Compensation: Reimbursement is to be based solely on the attached Fee Schedule as was agreed…

The Florida Department of Health has awarded contract C764A5 for healthcare reimbursement services with an annual contract value of $15,000.00. The contract period runs from July 1, 2026, through June 30, 2027. The prime contractor will provide professional medical services to clients utilizing Current Procedural Terminology (CPT) codes, with compensation structured on a reimbursement basis. The contract authorizes 15,000 units of service delivery, with the fee schedule established and authorized by acting Medical Director Dr. U. Choe.

Reimbursement will be calculated according to a tiered pricing structure: Specialty Provider professional services will be reimbursed at 86% of Medicare rates, while Ancillary, Imaging, and (J) code services will be reimbursed at 101% of Medicaid rates in accordance with applicable Medicaid guidelines and limits. Pricing references are maintained within the Health Management System (HMS) and can be accessed through Medicare and Florida Agency for Health Care Administration databases. The initial Purchase Order amount is subject to adjustment based on documented reimbursement needs, with all rate adjustments requiring authorization from the Medical Director.