[Georgia] June 2026 Provider Newsletter

By June 1, 2026: Billing team and clinical staff must review and implement clinical criteria updates for Medicare Advantage plans. By July 1, 2026: Prior authorization/precertification requirements change for parenteral nutrition codes—billing team must update system rules and encounter forms to require prior auth for affected parenteral nutrition HCPCS codes. By July 17, 2026: Billing team must audit all professional claims to ensure billed charges and units match actual services rendered; implement verification step in billing workflow to prevent claim denials. By September 1, 2026: Implement additional precertification/prior authorization requirement changes as specified in detailed policy documentation. Reference the full policy documents linked in the newsletter for specific code lists and clinical criteria. Failure to obtain required prior authorization will result in claim denials.