Below are Florida workers' comp billing manuals, forms, and daisyBill resources for filing compliant medical bills.
Reimbursement Manuals and Rules
The following manuals and administrative rules govern medical billing and reimbursement for workers’ compensation claims.
Manual Title |
Rule Number |
Effective Date |
Florida Workers’ Compensation Health Care Provider Reimbursement Manual |
1/1/2025 |
|
Florida Workers’ Compensation Reimbursement Manual for Ambulatory Surgical Centers (ASCs) |
7/1/2023 |
|
Florida Workers’ Compensation Reimbursement Manual for Hospitals |
5/25/2023 |
|
Insurer Electronic Medical Report Filing to the Division |
2/18/2016 |
Billing Form Requirements
To ensure compliance, medical bills must be submitted on the correct form, depending on the type of service provided.
Services |
Forms |
|
Physician Services Pathology / Laboratory |
Form DFS-F5-DWC-9-A (CMS-1500 for Physicians) |
|
Facility – Outpatient Facility – Inpatient |
UB-04 |
Pharmacy |
NCPDP |
Dental |
|
Statement of Charges for Drugs and Medical Equipment & Supplies Form |
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