MedicaidReimbursementMedium impact
[Georgia] May 2026 Reimbursement Policy Updates
CareSource·GA · Psychiatry, Family Medicine, Internal Medicine +1 more·Claims & Billing
Effective date
Jul 1, 2026
We identified it
May 9, 2026
Summary
CareSource Georgia Medicaid is releasing two reimbursement policy updates effective July 1, 2026: a NEW policy on Evaluation and Management (E/M) and Psychotherapy (PY-1767) and a REVISED policy on Evaluation and Management Services and Urinalysis (PY-1605). The billing team must review the full policy text to understand specific code changes, reimbursement adjustments, or documentation requirements that may affect claim submission and payment.
Action Required
Before July 1, 2026: Billing team must access the full policy documents for PY-1767 (NEW) and PY-1605 (REVISION) via CareSource.com > Providers > Tools & Resources > Provider Policies, select Georgia Medicaid. Review both policies to identify specific CPT codes affected, any prior authorization requirements, documentation changes, or fee schedule updates. Update billing software, encounter forms, and provider education materials accordingly. Claims submitted after July 1, 2026 must comply with the updated policies to avoid denials. Flag the previous version of PY-1605 as archived and ensure staff no longer reference outdated guidance.