MedicaidCoverageMedium impact
[Georgia] Policy Update March 2025
CareSource·GA · Psychiatry, Pediatrics·Medical Policy
Effective date
May 10, 2025
We identified it
May 9, 2026
Summary
CareSource Georgia Medicaid is updating its policy on Applied Behavior Analysis (ABA) for Autism Spectrum Disorder (Policy MM-0212), effective May 10, 2025. This is a standard monthly policy notification; the specific clinical or billing changes within the policy are not detailed in this cover document and require review of the full policy PDF to determine impact on billing workflows.
Action Required
By May 1, 2025: Billing team must access and review the full ABA for Autism Spectrum Disorder policy (MM-0212) at the CareSource provider portal (CareSource.com > Providers > Tools & Resources > Provider Policies) and compare against the prior version (GA-MED-P-3697712). Identify any changes to covered codes, prior authorization requirements, medical necessity documentation, or billing guidelines. Update billing software, encounter templates, and provider alerts accordingly before the May 10, 2025 effective date. Communicate any changes to clinical staff who order or document ABA services. Failure to implement required changes by the effective date may result in claim denials.