Reinstatement of Service Limits for Community Behavioral Health and Targeted Case Management Services Effective October 14, 2026

By October 14, 2026: Billing team must (1) obtain the current Community Behavioral Health and Targeted Case Management fee schedules from Florida Medicaid to identify reinstated service limits; (2) update billing system rules to enforce frequency and duration limits for CBH and TCM claims; (3) audit pending and scheduled claims to identify services that will exceed reinstated limits and coordinate with providers and managed care plans for medical necessity documentation and continuity of care planning; (4) update billing templates and provider alerts to flag when service limits are approached. For managed care plan enrollees, providers must contact their respective managed care plans to ensure care coordination and obtain any necessary prior authorizations under the new limits. Claims submitted after October 14, 2026 that exceed reinstated service limits will be denied unless medical necessity justifies exceptions. Contact Florida Medicaid Helpline at 1-877-254-1055 or FLMedicaidManagedCare@ahca.myflorida.com for fee schedules and limit details.