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Evaluation and Management Services

Florida Medicaid’s Covered Services and HCBS Waivers

Evaluation and Management Services

Medicaid reimburses for evaluation and management services to provide for qualified practitioner visits to maintain a recipient’s health, prevent disease, and treat illness.

Medicaid reimburses for evaluation and management services including:

  • Adult Health Screening Services
  • Child Health Check-Up Services
  • Custodial Care Facility Services and Nursing Facility Services
  • Office Visits
  • Early and Periodic Screening, Diagnosis, and Treatment
  • One adult health screening every 365 days, for recipients age 21 years and older
  • Preventative medicine services for recipients under the age of 21 years
  • One evaluation and management visit per month, per recipient
  • As medically necessary for recipients under the age of 21 years and pregnant recipients age 21 years and older
  • Up to two office visits per month, per specialty, for recipients age 21 years and older

This service is one of the minimum covered services for all Managed Medical Assistance plans serving Medicaid enrollees.

Eligibility

Florida Medicaid recipients requiring medically necessary evaluation and management services.

Resource Information

Information on Medicaid health plans and services is available on the Statewide Medicaid Managed Care webpage.

The Florida Medicaid coverage policies, fee schedules, and Rule are available on the Agency Website.