MedicaidPrior AuthHigh impact
[Georgia] Prior Authorization Requirement Update
CareSource·GA · Wound Care, PM&R (Physical Medicine & Rehab), Orthopedics·Provider Bulletin
Effective date
Jan 1, 2026
We identified it
Jun 13, 2026
Summary
CareSource Georgia Medicaid is adding prior authorization requirements for 118 specific billing codes effective January 1, 2026. These codes span multiple categories including laboratory tests, wound care supplies, durable medical equipment, prosthetics/orthotics, and skin substitutes.
Action Required
By December 31, 2025: Billing team must update authorization tracking system to require prior authorization for all 118 listed codes when billing CareSource Georgia Medicaid. Update encounter forms and EMR templates to alert providers that these codes require prior auth. Contact CareSource at 1-800-202-1058 for authorization requests. Claims submitted without prior authorization will be denied.