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MedicaidPrior AuthMedium impact

[Georgia] Prior Authorization Requirement Update

CareSource·GA · Wound Care, PM&R (Physical Medicine & Rehab), Orthopedics +1 more·Provider Bulletin
Effective date
Apr 1, 2025
We identified it
Jun 13, 2026
Days to comply

Summary

CareSource Georgia Medicaid is adding prior authorization requirements for 10 new medical codes effective April 1, 2025. These codes include wound care products, orthotic devices, and other medical supplies that will require approval before services can be rendered.

Action Required

Action needed
Before April 1, 2025: Billing team must update prior authorization requirements in billing system for codes C1601, Q4294, Q4295, E2298, Q4304, A4545, A6523, A6524, A6525, and L1320 for CareSource Georgia Medicaid patients. Update encounter forms and notify providers that these codes require prior authorization. Claims submitted without prior authorization will be denied.

Affected Billing Codes

C1601
Q4294
Q4295
E2298
Q4304
A4545
A6523
A6524
A6525
L1320