Florida PPEC Requirements Library

01.01 01 · Explore

Florida PPEC Terminology

Florida PPEC Terminology

Florida statute and rule use 'PPEC' (Prescribed Pediatric Extended Care). Do not import 'PPECC' from Texas — it is not a defined term in Florida law. Citations and AHCA correspondence must use 'PPEC'.

01.02 01 · Explore

Florida PPEC Terminology

What Is a Florida PPEC?

A Florida PPEC is a licensed nonresidential facility serving medically/technologically dependent children birth through age 20. Minimum three children. Each child must have a physician prescription and remain under physician care while attending. Children may not attend more than 12 hours in any 24-hour period (FS 400.902, 400.914).

02.01 02 · Establish

Founder / Entity Readiness

Florida Business Entity (Sunbiz)

Form your Florida entity through the Division of Corporations (Sunbiz). The entity name on Sunbiz must match the legal name on the AHCA PPEC application packet.

02.02 02 · Establish

Founder / Entity Readiness

License-First, Enrollment-Second Sequence

The AHCA PPEC license must be issued before Florida Medicaid (FLMMIS) provider enrollment can be completed for PPEC services. You cannot reverse this order.

03.01 02 · Establish

Facility Readiness

Isolation Room with Glass Observation Wall

Florida PPEC rules require a dedicated isolation room for children who may be contagious or need separation. The room must have a glass observation wall enabling continuous visual observation. This is a hard architectural requirement — design the floor plan around it, not after.

04.01 03 · License & enroll

Licensing Readiness (AHCA)

AHCA License Requirement

Every Florida PPEC must hold a valid AHCA license. Licensure is governed by Chapter 400, Part VI, Florida Statutes and FAC Chapter 59A-13.

04.02 03 · License & enroll

Licensing Readiness (AHCA)

Level 2 Background Screening (FS 435.04)

All PPEC personnel must clear Florida Level 2 background screening (FBI + FDLE fingerprints). Disqualifying offenses include child abuse, violent crimes, sexual offenses, and healthcare fraud. Cite FS 435.04 directly for the current disqualifying-offense list.

04.03 03 · License & enroll

Licensing Readiness (AHCA)

AHCA PPEC Application Packet (Forms 3110-8002 / 3110-1024 / 3110-8002CL)

Authoritative AHCA forms (August 2023 revisions, registered in DocRadar as `fl-ahca-ppec-document-binder`): (1) AHCA Form 3110-8002 — Prescribed Pediatric Extended Care Center Application; (2) AHCA Form 3110-1024 — Health Care Licensing Application Addendum; (3) AHCA Form 3110-8002CL — PPEC Application Checklist. FAC Rule 59A-13.004 was amended 4/28/2026; verify current form revisions against flrules.org before relying on older guidance.

05.01 03 · License & enroll

Medical Director Readiness

Medical Director — Board-Certified Pediatrician

The Florida PPEC Medical Director must be a board-certified pediatrician. The role covers medical oversight of every attending child, supervision of nursing and therapy staff on clinical matters, medical-policy authorship, and QA Committee participation.

06.01 04 · Build operations

Nursing Operations Readiness

Director of Nursing (DON) Qualifications

Full-time Florida-licensed RN with ≥2 years general pediatric nursing experience AND ≥6 months ICU or PPEC experience within the past 5 years. The DON owns nursing supervision, individual nursing protocols, and staffing-ratio compliance. Hire before the AHCA initial survey.

06.02 04 · Build operations

Nursing Operations Readiness

PPEC Staffing Ratios (FAC 59A-13.010)

1 child → 1 staff (must be RN). 2–6 children → 2 staff, at least 1 RN. Higher census scales per the 59A-13.010 schedule. Census planning and scheduling must be tightly coordinated against the ratio table. Verify the complete schedule at flrules.org before making staffing plans.

07.01 05 · Open & improve

Operations / QA Readiness

Quality Assurance Committee (FAC 59A-13.015)

Committee must include the Medical Director, Administrator, DON, and ≥3 additional members. Meets at least quarterly. Reviews ≥50% of medical records each quarter. Documents and tracks corrective actions. Design this structure as part of pre-opening planning.

08.01 03 · License & enroll

Medical Records Readiness

Nursing Protocol of Care — 10 Working Days + Monthly Review

Develop an individualized nursing protocol of care for each child within 10 working days of admission (FAC 59A-13.014). Protocol must be reviewed and updated monthly. Records must reflect all care provided and any changes to the child's condition or care plan.

08.02 03 · License & enroll

Medical Records Readiness

Medical Record Content and Retention

Map record-content and retention requirements from FAC Chapter 59A-13 into your record design before opening. Verify current retention period against the current 59A-13 text at flrules.org.

09.01 04 · Build operations

Admissions Readiness

PPEC Admission Requirements (FAC 59A-13.007)

Admission requires: (1) physician prescription authorizing PPEC attendance; (2) ongoing active physician care; (3) pre-admission planning by Medical Director and DON; (4) written parent/guardian consent covering purpose, responsibilities, authorized treatments, liability, and emergency plans.

09.02 04 · Build operations

Admissions Readiness

12-Hour Daily Attendance Cap (FS 400)

Children may not attend a Florida PPEC for more than 12 hours in any 24-hour period. Bake this cap into scheduling and billing logic from day one.

10.01 03 · License & enroll

Florida Medicaid Enrollment

FLMMIS Provider Enrollment (Online Wizard)

Enroll as a Florida Medicaid PPEC provider through the FLMMIS Online Enrollment Wizard at portal.flmmis.com. License first, enrollment second — the order cannot be reversed. AHCA / Gainwell fiscal-agent support: 1-800-289-7799, Option 4.

10.02 03 · License & enroll

Florida Medicaid Enrollment

NPI (CMS NPPES) Pre-Requisite

Obtain your NPI through the CMS NPPES system before completing FLMMIS enrollment. The NPI is the canonical provider identifier that links FLMMIS billing to your AHCA license.

11.01 05 · Open & improve

Authorization / Payer Readiness

Confirm current PPEC payer routing and document the authoritative source

Florida's Medicaid payer route for PPEC (fee-for-service vs managed care) is under legislative transition — Chapter 2025-88 / SB 1490 addresses PPEC managed-care carve-in. Before making billing or enrollment commitments, confirm the current route against current AHCA/Medicaid guidance and record the authoritative source and its effective date. Do not assume a fixed route.

11.02 05 · Open & improve

Authorization / Payer Readiness

Prior Authorization — Acentra Health (eQSuite)

PA for FL Medicaid PPEC services is managed by Acentra Health under AHCA contract. Portal: fl.acentra.com (eQSuite). PPEC PA line: 1-833-321-7070 (24/7). Required documents typically include the PPEC Plan of Care form, supporting documentation, physician order form, and physician visit documentation. PA must be in place before services begin.

11.03 05 · Open & improve

Authorization / Payer Readiness

PA Approval Does Not Guarantee Payment

Acentra PA approval authorizes the service; payment still depends on the claim meeting all FL Medicaid coverage criteria. Build cash-flow plans around this distinction — PA in hand is not money in the bank.

12.01 05 · Open & improve

Billing Evidence Readiness

FL PPEC Service Codes T1025/T1026 — source rates from the current AHCA fee schedule

FL Medicaid PPEC billing uses T1025 (full-day PPEC services, 5-12 hours) and T1026 (partial-day PPEC services, billed in 1-hour units). Look up the current maximum-fee amounts directly from the current AHCA Medicaid fee schedule; do not hard-code rate figures from secondary sources. Rounding: any portion of an hour beyond 15 minutes may round up to the next hour after the first hour.

12.02 05 · Open & improve

Billing Evidence Readiness

Daily Documentation → Billing Evidence

Design daily attendance and service documentation so it produces clean billing evidence in real time, aligned to the active Acentra PA period. Apply the 15-minute rounding rule consistently per T1025/T1026 fee-schedule guidance. Reconciling attendance against PA windows after-the-fact creates avoidable denials.

13.01 05 · Open & improve

Survey / Inspection Readiness

AHCA Initial and Subsequent Inspections

AHCA Bureau of Health Facility Regulation conducts initial and ongoing inspections of Florida PPECs. Operations must be continuously survey-ready: staffing ratios, documentation, QA program, and physical plant must meet 59A-13 standards at all times.

13.02 05 · Open & improve

Survey / Inspection Readiness

Plan of Correction (CAP) Workflow

Design a corrective-action / plan-of-correction template and escalation model before opening. Deficiency citations require timely documented responses — do not wait until you receive a finding to design the workflow.

14.01 05 · Open & improve

Systems / Software Readiness

PPEC-Native vs. Generic EHR Choice

Florida PPEC documentation (nursing protocol-of-care, monthly reviews, QA records, attendance, Acentra PA evidence) is materially different from outpatient EHR documentation. A PPEC-native system reduces the integration burden; a generic EHR can work but needs explicit adaptation.