MedicaidReimbursementHigh impact
State Fiscal Year 2025-26 Diagnosis-Related Groups and Enhanced Ambulatory Patient Groups Solventum Grouper Version Update
Florida Medicaid·FL·Provider Alert
Effective date
Jul 1, 2025
We identified it
Jun 16, 2026
Summary
Florida Medicaid updated to Solventum grouper version 2025.2.2 for DRG and EAPG hospital billing, resulting in higher reimbursement rates. Providers must submit claim adjustments for services with discharge dates July 1-23, 2025 to receive the increased payments.
Action Required
Immediately: Billing team must submit claim adjustments for all Florida Medicaid fee-for-service claims and encounters with discharge dates between July 1-23, 2025. Use Web Portal (frequency code 7) or X12 837 transaction with 13-digit ICN. Update billed amounts if less than new rates since Florida Medicaid pays lesser of billed or allowed amount. Access updated fee schedules at Rule 59G-4.002 on Agency website.