[Georgia] Clarification on Behavioral Health Outpatient Therapy Codes

By July 10, 2025: Billing team must implement session tracking and prior authorization requirements in billing system for behavioral health therapy codes. (1) Configure system to count combined individual therapy sessions (90837, 90832, 90834) per member per calendar year starting January 1, 2025, and flag when combined total reaches 24; (2) Configure system to count combined family therapy sessions (90846, 90847) per member per calendar year and flag when combined total reaches 24; (3) For any sessions 24+ with date of service July 10, 2025 or later, require prior authorization submission before claim processing; (4) For DBHDD providers, ensure family therapy is counted by session (not unit); (5) Update claim denial protocols to reject claims for sessions 24+ without prior authorization documentation; (6) Train billing staff to obtain prior authorization before scheduling or billing therapy session 25 and beyond; (7) Notify providers to request prior authorization when session 24 is reached. Failure to obtain prior authorization will result in claim denials.