Florida Medicaid Telehealth: Coverage, Providers, and Prescriptions

Florida Medicaid telehealth covers medically necessary services delivered by live two-way video between you and a Florida-licensed, Medicaid-enrolled provider, with behavioral health, primary care, specialist consultations, and certain children’s screenings among the most common uses. Most recipients are enrolled in a Statewide Medicaid Managed Care (SMMC) plan, and those plans may offer broader telehealth options than the fee-for-service (FFS) baseline set by the Agency for Health Care Administration (AHCA).

What Florida Medicaid Covers by Telehealth

Coverage attaches to the service, not the screen. The visit must be medically necessary and meet the same clinical standard as an in-person appointment, and a provider is expected to decline the virtual format if it would compromise care for your specific situation.

Under Florida Statute 456.47, telehealth means synchronous or asynchronous telecommunications used for assessment, diagnosis, consultation, treatment, monitoring, or transfer of medical data. Email and fax are expressly excluded.¹ In practice, Florida Medicaid recognizes three delivery methods:

Synchronous live video: real-time, two-way audio and video that mirrors a face-to-face visit.
Asynchronous store-and-forward: images, records, or data sent electronically for a provider to review later.
Remote patient monitoring: devices that transmit readings like blood pressure or blood sugar to your provider between visits.

The FFS program primarily reimburses live video. SMMC plans may cover all three and cannot be more restrictive than AHCA’s rules, though they can be more generous. If you’re in a managed care plan, store-and-forward consults or remote monitoring may be on the table that an FFS recipient wouldn’t have.

Behavioral health has the widest telehealth footprint. AHCA reimburses behavioral health evaluations, diagnostic assessments, treatment recommendations, medication management screenings, and individual and family therapy by telemedicine at the same rates as the community behavioral health fee schedule.² Primary care and various specialist visits are also available virtually when the procedure code is approved for telemedicine and the provider judges it clinically appropriate. Your plan’s member services line or provider directory is the most reliable way to confirm what applies to you.

Audio-Only Phone Calls

Audio-only telephone visits are not covered under FFS. When the federal Public Health Emergency ended in May 2023, the temporary flexibility that had allowed phone-only visits for many behavioral health and medical services expired, and the statutory definition of telehealth does not include audio-only calls.¹ SMMC plans may still cover some audio-only services at their discretion. If you rely on phone appointments, confirm coverage with your plan before the visit.

Who Can Treat You

Florida’s telehealth statute defines providers broadly. Licensed physicians, physician assistants, advanced practice registered nurses, psychologists, clinical social workers, mental health counselors, marriage and family therapists, physical therapists, occupational therapists, speech-language pathologists, pharmacists, and dentists all qualify, among others, as long as they stay within their scope of practice.³

For a visit to be billed to Florida Medicaid, two things have to be true: the provider must be licensed in Florida, and they must be enrolled as a Medicaid-participating provider. Holding a telehealth license is not the same as accepting Medicaid.

Out-of-state practitioners can deliver telehealth to patients located in Florida, but only after registering with the Florida Department of Health as an out-of-state telehealth provider.⁴ Whether they can bill Florida Medicaid depends on their separate enrollment with the program.

Where You Have to Be

Florida law lets the patient and provider sit in separate locations and doesn’t restrict the patient’s setting within the state.¹ Your home, a relative’s house, or a workplace all work.

You do, however, have to be physically in Florida during the appointment. Florida-licensed providers practice under Florida law, and their authority to see you by telehealth depends on your location at the time of service. If you’re traveling out of state, a Florida Medicaid telehealth visit may not be covered.

Prescriptions and Controlled Substances

Routine prescriptions can generally be written during a telehealth visit. Schedule III through V controlled substances can also be prescribed by telehealth when the provider has designated themselves as a controlled substance prescribing practitioner on their state profile.

Schedule II drugs are tightly limited. A provider cannot prescribe a Schedule II medication by telehealth unless the prescription is for one of the following:¹

Treatment of a psychiatric disorder.
Inpatient treatment at a licensed hospital.
Hospice care.
Care of a nursing home resident.

Outside those categories, a Schedule II prescription will require an in-person visit. For non-cancer chronic pain lasting more than 90 days, Florida law also requires a physical examination and complete medical history before a provider first prescribes any Schedule II through IV controlled substance. Renewals of an existing controlled substance prescription do not require a physical exam and can be handled by telehealth.

Booking a Telehealth Visit

How you start depends on how you receive your benefits.

If you’re in an SMMC managed care plan, call the member services number on your plan ID card. Member services can tell you which in-network providers offer telehealth, which services are covered that way, and whether your plan covers store-and-forward or remote monitoring beyond live video.
If you’re on fee-for-service, contact your primary care provider or specialist directly and ask whether they offer telehealth appointments and bill Medicaid for them.

Once the appointment is scheduled, ask whether you need to download a specific app, create an account, or complete intake forms in advance. The platform has to meet HIPAA security standards, so the office will usually direct you to a particular secure tool rather than a general-purpose video app.⁵ On the day of the visit, check that your device’s camera and microphone work and that your internet connection is stable.

If you need a sign language interpreter or another disability accommodation, the provider is responsible for arranging it, including a qualified interpreter who can join the video session from a separate location. The provider cannot charge you for the interpreter or require you to bring your own.⁶

Telehealth visits are documented in your medical record using the same standards as in-person care, and any video, audio, or electronic records created during the session are confidential medical records.⁷ Many providers ask for verbal or written consent before the first telehealth visit, though the state’s telehealth statute itself does not impose a standalone informed consent requirement.

If a Telehealth Service Is Denied

If your managed care plan denies, reduces, or ends a telehealth service you believe is medically necessary, you can challenge the decision through the same appeal process that applies to any Medicaid service.

File an internal appeal with your plan within 60 calendar days of the denial notice. You can appeal orally or in writing, though a written appeal with supporting documentation from your treating provider tends to carry more weight. The plan must acknowledge receipt within five business days and resolve the appeal within 30 days.
If the plan upholds the denial, request a state fair hearing through AHCA within 120 days. You can call the Medicaid Helpline at 1-877-254-1055 or email MedicaidHearingUnit@ahca.myflorida.com.
If the denied service was previously authorized and you file your appeal within 10 calendar days of the denial notice, you may be able to keep receiving the service while the appeal is pending.

Fee-for-service recipients can skip the managed care internal step and request a fair hearing directly through AHCA.

1
Online Sunshine. Florida Statutes 456.47 – Use of Telehealth to Provide Services
2
Florida Agency for Health Care Administration. Florida Medicaid Telemedicine Guidance for Medical and Behavioral Health Providers
3
Florida Health Source. Frequently Asked Questions – Telehealth
4
Florida Health Source. Florida Telehealth
5
Telehealth.HHS.gov. HIPAA Rules for Telehealth Technology
6
ADA.gov. Telehealth
7
Florida Senate. Florida Statutes 456.47 – Use of Telehealth to Provide Services