MedicaidBilling CodesHigh impact
[Georgia] Place of Service Code for EPSDT Visits
CareSource·GA · Pediatrics·Provider Bulletin
Effective date
May 1, 2026
We identified it
May 9, 2026
Summary
Effective May 1, 2026, Georgia Medicaid providers must use place of service (POS) code 99 when billing office visits for EPSDT preventive health screening services. Diagnostic x-ray, laboratory testing, and treatment services provided during the same visit can be billed on the same CMS 1500 claim form. Claims will deny if any POS code other than 99 is used for EPSDT preventive visits.
Action Required
By April 30, 2026: Billing team must update all billing system rules and encounter forms to require POS code 99 for all EPSDT preventive health screening office visits billed to Georgia Medicaid (CareSource). Verify that diagnostic services (x-ray, lab tests except hematocrit/hemoglobin, and treatment services) can be submitted on the same CMS 1500 claim form without triggering bundling denials. Train providers and front desk staff on the new POS requirement. Test billing workflows with sample claims. Starting May 1, 2026, any EPSDT preventive visit claim using a POS code other than 99 will be denied by CareSource. Contact CareSource Provider Relations at GAProviderRelations@CareSource.com or 1-855-202-1058 with questions.