BEHAVIORAL HEALTH SERVICES PROVIDER IN FLORIDA

SUPPORTING MENTAL HEALTH, EMOTIONAL WELL-BEING, AND RECOVERY THROUGH COMPREHENSIVE COMMUNITY-BASED CARE

Behavioral Health Services in Florida offer therapy, counseling, psychiatric support, crisis stabilization, and rehabilitative care for individuals with mental health disorders, behavioral challenges, or co-occurring conditions. These services are authorized under Florida’s Medicaid State Plan, Home and Community-Based Services (HCBS) waiver programs, and specialized behavioral health initiatives, promoting recovery, resilience, and community integration.

1. GOVERNING AGENCIES

Agency: Florida Agency for Health Care Administration (AHCA)

Role: Oversees Medicaid provider enrollment, service authorization, and reimbursement for Behavioral Health Services

Agency: Florida Department of Children and Families (DCF) — Office of Substance Abuse and Mental Health (SAMH)

Role: Administers state-funded and Medicaid-funded behavioral health programs, including crisis services and community mental health centers

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight ensuring Behavioral Health Services meet Medicaid standards and quality of care requirements

2. BEHAVIORAL HEALTH SERVICE OVERVIEW

Behavioral Health Services include a broad range of interventions that support individuals’ mental and emotional well-being, facilitate recovery, and promote full participation in community life.

Approved providers may deliver:

• Individual, group, and family therapy (psychotherapy)

• Psychiatric evaluation, medication management, and monitoring

• Behavioral assessment and intervention planning

• Crisis intervention, stabilization, and mobile crisis response services

• Skills training in coping mechanisms, emotional regulation, and social functioning

• Psychosocial rehabilitation services

• Peer support and recovery coaching (where authorized)

Services must align with a participant’s individualized Treatment Plan and focus on improving behavioral health outcomes and quality of life.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register business with the Florida Division of Corporations (Sunbiz)

• Obtain EIN from the IRS and NPI (Type 2)

• Obtain applicable behavioral health licensure through DCF for Mental Health or Substance Abuse treatment (if providing residential or intensive outpatient services)

• For outpatient therapy services, licensure may not be required if services are delivered by licensed clinicians (e.g., LCSWs, LMHCs, LMFTs, Psychologists, Psychiatrists)

• Enroll as a Medicaid provider through Florida’s Medicaid Management Information System (FLMMIS)

• Maintain general liability, professional liability, and malpractice insurance

4. AHCA/DCF PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Submit Provider Enrollment Application for Behavioral Health Services through AHCA’s Florida Medicaid portal

• Apply for DCF licensure if operating a licensed mental health or substance abuse treatment facility

Application and Documentation Submission:

• Submit Articles of Incorporation, proof of EIN/NPI, applicable clinical licenses, operational policies, treatment plan templates, and insurance certificates

• Provide documentation of staff credentials, emergency protocols, incident management systems, and participant intake procedures

Program Readiness Review:

• AHCA and DCF review provider readiness including clinical quality, documentation compliance, participant protections, and Medicaid billing systems

Approval & Medicaid Enrollment:

• Upon approval, configure billing codes appropriate to each service type (e.g., outpatient therapy, crisis intervention, psychiatric services)

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License (Florida Division of Corporations)

• IRS EIN confirmation

• NPI confirmation

• Clinical licensure verification for staff (LCSW, LMHC, LMFT, psychologist, psychiatrist, etc.)

• DCF behavioral health license (if required based on services offered)

• Proof of general, professional, and malpractice insurance

• HCBS-Compliant Policy & Procedure Manual including:

  • Participant intake, assessment, diagnosis, and individualized treatment planning

  • Behavioral health service delivery protocols and clinical supervision plans

  • HIPAA confidentiality, participant rights, and grievance handling procedures

  • Emergency preparedness, crisis response, and suicide prevention policies

  • Staff credentialing, background checks, and clinical supervision documentation

  • Medicaid billing, service authorization tracking, and audit readiness systems

6. STAFFING REQUIREMENTS

Role: Clinical Director / Behavioral Health Program Manager

Requirements: Master's or Doctorate degree in a behavioral health discipline; active Florida licensure; experience supervising behavioral health programs; background screening clearance

Role: Licensed Clinicians (LCSW, LMHC, LMFT, Psychologists, Psychiatrists)

Requirements: Active Florida license in relevant discipline; Medicaid enrollment credentialing; background screening clearance

Role: Behavioral Health Specialists / Case Managers/Peer Support Specialists

Requirements: Bachelor’s degree preferred (Peer Specialists may require certification); training in behavioral health support; background screening clearance

All staff must complete:

• HIPAA confidentiality, participant rights, and abuse prevention training

• Crisis intervention, suicide prevention, and emergency response training

• Annual competency evaluations and Medicaid compliance training

7. MEDICAID WAIVER PROGRAMS AND BEHAVIORAL HEALTH INITIATIVES

The following Florida Medicaid programs and waivers authorize Behavioral Health Services:

• Florida Medicaid State Plan Behavioral Health Services

• Long-Term Care (LTC) Waiver for behavioral supports in older adults

• Florida Assertive Community Treatment (FACT) programs

• Children's Mental Health Waivers (for serious emotional disturbance)

• Substance Abuse and Mental Health (SAMH) programs via DCF

Approved providers may deliver:

• Comprehensive outpatient behavioral health treatment

• Crisis response and stabilization

• Intensive case management and psychosocial rehabilitation

• Medication-assisted treatment (MAT) for co-occurring disorders (if licensed)

8. TIMELINE TO LAUNCH

Phase: Business Formation and Initial Licensing (if applicable)

Timeline: 1–2 months

Phase: Staff Hiring, Credentialing, and Clinical Program Development

Timeline: 2–3 months

Phase: AHCA Medicaid Enrollment and Readiness Review

Timeline: 60–90 days

Phase: Medicaid Billing System Setup and Claims Management

Timeline: 30–45 days

9. CONTACT INFORMATION

Florida Agency for Health Care Administration (AHCA)

Website: https://ahca.myflorida.com/

Florida Department of Children and Families (DCF) — Substance Abuse and Mental Health (SAMH)

Website: https://www.myflfamilies.com/service-programs/substance-abuse/

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov/

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — FLORIDA BEHAVIORAL HEALTH SERVICES PROVIDER

WCG supports behavioral health agencies, therapy practices, and crisis response organizations in launching Medicaid-compliant Behavioral Health Services under Florida’s Medicaid State Plan and HCBS waiver programs.

Scope of Work:

• Business registration and EIN/NPI setup

• DCF licensing (if applicable) and AHCA Medicaid provider enrollment support

• Development of Behavioral Health Services Policy & Procedure Manual

• Staff credentialing templates and participant intake/treatment planning forms

• Medicaid billing setup and claims management

• Website, domain, and email setup

• Clinical documentation, service tracking, and audit readiness templates

• Crisis response, emergency preparedness, and suicide prevention policies

• Quality assurance programs for clinical outcome monitoring

• Community outreach and partnership development strategies

Continue To Our Client Portal To Get Started

Our Client Portal offers a wealth of resources that you can explore related to various programs and state requirements.