04/01/2023. The Department of Community Heath received approval from the Center of Medicare and Medicaid Services (CMS) for a temporary 5% growth increase effective July 1, 2020 through June 30, 2021 for all nursing home providers. https://dbhdd.georgia.gov/community-provider-manuals, https://www.myamerigroup.com/ga/georgia-home.html, https://dbhdd.georgia.gov/access-services, Mental Health and Substance Use Disorder Parity. Hand pulling book from library archive shelf. Required Documentation to enroll with Georgia Medicaid: PDF: 468.3: 06/20/2019 : Step By Step . 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 . All policies found in the Peach State Health PlanPayment Policy Manual apply with respect to Peach State Health Planmembers. 5vo{mn{4ym+Bn!=X\
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An official website of the State of Georgia. Call Us. Each payment rule is sourced by a generally accepted coding principle. 322.9. According to Georgia Medicaid guidelines, enteral nutrition supplies and equipment must be reported with the purchase modifier NU (New equipment). Orthotic and Prosthetic Fee Schedule - PDF. It is not intended to serve as medical, health, legal or financial advice or as a substitute for professional advice of a medical coding professional, healthcare consultant, physician or medical professional, legal counsel, accountant or financial advisor. Additionally, monaural hearing aids, when billed, must be reported with modifier RT or LT and are limited to one unit per side in a three-year period. endstream
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2021 Medicaid Enhancements to Reimbursement Policies. Family Planning Services have two main components, frequency limitations and modifier requirements. If you are at an office or shared network, you can ask the network administrator to run a scan across the network looking for misconfigured or infected devices. Physical Therapy Speech Therapy Occupational Therapy Home Health Aide Cost Report Reference / Formula; Build-Up (All Agencies Statewide) 35) Total Allowable Costs (All Agencies Statewide) Sch. Clinical policies are one set of guidelines used to assist in administering health plan benefits, either by prior authorization or payment rules. Policies in the Peach State Health PlanPayment Policy Manual may have either a Peach State Health Planor a Centene heading. Local, state, and federal government websites often end in .gov. Medicaid Coverage of Speech-Language Pathologists and Audiologists 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. aJY $,0V #hE2!FF!&`B+4fC&%@ c cTh Clinical Payment Policy | Georgia Medicaid | Peach State Health Plan endobj
State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. Therefore, when crisis intervention services are billed with modifier U1, U2, U3, U4 or U5 and modifier U6, U7 or GT are not also appended, the crisis intervention services (H2011) will be recommended for denial. Local, state, and federal government websites often end in .gov. Under managed care, Georgia pays a fee to a managed care plan for each person enrolled in the plan. Under the FFS model, Georgia pays providers directly for each covered service received by a Medicaid beneficiary. Please locate the pdf file where the Provider's Name would fall. Press Space or Escape to collapse the expanded menu item. As Georgias Behavioral Health Authority, DBHDD provides services through a network of community providers. Reimbursement policies are designed to assist you when submitting claims to CareSource. Webinar: Medicare Advantage Compliance and Therapy Services, Webinar: Scheduling to Increase Revenue and Reduce Cancellations, Webinar: The Business of Providing PT/OT to Medicare Patients Recorded September 22, 2022, Webinar: Medicare Documentation and Billing Physical and Occupational Therapy September 8, 2022, Webinar: Remote Therapeutic Monitoring July 20, 2022, Webinar: HIPAA Recognized Security Practices, Webinar: Creating a PT/OT Bonus Plan for Your Practice, Webinar: Medicare PT/OT Services and NCCI, Webinar: Defending Your Therapy Practice from Medicare Audits, Webinar: Advising PT/OT Patients about Cannabis: Medical Marijuana and CBD, Webinar: HIPAA Risk Assessments and Mitigation, Webinar: Effective Compliance and Billing Audits for Therapy Practices, Webinar: Financial and Productivity Benchmarking for Outpatient Physical and Hand Therapy, Webinar: Adult Scoliosis Recognition and Physical Therapy Interventions, Webinar: 2022 Billing and Coding Updated for PT/OT, Webinar: CQ-CO Modifiers and Medicare in 2022, Webinar: PT/OT Burnout Resilience & Balance, Webinar: Medicare ABNs and Therapy Services, Webinar: Osteoarthritis Management by Physical Therapists, Webinar: Effective Compliance Plans for Therapy Practices, Webinar: Manual Therapy Principles of the Shoulder, Webinar: HIPAA for Physical and Occupational Therapy, Webinar: Tricare Compliance for PT and OT, Webinar: Documentation of Skilled Therapy, Webinar: Hip Stability and its Effects on Balance and Fall Prevention, Webinar: Managing Conflict Resolution for PTs and OTs, Webinar: Core Stability and its Effects on Balance and Fall Prevention, Webinar: Posture, Aging and Orthopedic Effects on Balance, Webinar: Pills and Spills An Assessment of Medications and Fall Risk in Older Patients, Alabama PT Identification and Notifications, Alabama PT Board Position Statements and Forms, Alabama OT Identification and Notification, Alabama OT Board Position Statements and Forms, Alabama SLP Board Position Statements and Forms, Alabama Covid-19 Resources for Therapy Providers, Alabama Medicaid Coverage of Therapy Services, Alaska Covid-19 Resources for Therapy Providers, Alaska Medicaid Coverage of Therapy Services, Arizona OT Identification and Notifications, Arizona Medicaid Coverage of Therapy Services, Arizona Covid-19 Resources for Therapy Providers, Arkansas Covid-19 Resources for Therapy Providers, Arkansas Medicaid Coverage of Therapy Services, California Covid-19 Resources for Therapy Providers, California Medicaid Coverage of Therapy Services, Colorado Covid-19 Resources for Therapy Providers, Colorado Medicaid Coverage of Therapy Services, Colorado Medicaid Physical and Occupational Therapy, Colorado Medicaid PT and OT Prescription and Referral, Colorado Medicaid PT and OT Documentation Requirements, Colorado Medicaid PT and OT Covered Services, Colorado Medicaid PT and OT Prior Authorization, Connecticut Medicaid Coverage of Therapy Services, Delaware Covid-19 Resources for 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Medicaid Coverage of Therapy Services, Maryland Workers Compensation Fee Schedules, Massachusetts OT Supervision and Delegation, Massachusetts Covid-19 Resources for Therapy Providers, Massachusetts Medicaid Coverage of Therapy Services, Massachusetts Medicaid Therapy Fee Schedules, Massachusetts Medicaid Outpatient Therapy, Massachusetts Medicaid Provider Enrollment, Massachusetts Workers Compensation Fee Schedules, Michigan Covid-19 Resources for Therapy Providers, Michigan Medicaid Coverage of Therapy Services, Michigan Workers Compensation Fee Schedules, Minnesota Covid-19 Resources for Therapy Providers, Minnesota Medicaid Coverage of Therapy Services, Minnesota Workers Compensation Fee Schedules, Mississippi Covid-19 Resources for Therapy Providers, Mississippi Medicaid Coverage of Therapy Services, Mississippi Medicaid Therapy Fee Schedules, Mississippi Workers Compensation Fee Schedules, Missouri Covid-19 Resources for Therapy Providers, Missouri Medicaid Coverage of Therapy Services, Missouri Workers Compensation Fee Schedules, Montana Covid-19 Resources for Therapy Providers, Montana Medicaid Coverage of Therapy Services, Montana Workers Compensation Fee Schedules, Nebraska Covid-19 Resources for Therapy Providers, Nebraska Medicaid Coverage of Therapy Services, Nebraska Workers Compensation Fee Schedules, Nevada Covid-19 Resources for Therapy Providers, Nevada Medicaid Coverage of Therapy Services, Nevada Workers Compensation Fee Schedules, New Hampshire Covid-19 Resources for Therapy Providers, New Hampshire Medicaid Coverage of Therapy Services, New Hampshire Medicaid Therapy Fee Schedules, New Hampshire Medicaid Outpatient Therapy, New Hampshire Medicaid Provider Enrollment, New Hampshire Workers Compensation Fee Schedules, Use of a Computer to Prepare Patient Records, New Jersey OT Identification and Notification, New Jersey Covid-19 Resources for Therapy Providers, New Jersey Medicaid Coverage of Therapy Services, New Jersey Medicaid Therapy Fee Schedules, New Jersey Workers Compensation Fee Schedules, New Mexico Covid-19 Resources for Therapy Providers, New Mexico Medicaid Coverage of Therapy Services, New Mexico Workers Compensation Fee Schedules, New York Covid-19 Resources for Therapy Providers, New York Medicaid Coverage of Therapy Services, New York Workers Compensation Fee Schedules, North Carolina PT Continuing Education Activities, North Carolina PT General Scope of Practice, North Carolina PT Additional PT Practices, North Carolina PT Additional PTA Practices, North Carolina PT Supervision and Delegation, North Carolina PT Supervision and Documentation, North Carolina PT Identification and Notification, North Carolina PT Licensure by Endorsement, North Carolina OT Identification and Notification, North Carolina Covid-19 Resources for Therapy Providers, North Carolina Medicaid Coverage of Therapy Services, North Carolina Medicaid Outpatient Therapy, North Carolina Medicaid Provider Enrollment, North Carolina Pediatric Therapy Services, North Carolina Workers Compensation Fee Schedules, North Dakota Covid-19 Resources for Therapy Providers, North Dakota Medicaid Coverage of Therapy Services, North Dakota Medicaid Provider Enrollment, North Dakota Workers Compensation Fee Schedules, Ohio OT Temporary License Military Spouse, Ohio Covid-19 Resources for Therapy Providers, Ohio Medicaid Coverage of Therapy Services, Oklahoma PT Board Position Statements and Forms, Oklahoma Covid-19 Resources for Therapy Providers, Oklahoma OT Board Position Statements and Forms, Oklahoma Medicaid Coverage of Therapy Services, Oklahoma Workers Compensation Fee Schedules, Oregon Covid-19 Resources for Therapy Providers, Oregon Medicaid Coverage of Therapy Services, Oregon Workers Compensation Fee Schedules, Pennsylvania PT Transdermal Administration of Drugs, Pennsylvania PT Direct Access Certificates, Pennsylvania PT Supervision and Delegation, Pennsylvania PT Identification and Notification, Pennsylvania Covid-19 Resources for Therapy Resources, Pennsylvania Medicaid Coverage of Therapy Services, Pennsylvania Medicaid Provider Enrollment, Pennsylvania Workers Compensation Fee Schedules, Rhode Island Covid-19 Resources for Therapy Providers, Rhode Island Medicaid Coverage of Therapy Services, Rhode Island Medicaid Provider Enrollment, Rhode Island Workers Compensation Fee Schedules, South Carolina Covid-19 Resources for Therapy Providers, South Carolina Medicaid Coverage of Therapy Services, South Carolina Medicaid Outpatient Therapy, South Carolina Medicaid Provider Enrollment, South Carolina Pediatric Therapy Services, South Carolina Workers Compensation Fee Schedules, South Dakota Covid-19 Resources for Therapy Resources, South Dakota Medicaid Coverage of Therapy Services, South Dakota Medicaid Provider Enrollment, South Dakota Workers Compensation Fee Schedules, Tennessee Covid-19 Resources for Therapy Providers, Tennessee Medicaid Coverage of Therapy Services, Tennessee Workers Compensation Fee Schedules, Texas PT Board Position Statements and Forms, Texas OT Identification and Notifications, Texas Medicaid Coverage of Therapy Services, Texas Medicaid Outpatient Therapy for Children, Texas Medicaid Coverage of PT, OT, and SLP Therapy Service for Adults, Texas Medicaid Therapy Frequency and Duration Criteria, Texas Medicaid Co-Treatment and Group Therapy, Texas Medicaid Definitions for Outpatient Therapy, Texas Covid-19 Resources for Therapy Providers, Utah Covid-19 Resources for Therapy Providers, Utah Medicaid Coverage of Therapy Services, Vermont Covid-19 Resources for Therapy Providers, Vermont Medicaid Coverage of Therapy Services, Vermont Workers Compensation Fee Schedules, Virginia OT Out-of-State Licensee Voluntary Practice, Virginia Covid-19 Resources for Therapy Providers, Virginia Medicaid Coverage of Therapy Services, Virginia Workers Compensation Fee Schedules, Washington OT Identification and Notification, Washington OT Exemption for Short-Term Practice, Washington OT Inactive and Retired Status, Washington Covid-19 Resources for Therapy Providers, Washington Medicaid Coverage of Therapy Services, Washington Medicaid Therapy Fee Schedules, Washington Workers Compensation Fee Schedules, West Virginia Covid-19 Resources for Therapy Providers, West Virginia Medicaid Coverage of Therapy Services, West Virginia Medicaid Therapy Fee Schedules, West Virginia Medicaid Outpatient Therapy, West Virginia Medicaid Provider Enrollment, West Virginia Workers Compensation Fee Schedules, Wisconsin Covid-19 Resources for Therapy Provider, Wisconsin Medicaid Coverage of Therapy Services, Wisconsin Workers Compensation Fee Schedules, Wyoming Physical Therapy Procedures and Modalities, Wyoming Covid-19 Resources for Therapy Providers, Wyoming Medicaid Coverage of Therapy Services, Wyoming Workers Compensation Fee Schedules, Merit-Based Incentive Payment System (MIPS), Measure 126: Diabetes Mellitus: Diabetic Foot and Ankle Care, Peripheral Neuropathy, Measure 127: Diabetes Mellitus: Diabetic Foot and Ankle Care, Ulcer Prevention, Measure 128: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan, Measure 130: Documentation of Current Medications in the Medical Record, Measure 134: Preventive Care and Screening: Screening for Depression and Follow-Up Plan, Measure 181: Elder Maltreatment Screen and Follow-Up Plan, Measure 182: Functional Outcome Assessment, Measure 217: Functional Status Change for Patients with Knee Impairments, Measure 218: Functional Status Change for Patients with Hip Impairments, Measure 219: Functional Status Change for Patients with Lower Leg, Foot or Ankle Impairments, Measure 220: Functional Status Change for Patients with Low Back Impairments, Measure 221: Functional Status Change for Patients with Shoulder Impairments, Measure 222: Functional Status Change for Patients with Elbow, Wrist or Hand Impairments, Measure 223: Functional Status Change for Patients with General Orthopedic Impairments, Measure 226: Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention, Measure 281: Dementia Cognitive Assessment, Measure 282: Dementia: Functional Status Assessment, Measure 288: Dementia: Education and Support of Caregivers for Patients with Dementia, Measure 318: Falls Screening for Future Fall Risk, Measure 478: Functional Status Change for Patients with Neck Impairments, Measure 131: Pain Assessment and Follow-Up, Medicare Enrollment of Occupational Therapists, Medicare Enrollment of Physical Therapists, Medicare Coverage of Specific Modalities and Procedures, National Coverage Determinations for Therapy Services, Medicare Therapy Limitations and Noncovered Services, Medicare Documentation for Therapy Services, Levels of Appeals and Time Limits for Filing, Medicare Therapy Bill Type and Revenue Codes, Medicare Skilled Nursing Facilities Therapy Services, Medicare Home Health Conditions for Coverage, Security Rule - Administrative Safeguards, When Patient Authorization is Not Required, Early Intervention Referrals and Screening, Common Physical and Occupational Therapy Codes, NCCI Medically Unlikely Edits Therapy Services, NCCI Practitioner Edits Therapy Services Q3 2022, NCCI Practitioner Edits Therapy Services Q4 2022, NCCI Practitioner Edits Therapy Services Q1 2023, NCCI Hospital Edits Therapy Services Q3 2022, NCCI Hospital Edits Therapy Services Q4 2022, NCCI Hospital Edits Therapy Services Q1 2023, End of Covid-19 Emergency Period - Medicare Therapy Waivers, Medicare Certification and Recertification Plan of Care FAQs, Multiple Procedure Payment Reduction (MPPR), Medicare Total Time Rule v. AMA 8-Minute Rule, Medicare Documentation Requirements for Therapy Services, Medicare Documentation Requirements for Therapy Practices, New Section: Medicare Therapy Limitations and Noncovered Services, Medicare Telehealth Services During Covid-19 Emergency Period, New Section: Outpatient Rehabilitation Facilities.
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