MedicaidPrior AuthHigh impact
[Georgia] Prior Authorization Requirement Update
CareSource·GA · Orthopedics, PM&R (Physical Medicine & Rehab), Wound Care·Provider Bulletin
Effective date
Jan 1, 2026
We identified it
Jun 13, 2026
Summary
CareSource Georgia Medicaid is adding prior authorization requirements for 130 specific billing codes effective January 1, 2026. This revised notification includes laboratory codes, durable medical equipment, orthotics/prosthetics, and skin substitutes that will require prior authorization approval before services can be provided.
Action Required
By December 31, 2025: Billing team must update authorization tracking system to require prior authorization for all 130 listed codes before providing services to CareSource Georgia Medicaid members. Contact Provider Services at 1-800-202-1058 for authorization requests. Update encounter forms and EMR alerts to remind providers. Claims will be denied without proper prior authorization.