MedicaidPrior AuthHigh impact
[Georgia] Prior Authorization Requirement Update
CareSource·GA · Physical Therapy, Occupational Therapy, Wound Care +3 more·Provider Bulletin
Effective date
Jul 10, 2025
We identified it
Jun 13, 2026
Summary
CareSource Georgia Medicaid is adding prior authorization requirements for skin substitutes, outpatient therapy codes, new Q1 2025 codes, and other outpatient services effective July 10, 2025. This affects a wide range of commonly used therapy and treatment codes that will require pre-approval before services can be rendered.
Action Required
By July 10, 2025: Billing team must update prior authorization requirements in billing system for all listed codes. Front desk staff must obtain prior authorization before scheduling services using these codes for CareSource Georgia Medicaid patients. Update encounter forms and EMR alerts to flag these codes. Note special requirement for therapy codes 90832, 90834, 90837, 90846, 90847 - prior auth needed when combined individual and family sessions exceed 24 outpatient visits. Services rendered without prior authorization will be denied.