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MedicaidReimbursementMedium impact

Prescribed Pediatric Extended Care (PPEC) Services Fee Schedule Increase

Florida Medicaid·FL · Pediatrics·Claims & Billing
Effective date
Jul 1, 2025
We identified it
Jun 16, 2026
Days to comply

Summary

Florida Medicaid has increased fee schedule rates for PPEC (Prescribed Pediatric Extended Care) services codes T1025 and T1026 effective July 1, 2025. Providers must submit claim adjustments for services billed between July 1-August 1, 2025 to receive the higher reimbursement rates.

Action Required

Action needed
By August 1, 2025: Billing team must submit claim adjustments for all T1025 and T1026 PPEC claims with dates of service July 1, 2025 or later that were submitted between July 1-August 1, 2025. Use frequency code '7' for X12 837 transactions or adjust via secure web portal. Update billed amounts if original amount was less than new max fee. Download updated fee schedule from Florida Medicaid public web portal.

Affected Billing Codes

T1025
T1026