4 code that’s enrolled with Florida Medicaid

Helpful tips

  • Providers should review the new Provider Master List (PML) Tip Sheet posted on AHCA’s website and become familiar with the PML effective March 1,2022
  • Providers should review their PML information and claim information and make sure all data elements match (e.g., NPI, taxonomy, address, ZIP+4)
  • Refer to the Florida Medicaid Taxonomy Guide for taxonomies corresponding to your enrolled provider type and specialty (refer to FLMMIS Provider Enrollment for provider type)
  • Review the Secure Web Portal Account Maintenance Quick Reference Guide for FLMMIS sign-in assistance 
  • Find more information about the NPI Crosswalk Elimination initiative in AHCA’s NPI Crosswalk Overview
  • Providers who need make updates may review Florida Medicaid's Provider Enrollment Policy for more information

For information on how to submit a claim correction to UnitedHealthcare, go to our UnitedHealthcare Claims Interactive Guide

PCA-1-22-02981-C&S-EM-09082022
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