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CareSourceMedicaid · Prior Auth · Provider Bulletin · GA · Wound Care, PM&R (Physical Medicine & Rehab), OrthopedicsHigh impact

[Georgia] Prior Authorization Requirement Update

Act
by Dec 31, 2025
Effective date
Jan 1, 2026
Identified
Jun 13, 2026

Summary

CareSource Georgia Medicaid is adding prior authorization requirements for 118 specific billing codes effective January 1, 2026. These codes span multiple categories including laboratory tests, wound care supplies, durable medical equipment, prosthetics/orthotics, and skin substitutes.

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What to do

by Dec 31, 2025 · 4 steps
01Billing team must update authorization tracking system to require prior authorization for all 118 listed codes when billing CareSource Georgia Medicaid.
02Update encounter forms and EMR templates to alert providers that these codes require prior auth.
03Contact CareSource at 1-800-202-1058 for authorization requests.
04Claims submitted without prior authorization will be denied.

Codes mentioned

A2030A2031A2032A2033A2034A2035A6515A6516A6517A6518A6519A6611C8005E0201E1022E1023E1032E1033E1034E1832L0720L1933L1952L5827L6028L6029L6030L6031L6032L6033L6037L6700L7406Q4354Q4355Q4356Q4357Q4358Q4359Q4360Q4361Q4362Q4363Q4364Q4365Q4366Q4367S4024Q4368Q4369Q4370Q4371Q4372Q4373Q4375Q4376Q4377Q4378Q4379Q4380Q4381Q4382

Original notice

[Georgia] Prior Authorization Requirement Update
caresource.com · Always check the source before changing claims.
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Related changes

See all CareSource changes →
[Ohio] Prior Authorization Requirement UpdateHighEffective Jan 1, 2026 · Provider Bulletin[Georgia] Prior Authorization Requirement UpdateHighEffective Jan 1, 2026 · Provider Bulletin[Georgia] Prior Authorization Requirement UpdateHighEffective Aug 1, 2026 · Provider Bulletin[Georgia] Prior Authorization Requirement UpdateHighEffective Jul 10, 2025 · Provider BulletinBrowse every CareSource change in the policy list

Related policy hubs

CareSource policiesGA policy changesWound CarePM&R (Physical Medicine & Rehab)OrthopedicsCode A2030Code A2031Code A2032Code A2033Code A2034Code A2035Code A6515Code A6516Code A6517Code A6518Code A6519Code A6611Code C8005Code E0201Code E1022Code E1023Code E1032Code E1033Code E1034Code E1832Code L0720Code L1933Code L1952Code L5827Code L6028Code L6029Code L6030Code L6031Code L6032Code L6033Code L6037Code L6700Code L7406Code Q4354Code Q4355Code Q4356Code Q4357Code Q4358Code Q4359Code Q4360Code Q4361Code Q4362Code Q4363Code Q4364Code Q4365Code Q4366Code Q4367Code S4024Code Q4368Code Q4369Code Q4370Code Q4371Code Q4372Code Q4373Code Q4375Code Q4376Code Q4377Code Q4378Code Q4379Code Q4380Code Q4381Code Q4382

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