← Back to list
[Georgia] Prior Authorization Requirement Update
Act
by Mar 31, 2026
Effective date
Apr 1, 2026
Identified
May 9, 2026
Summary
CareSource Georgia Medicaid is implementing new prior authorization requirements effective April 1, 2026, for 57 specific billing codes across multiple service categories including genetic testing, durable medical equipment, orthotic/prosthetic devices, and surgical procedures. All non-participating providers and inpatient services already require prior auth; this update expands requirements to include these specific codes for all providers.
Get alerts when payers change rules like this one
We check CareSource and other payers every day and email you when a change matches your specialty and state.
Get CareSource alertsPolicy Monitoring is free. No card required.
What to do
by Mar 31, 2026 · 4 steps
01Billing team must update all billing system workflows to require prior authorization for the 57 specified codes in Addendum A before submitting claims to CareSource Georgia Medicaid.
02Update claim submission templates, encounter forms, and provider alerts to flag these codes for prior auth initiation.
03Inform all providers that claims for these codes submitted without prior authorization will be denied.
04Contact CareSource Provider Services at 1-855-202-1058 (Mon-Fri, 7 a.m.-7 p.m. ET) with any implementation questions.
Codes mentioned
33542622648117381234812398125281254813838143481503815298411286225862358780188120881218831388368A2036A2037A2038A2039A4288E0658E0659L1007L5657L6034L6035L6036L6038L6039Q4383Q4384Q4385Q4386Q4387Q4388Q4389Q4390Q4391Q4392Q4393Q4394Q4395Q4396Q43976445164625994689947199472A9300E0555E0585E0672E0710E0764E0779E2218K0065Q9991S8096S812099417157713820715772C7568C7569C7570C75717047370472
Original notice
[Georgia] Prior Authorization Requirement Update
caresource.com · Always check the source before changing claims.
Related changes
See all CareSource changes →[Ohio] Prior Authorization Requirement UpdateMediumEffective May 4, 2026 · Provider Bulletin[Georgia] Prior Authorization Requirement UpdateHighEffective Aug 1, 2026 · Provider Bulletin[Georgia] Prior Authorization Requirement UpdateHighEffective Jul 10, 2025 · Provider Bulletin[Georgia] Prior Authorization Requirement UpdateMediumNo effective date · Provider BulletinBrowse every CareSource change in the policy list
Related policy hubs
CareSource policiesGA policy changesGeneticsPathologyCardiothoracic SurgeryPain ManagementCritical CareDermatologyRadiologyGeneral SurgeryPlastic SurgeryCode 33542Code 62264Code 81173Code 81234Code 81239Code 81252Code 81254Code 81383Code 81434Code 81503Code 81529Code 84112Code 86225Code 86235Code 87801Code 88120Code 88121Code 88313Code 88368Code A2036Code A2037Code A2038Code A2039Code A4288Code E0658Code E0659Code L1007Code L5657Code L6034Code L6035Code L6036Code L6038Code L6039Code Q4383Code Q4384Code Q4385Code Q4386Code Q4387Code Q4388Code Q4389Code Q4390Code Q4391Code Q4392Code Q4393Code Q4394Code Q4395Code Q4396Code Q4397Code 64451Code 64625Code 99468Code 99471Code 99472Code A9300Code E0555Code E0585Code E0672Code E0710Code E0764Code E0779Code E2218Code K0065Code Q9991Code S8096Code S8120Code 99417Code 15771Code 38207Code 15772Code C7568Code C7569Code C7570Code C7571Code 70473Code 70472