CPT codes are copyright 1995-2022American Medical Association. Copyright CareSource 2023. Please enable it in order to use the full functionality of our website. Board of Speech Pathology and Audiology | Georgia Secretary of State (ga.gov) Fee Schedule (*All fees include a $10 mail in application processing fee) *Application for Speech Language Pathologist or Audiologist by Examination, ASHA, or Endorsement $ 120.00 *Application for PCE or RPE $ 40.00 *Application for Speech Aide $ 50.00 Press Tab or Shift+Tab to navigate through menu. Provider Fee Payment. Peach State Health Plan utilizes InterQualcriteria for those medical technologies, procedures or pharmaceutical treatments for which a Peach State Health Planclinical policy does not exist. 4 0 obj endstream endobj startxref According to Georgia Medicaid guidelines, the insertion of an implantable contraceptive device and the implantable contraceptive reported as part of a Medicaid family planning program is limited to once in a three-year period. Join today as either a monthly or a yearly member and enjoy full access to the site and a significant discount to our live and recorded webinars. Press Space or Escape to collapse the expanded menu item. According to Georgia Medicaid guidelines, children's intervention services must be reported with modifier HA (Child/adolescent . Please locate the pdf file where the Provider's Name would fall. Under managed care, Georgia pays a fee to a managed care plan for each person enrolled in the plan. Georgia Medicaid offers benefits on a Fee-for-Service (FFS) basis or through managed care plans. https://suicidepreventionlifeline.org/, Local and regional calls are routed from the National Suicide Prevention Lifeline to DBHDDs Georgia Crisis and Access Line (GCAL) 1-800-715-4225 https://dbhdd.georgia.gov/access-services, Voices for Georgias Children has given permission and provided the following video on Suicide Prevention: https://vimeo.com/270156589, http://georgiavoices.org/videos/suicide-prevention-psas-2/. Office of Analytics and Program Improvement, Medicaid Promoting Interoperability Program. 471 0 obj <>/Filter/FlateDecode/ID[<467E25C1DCB7FA4CA9B5341409AF092E>]/Index[455 37]/Info 454 0 R/Length 91/Prev 216195/Root 456 0 R/Size 492/Type/XRef/W[1 3 1]>>stream Diaphragm fitting, condoms and contraceptive injection of medroxyprogesterone acetate must be submitted with modifier FP (Service provided as part of Medicaid family planning program). Open the pdf and scroll down to the Provider R-32 you need and print. Under managed care, Georgia pays a fee to a managed care plan for each person enrolled in the plan. How do I know if I am in the right place? An official website of the State of Georgia. It is our intent to make claim payment policies that are simple to understand and in alignment with State Medicaid Manuals. Members have full access to the material and can also email us regarding any billing or compliance issue, please considerjoining todayif you need assistance. Other policies (e.g., clinical policies) or contract terms may further determine whether a technology, procedure or treatment that is not addressed in the Payment Policy Manual is payable by Peach State Health Plan. Policies in the Peach State Health PlanClinical Policy Manual may have either a Peach State Health Planor a Centene heading. Please locate the pdf file where the Provider's Name would fall. Answers to frequently asked questions about Medicaid and audiology and speech-language pathology services. 04/01/2023. Under the FFS model, Georgia pays providers directly for each covered service received by a Medicaid beneficiary. These rates are inclusive of 13.37% Growth and audited 2018 GL/PL Insurance Costs. 2200 Research Blvd., Rockville, MD 20850 Reimbursement Policies. Please enable Cookies and reload the page. Reimbursement policies are designed to assist you when submitting claims to CareSource. State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. PDF. PDF. <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Georgia Families Medicaid; Georgia Families PeachCare for Kids . Maximum Units are specific to crisis intervention services (H2011) provided in a Skilled nursing facility or a Nursing facility, as they are limited to 144 units per year when billed with the following modifier combinations: According to Georgia Medicaid guidelines, crisis intervention services should be reported with modifier U6 (In-Clinic), U7 (Out-of-Clinic), or telehealth (GT) modifier. In turn, the plan pays providers for all of the Medicaid services a beneficiary may require that are included in the plans contract with the state. The American Speech-Language-Hearing Association (ASHA) developed this document to provide an analysis of the 2022 Medicare Physician Fee Schedule (MPFS), including comments on relevant policy changes, a list of Current Procedural Terminology (CPT American Medical Association) codes used by speech-language pathologists (SLPs) with their national FY 2021 revised rates inclusive of 18.37% Growth and Quality Incentive. 3 0 obj SFY 2023 Hospital Provider Fee Memorandum - Posted 06/15/22. Find clinical tools and information about working with CareSource. Therefore, the EPSDT service will be recommended for denial when outside of the required age recommendation: According to Georgia Medicaid guidelines, developmental and/or autism screenings are allowed for patients nine months, 18 months and 30 months of age. Effective January 24, 2021 a significant enhancement to our physician reimbursement policies that promote correct coding. PDF 74.88 KB - January 05, 2022 Division/Office. This change is estimated to increase E&D Waiver expenditures for SFY 2022 as follows: The Georgia General Assembly passed legislation to increase Elderly and Disabled Waiver rates by 10% effective July 1, 2021. In addition, Peach State Health Planmay from time to time delegate utilization management of specific services; in such circumstances, the delegated vendors guidelines may also be used to support medical necessity and other coverage determinations. In addition, Peach State Health Planmay from time to time employ a vendor that applies payment policies to specific services; in such circumstances, the vendors guidelines may also be used to determine whether a service has been correctly coded. According to Georgia Medicaid guidelines, early and periodic screening, diagnostic and treatment (EPSDT) services should follow the recommended age requirement indicated in the American Academy of Pediatrics (AAP) and Bright Futures 'Recommendations for Pediatric Health Care' periodicity schedule. endstream endobj 459 0 obj <>stream Georgia Medicaid Coverage of Therapy Services. Primary: (404) 657-5468. 491 0 obj <>stream endobj %PDF-1.7 % Section 1902(a)(30)(A) of the Social Security Act requires that such payments be consistent with efficiency, economy, and quality of care, and are sufficient to provide access equivalent to the general population. Therefore, enteral nutrition supplies are recommended for denial when billed without modifier NU. Community providers of behavioral health services can be accessed by contacting The Georgia Crisis and Access Line (GCAL) at 800-715-4225 or via the web by visiting www.mygcal.com . After dialing 1-800-273-TALK (1-800-273-8255), the caller is routed to their nearest crisis center to receive immediate counseling and local mental health referrals. According to Georgia Medicaid guidelines, enteral nutrition supplies and equipment must be reported with the purchase modifier NU (New equipment). check your deductible, change your These reimbursement policies apply to our Georgia Medicaid plans. 0 1997- American Speech-Language-Hearing Association. We believe that this will enable you and your billing staff to better understand our claims payment process given the widespread use of these policies. Division of Health Benefits. Hand pulling book from library archive shelf. . The increase will affect all services provided through the Waiver Program. . Before sharing sensitive or personal information, make sure youre on an official state website. Web form outage is expected around 5:30pm on April 28, 2023. % Authorization for Cancer Treatment/New Century Health, 25-Hydroxyvitamin D Testing in Children and Adolescents (PDF), Allogeneic Hematopoietic Cell Transplants for Sickle Cell(PDF), Ambulatory Surgery Center Optimization (PDF), Cosmetic and Reconstructive Surgery (PDF), Diaphragmatic/Phrenic Nerve Stimulation (PDF), Drugs of Abuse: Definitive Testing (PDF), Facility-based Sleep Studies for Obstructive Sleep Apnea (PDF), Genetic Testing Aortopathies and Connective Tissue Disorder (PDF), Genetic Testing Dermatologic Conditions (PDF), Genetic Testing Epilepsy Neurodegenerative Neuromuscular Disorder (PDF), Genetic Testing Exome and Genome Sequencing for the Diagnosis of Genetic Disorders (PDF), Genetic Testing Gastroenterologic Disorders (non-cancerous) (PDF), Genetic Testing General Approach to Genetic Testing (PDF), Genetic Testing Hematologic Conditions (non-cancerous) (PDF), Genetic Testing Hereditary Cancer Susceptibility (PDF), Genetic Testing Immune Autoimmune and Rheumatoid Disorders (PDF), Genetic Testing Metabolic Endocrine and Mitochondrial Disorders(PDF), Genetic Testing Multisystem Inherited Disorders, Intellectual Disability and Developmental Delay(PDF), Genetic Testing Non-Invasive Prenatal Screening (NIPS)(PDF), Genetic Testing Preimplantation Genetic Testing(PDF), Genetic Testing Prenatal and Precon Carrier Screening(PDF), Genetic Testing Prenatal Diagnosis (via Amnio CVS or PUBS) and Pregnancy Loss(PDF), Genetic Testing Skeletal Dysplasia and Rare Bone Disorders(PDF), Helicobacter Pylori Serology Testing (PDF), Implantable Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea (PDF), Implantable Wireless Pulmonary Artery Pressure Monitoring (PDF), Infant Apnea Monitors Clinical Policy (PDF), Intestinal and Multivisceral Transplant (PDF), Intradiscal Steroid Injections for Pain Management(PDF), IV Moderate Sedation, IV Deep Sedation, and General Anesthesia for Dental Procedures(PDF), Low-Frequency Ultrasound Therapy for Wound Management (PDF), Measurement of Serum 1,25-dihydroxyvitamin D (PDF), Neonatal Abstinence Syndrome Guidelines (PDF), Nerve Blocksand Neurolysis for Pain Management (PDF), Neuromuscular Electrical Stimulation (PDF), Nonmyeloablative Allogeneic Stem Cell Transplants (PDF), Oncology Circulating Tumor DNA and Circulating Tumor Cells (PDF), Oncology Molecular Analysis of Solid Tumors and Hematologic Malignancies (PDF), Percutaneous Left Atrial Appendage Closure Device for Stroke Prevention (PDF), Phototherapy for Neonatal Hyperbilirubinemia(PDF), Physical, Occupational, and Speech Therapy Services (PDF), Physical, Occupational, Speech, and Feeding Therapy (PDF), Posterior Tibial Nerve Stimulation for Voiding Dysfunction (PDF), Reduction Mammoplasty and Gynecomastia Surgery (PDF), Sacroiliac Joint Interventions for Pain Management (PDF), Sclerotherapy and Chemical Endovenous Ablation for Varicose Veins(PDF), Selective Dorsal Rhizotomy for Spasticity in Cerebral Palsy (PDF), Selective Nerve Root Blocks and Transforaminal Epidural Injections for Pain Management (PDF), Skin Substitutes for Chronic Wounds (PDF), Spinal Cord, Peripheral Nerve, and Percutaneous Electrical Nerve Stimulation (PDF), Stereotactic Body Radiation Therapy (PDF), Testing for Select Genitourinary Conditions (PDF), Total Parenteral Nutrition and Intradialytic Parenteral Nutrition (PDF), Transcather Closer of Patent Foramen Ovale (PDF), Transplant Service Documentation Requirements, Trigger Point Injections for Pain Management (PDF), Urinary Incontinence Devices and Treatments (PDF), IV Moderate Sedation, IV Deep Sedation, and General Anesthesia for Dental Procedures (PDF), Non-myeloablative Allogeneic Stem Cell Transplants (PDF), Physical, Occupation, and Speech Therapy Services, Sclerotherapy and chemical endovenous ablation for Varicose Veins(PDF), Transcatheter Closure of Patent Foramen Ovale (PDF), Behavioral Health Treatment Document Requirement(PDF), Deep Transcranial Magnetic Stimulation for Obsessive Compulsive Disorder (PDF), Substance Use Disorder Treatment and Services (PDF), Biofeedback for Behavioral Health Disorders (PDF), Transcranial Magnetic Stimulation for Treatment Resistant Major Depression (PDF), Adjacent Tissue Transfer Grafts involving Eyelid (PDF), Anterior Segment Photography with FA (PDF), Blepharoplasty, Ptosis and Canthoplasty (PDF), Dark Adaptation and Color Vision Examinations (92283/92284) (PDF), Destruction of a Localized Lesion of the Retina (PDF), Destruction of Localized Lesion of Choroid (PDF), Examination Guidelines for Diabetic Patients (PDF), Indocyanine Green (ICG) Angiography (PDF), Infracture of the Inferior Turbinate (PDF), Laser Iridotomy and Iridectomy for Glaucoma (PDF), Photodynamic and Intravitreal Therapies and Pharmaceuticals (PDF), Probing and Closure of the Lacrimal Duct System (PDF), Surgical Excision of Eyelid Lesions (PDF), Teleretinal Screening for Diabetic Retinopathy (PDF), Ado-Trastuzumab Emtansine (Kadcyla) (PDF), Age Limit Override (Codeine, Tramadol, Hydrocodone) (PDF), Alendronate (Binosto, Fosamax plus D) (PDF), Alpha-1 Proteinase Inhibitors (Aralast NP, Glassia, Prolastin-C, Zemaira) (PDF), Antithymocyte Globulin (Thymoglobulin, Atgam) (PDF), Anti-Inhibitor Coagulant Complex, Human (Feiba) (PDF), Aprepitant (Emend, Cinvanti), Fosaprepitant (Emend for injection) (PDF), Aripiprazole Long-Acting Injections (Abilify Maintena, Aristada) (PDF), Baclofen (Gablofen, Lioresal, Ozobax) (PDF), Bevacizumab (Avastin, Mvasi, Zirabev) (PDF), Blocking Adjudication of Controlled Substance Prescriptions for Selected Prescribers(PDF), Brand Name Override and Non-Formulary Medications (PDF), Brexucabtagene Autoleucel (Tecartus)(PDF), Brinzolamide/Brimonidine (Simbrinza) (PDF), Budesonide Suspension (Pulmicort Respules) (PDF), Buprenorphine Implant/Injection (Probuphine, Sublocade) (PDF), Buprenorphine-Naloxone (Bunavail, Cassipa, Suboxone) (PDF), C1 Esterase Inhibitors (Berinert, Cinryze, Haegarda) (PDF), C1 Esterase Inhibitors (Berinert, Cinryze, Haegarda, Ruconest) (PDF), Cabozantinib (Cometriq, Cabometyx) (PDF), Ciprofloxacin-Dexamethasone (Ciprodex) (PDF), Ciprofloxacin/Fluocinolone (Otovel) (PDF), Clindamycin Phosphate/Benzoyl Peroxide (BenzaClin) (PDF), Clinical Pharmacy Services Inter-rater Reliability (PDF), Conjugated Estrogens/Bazedoxifene (Duavee) (PDF), Corticosteroid Intravitreal Implants (Iluvien, Ozurdex, Retisert, Yutiq) (PDF), Cysteamine oral (Cystagon, Procysbi) (PDF), Cytomegalovirus Immune Globulin (Cytogam)(PDF), Desmopressin Acetate (DDAVP, Stimate, Noctiva) (PDF), Dextromethorphan-Quinidine (Nuedexta) (PDF), Dimethyl Fumarate (Tecfidera), Diroximel Fumarate (Vumerity) (PDF), Dipeptidyl Peptidase-4 (DPP-4) Inhibitors (PDF), Doxepin (Silenor, Prudoxin, Zonalon) (PDF), Doxycycline Hyclate (Acticlate, Doryx), Doxycycline (Oracea) (PDF), Early and Periodic Screening, Diagnostic, and Treatment Benefit for Pediatric Members (PDF), Elexacaftor/Ivacaftor/Tezacaftor; Ivacaftor (Trikafta) (PDF), Emtricitabine/Tenofovir Alafenamide (Descovy)(PDF), Everolimus (Afinitor, Afinitor Disperz, Zortress) (PDF), Factor IX Complex, Human (Profilnine) (PDF), Factor VIIa, Recombinant (NovoSeven RT) (PDF), Factor VIIa, Recombinant (NovoSeven RT, SevenFact) (PDF), Factor XIII A-Subunit, Recombinant (Tretten) (PDF), Fam-trastuzumab Deruxtecan-nxki (Enhertu) (PDF), Fentanyl IR (Abstral, Actiq, Fentora, Lazanda, Subsys) (PDF), Filagrastim (Neupogen), Filagrastim-sndz (Zarxio), Tbo-filagrastim (Granix) (PDF), Formulary Medications without Specific Guidelines (PDF), Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists (PDF), Granisetron (Kytril, Sancuso, Sustol) (PDF), histrelin acetate (Vantas, Supprelin LA) (PDF), Hydroxyprogesterone Caproate (Makena/compound), Indacaterol/Glycopyrrolate (Utibron Neohaler) (PDF), Infertility and Fertility Preservation (PDF), Infliximab (Remicade, Inflectra, Renflexis) (PDF), Insulin Delivery Systems (V-Go, OmniPod, InPen) (PDF), Interferon beta-1b (Betaseron, Extavia) (PDF), Intrathecal Baclofen (Gablofen, Lioresal) (PDF), Isotretinoin (Absorica, Absorica LD, Amnesteem, Claravis, Myorisan, Zenatane) (PDF), Itraconazole (Sporanox, Onmel, Tolsura) (PDF), Lesinurad (Zurampic), Lesinurad/Allopurinol (Duzallo) (PDF), leuprolide acetate (Eligard, Lupaneta Pack, Lupron Depot, Lupron Depot-Ped) (PDF), Levalbuterol (Xopenex HFA/Inhalation Solution) (PDF), Lidocaine Transdermal (Lidoderm, ZTlido) (PDF), Lutetium Lu 177 Dotatate (Lutathera)(PDF), Montelukast oral granules (Singulair) (PDF), Methotrexate (Otrexup, Rasuvo, Xatmep, Reditrex) (PDF), Methoxy polyethylene glycol-epoetin beta (Mircera) (PDF, Methylnaltrexone Bromide (Relistor) (PDF), Minocycline ER (Solodyn, Ximino, Minolira) and Microspheres (Arestin) (PDF), Moxetumomab pasudotox-tdfk (Lumoxiti) (PDF), Multiple Procedure Payment Reduction (MPPR) for Therapeutic Services (PDF), Nadofaragene Firadenovec (Instiladrin) (PDF), Naproxen oral suspension (Naprosyn) (PDF), Neomycin/Fluocinolone Cream (Neo-Synalar)_(PDF), Netarsudil (Rhopressa), Netarsudil/Latanoprost (Rocklatan) (PDF), Netupitant and Palonosetron (Akynzeo), Fosnetupitant and Palonosetron (Akynzeo IV) (PDF), No Coverage Criteria/Off-Label Use Policy (PDF), Non-Formulary and Formulary Contraceptives (PDF), Octreotide (Sandostatin, Sandostatin LAR) (PDF), Octreotide Acetate (Sandostatin, Sandostatin LAR Depot, Bynfezia) (PDF), Olanzapine Long-Acting Injection (Zyprexa Relprevv)(PDF), Onasemnogene Abeparvovec (Zolgensma) (PDF), Paclitaxel, Protein-Bound (Abraxane) (PDF), Peanut Allergen Powder-dnfp (Palforzia) (PDF), Pegaspargase (Oncaspar), Calaspargase pegol-mknl (Asparlas) (PDF), peginterferon alfa-2b (PegIntron, Sylatron) (PDF), Pharmacy and Therapeutics Committee(PDF), Pharmacy Prior Authorization and Medical Necessity Criteria(PDF), Potassium Chloride for Oral Solution (Klor-Con Powder) (PDF), Propranolol HCl Oral Solution (Hemangeol) (PDF), Protein C Concentrate, Human (Ceprotin) (PDF), Repository Corticotropin Injection (H.P. This area of the Billing and Reimbursement site provides information on the major aspects of Medicaid related to audiology and speech-language pathology services, including audiology and speech-language pathology requirements and information for school based professionals. The three segments identify the labeler, the product, and the commercial package size. Before sharing sensitive or personal information, make sure youre on an official state website. American Speech-Language-Hearing Association Press Enter on an item's link to navigate to that page. <> 04/01/2023. Therapy Comply does not claim copyright over US Federal and State materials. Guidance on therapy services covered through Georgia Medicaid and other important compliance issues such as enrollment, billing, audits, and managed care. Members also have access to compliance and billing support. The information that has been accurate previously can be particularly dependent on changes in time or circumstances. c. Speech Therapy and Audiology Fee Schedule - Jan. 5, 2022 - PDF. 5vo{mn{4ym+Bn!=X\ + L|_%IhX%6]]J+cma7|Wcg((?&wzsC5Q{1;PU8?|_v?W?Zb q Reimbursement rates have been recalculated effective July 1, 2020 through June 30, 2021. 2021 Medicaid Enhancements to Reimbursement Policies. Learn moreabout how we provide comprehensive support for members. The payment rate for out-of-state enrolled hospitals will not exceed 65% of covered charges. Examples of provider administered drugs: Copyright 2023 Wellcare Health Plans, Inc. Behavioral Health and Rehabilitation Services, Durable Medical Equipment and Supplies - Enteral Nutrition, Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Services, Family Planning Services Contraceptives, U1 (Practitioner Level 1) - U6 (In-Clinic), U1 (Practitioner Level 1) - U7 (Out-of-Clinic), U2 (Practitioner Level 2) - U6 (In-Clinic), U2 (Practitioner Level 2) - U7 (Out-of-Clinic), U3 (Practitioner Level 3) - U6 (In-Clinic), U3 (Practitioner Level 3) - U7 (Out-of-Clinic), U4 (Practitioner Level 4) - U6 (In-Clinic), U4 (Practitioner Level 4) - U7 (Out-of-Clinic). In response to the Centers for Medicare & Medicaid Services (CMS) approval of Medicaid Section 1135 Waivers for COVID-19, the State of Georgia Department of Community Health will expedite new enrollment applications until further notice. Other non-clinical policies (e.g., payment policies) or contract terms may further determine whether a technology, procedure or treatment that is not addressed in the Clinical Policy Manuals or InterQualcriteria is payable by Peach State Health Plan. They are used to help identify whether health care services are correctly coded for reimbursement. Additionally, the following implantable contraceptive devices and procedures should be reported with modifier FP (Service provided as part of Medicaid family planning program): According to Georgia Medicaid guidelines, hearing aid devices, items and services are not covered for patients 21 years of age or older. The Initial Reimbursement Rate Sheets for FYE June 30, 2022, are located below. Local, state, and federal government websites often end in .gov. These services are provided by speech-language-pathologists \ w|p&buSa!HTNH8zEl&~taFZ>qy|Zu_i-gF7*K_xhM |ykr\5fOy6wAT)+EhK4 9IOfUFJ?!A9Hkz Gv&v>QeIY1.?yL.Tv?{!% Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. "@$E"Y[d$dvox`sX#@Q 1$Nw A You will need Adobe Reader to open PDFs on this site. Non-Member: 800-638-8255, Site Help | AZ Topic Index | Privacy Statement | Terms of Use %%EOF endobj According to Georgia Medicaid guidelines, as part of the EPSDT program, an inter-periodic hearing screening and a periodic preventive service for patients less than 21 years of age should not be reported on the same day. They include but are not limited to policies relating to evolving medical technologies and procedures, as well as pharmacy policies. They are routinely updated to promote accurate coding and policy clarification. hVQo8+zz$[! Principal Appropriate Utilization Group, LLC 881 Piedmont Avenue Atlanta, GA 30309 (404) 728-1974; FAX (404) 728-1975 [email protected] Download the free version of Adobe Reader. 322.9. The Department of Community Health (DCH) administers Medicaid reimbursement and associated policy for mental health treatment and services through partnership with The Department of Behavioral Health and Developmental Disabilities (DBHDD). The policies below are in PDF format. 1 0 obj 558.5. 4a, Col 004, lines 002,005,006,008,009,015: 37) Georgia Georgia Medicaid Coverage of Therapy Services Georgia Medicaid Coverage of Therapy Services Guidance on therapy services covered through Georgia Medicaid and other important compliance issues such as enrollment, billing, audits, and managed care. Speech Therapy and Audiology Fee Schedule - Jan. 5, 2022 - PDF. Under the FFS model, Georgia pays providers directly for each covered service received by a Medicaid beneficiary. FwRWR,~\^/>-/RO}WJ:}Vw^FQ+(lvP,Y6G}YQ^b|8>bw%[ggQ-.qh OHay_ R,~p]/z-,/z. E\Y?>Jvubzu{D|q,[-n;+wc`l^/[tzEO~yQ-B~nv{ Bxx:#(T~e ZZ. Family Planning Services have two main components, frequency limitations and modifier requirements. 2 0 obj If you have a question about a specific matter, you should contact a professional advisor directly. b. Toll Free: (877) 423-4746. Wellcare uses cookies. Payments for claims may be subject to limitations and/or qualifications. Each payment rule is sourced by a generally accepted coding principle. They are routinely updated to promote accurate coding and policy clarification. Medicaid reimbursement rates and associated policy of this program are found here: Provider Manuals. CPT copyright American Medical Association. By continuing to use our site, you agree to our Privacy Policy and Terms of Use. Georgia Medicaid offers benefits on a Fee-for-Service (FFS) basis or through managed care plans. First Published . The information contained in this web site is intended as general information only. If you do not have Adobe Acrobat Reader, you may download ithere. Members: 800-498-2071 Georgia Chiropractic Association 1926 Northlake Parkway, Suite 201 Tucker, GA 30084 (770) 723-1100; FAX (770) 723-1722 [email protected] Physical Therapy Services Stuart Platt, P.T., M.S.P.T. CPT is a registered trademark of the American Medical Association. The goals of this endeavor will be implemented. Additional information on available services and policy requirements can be obtained by visiting https://dbhdd.georgia.gov/community-provider-manuals. According to Georgia Medicaid guidelines, a brief emotional/behavioral assessment performed during a non-periodic screening visit for a patient less than 21 years of age must be reported with modifier EP (EPSDT program) and billed in Place of Service 99 (Other). The NDC serves as a universal product identifier for drugs.

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