MedicaidAdministrativeMedium impact
Referring, Ordering, Prescribing, and Attending (ROPA) Provider Long Term Care Fee-for Service Claim Requirements
Florida Medicaid·FL · Geriatrics·Claims & Billing
Effective date
Oct 11, 2025
We identified it
Jun 16, 2026
Summary
Florida Medicaid has updated ROPA edit 1976 for Long Term Care claims, effective July 25, 2025. Starting October 11, 2025, claims will be denied if either the Referring OR Attending Provider NPI is missing or invalid (previously required both to be missing). There is a 60-day grace period from August 11 to October 11, 2025 where claims will still pay despite the missing information.
Action Required
By October 11, 2025: Billing team must update Long Term Care Fee-for-Service claim procedures to ensure BOTH Referring and Attending Provider NPIs are included and valid on all claims. Update billing system edits and train staff that claims missing either NPI will be denied after October 11. Contact Provider Services at 1-800-289-7799, option 7 for billing assistance if needed.