Florida Blue insurance plan guidelines

Updated

In January 2026, Lucet Behavioral Health, Florida Blue’s network administrator, updated its office requirements to ensure that care gets provided to members from HIPAA-compliant commercial locations. To remain compliant with these revised standards, Headway must confirm that all office locations participating in its Florida Blue network meet Lucet’s updated guidelines.

 

Lucet's Florida Blue office guidelines

To render in-person services, your office must meet all of the following:

  • Commercial service address (no churches)
  • Non-residential (even when the residential location has a separate office area e.g., garage, office room)
  • Actively used in-person appointments (no prior offices)
  • Must have a private area with a closable door to ensure member privacy
     

Plans accepted

Florida Blue is Florida's Blue Cross Blue Shield (BCBS) plan. The following subsidiaries are accepted through Headway:

  • Blue Cross and Blue Shield of Florida, Inc. (DBA Florida Blue)
  • Health Options, Inc. (DBA Florida Blue HMO)
  • Florida Blue Medicare, Inc. (Florida Blue Medicare)

 

What happens if your practice location doesn't qualify

Headway is unable to authorize service locations that do not meet Lucet’s office guidelines. If you do not have a service location that meets these guidelines, you will only be eligible to offer virtual care to Florida Blue members. 

If you archive your practice location, you will remain credentialed with Florida Blue through Headway, but your status will be updated to virtual-only. This allows you to continue seeing Florida Blue members in Florida via telehealth.

Regardless of visit type, clients must be residing in Florida at the time of the session.

 

Submitting an appeal

If you believe your office address was incorrectly flagged and complies with the Florida Blue Office Guidelines, please complete our address verification survey to provide us with additional information. Our credentialing team will review your submission and contact you with any follow-up questions and a final decision regarding your care location, if needed.

 

Updating your address

Checking your credentialing status 

Open your Headway profile and select the Insurance status tab. You'll also receive an email on the day you go live with Florida Blue and can start billing.

If no date appears in your Insurance status tab, our team is actively working on your credentialing.

 

Start seeing Florida Blue clients

You can begin accepting Florida Blue clients as soon as you're live. Add your current Florida Blue clients as soon as possible so we can start the verification process. For questions about client copays or deductibles, reach out to our support team.

We also recommend adding Florida Blue to your external marketing profiles like Psychology Today, Zocdoc, and Google My Business, to start building your pipeline and waitlist.

To find your rates by CPT code, go to SettingsBillingSee Rates in the provider portal.

 

How billing works through Headway

If you're credentialed with Florida Blue only through Headway, that credentialing doesn't apply outside the platform and claims billed elsewhere won't be reimbursed. Sessions with this credentialing must be billed through Headway. 

Headway bills under its state TIN (associated with Sunshine Medical Behavioral Health Services, P.A., Headway's professional corporation for Florida Blue contracts) with your individual NPI as the rendering provider. You may see this entity name or TIN in CAQH, insurance portals, or payer rosters.

 

Accepting BlueCard members

The BlueCard program lets BCBS members from other states access care while in Florida. If a BCBS or Anthem BCBS member from outside Florida is temporarily residing in Florida, you can see them as an out-of-area provider.

To identify a BlueCard member:

  • Their Member ID begins with a three-character prefix (e.g., 1AA, A1A, AA1)
  • Their ID card shows a suitcase logo

If you're unsure, call the number on the back of the card or contact our team.
 

Disclaimer: This document is for educational purposes only and is not intended as professional or legal advice. It may contain errors or missing information, and recent changes in policies, regulations, or payer requirements may not be reflected. Because requirements vary by organization and jurisdiction, please consult legal counsel, the appropriate regulatory or licensing authority or your designated Headway contact for guidance specific to your situation.

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