MedicaidCoverageMedium impact
[Georgia] Policy Updates January 2025
CareSource·GA · Plastic Surgery·Medical Policy
Effective date
Mar 1, 2025
We identified it
May 9, 2026
Summary
CareSource Georgia Medicaid is revising the Breast Reconstruction Surgery policy (MM-0732) effective March 1, 2025. The document provides notice of this policy update but does not specify the actual content changes. Billing teams must obtain and review the full revised policy to understand any new requirements for prior authorization, documentation, or coverage criteria.
Action Required
By February 28, 2025: Billing team and providers must access the full Breast Reconstruction Surgery policy (MM-0732, GA-MED-P-3382361) from CareSource.com > Providers > Tools & Resources > Provider Policies to review the specific revisions. Determine if prior authorization requirements, documentation standards, or covered procedure codes have changed. Update billing software, encounter forms, and provider workflows accordingly. Verify whether prior authorization is required for breast reconstruction claims under the new policy. Failure to comply with updated requirements may result in claim denials or payment delays for Georgia Medicaid members.