Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. These reimbursement policies apply to our Georgia Medicaid plans. Clinical Payment Policy | Georgia Medicaid | Peach State Health Plan 4a, Col 004, lines 002,005,006,008,009,015: 37) After dialing 1-800-273-TALK (1-800-273-8255), the caller is routed to their nearest crisis center to receive immediate counseling and local mental health referrals. 471 0 obj <>/Filter/FlateDecode/ID[<467E25C1DCB7FA4CA9B5341409AF092E>]/Index[455 37]/Info 454 0 R/Length 91/Prev 216195/Root 456 0 R/Size 492/Type/XRef/W[1 3 1]>>stream The Department also received approval for quality incentives related to the Joint Commission and American Health Care Association (AHCA) Accreditation effective August 14, 2020. Please locate the pdf file where the Provider's Name would fall. They are used to help identify whether health care services are correctly coded for reimbursement. According to Georgia Medicaid guidelines, enteral nutrition supplies and equipment must be reported with the purchase modifier NU (New equipment). According to Georgia Medicaid guidelines, a brief emotional/behavioral assessment performed during a non-periodic screening visit for a patient less than 21 years of age must be reported with modifier EP (EPSDT program) and billed in Place of Service 99 (Other). Download the free version of Adobe Reader. Please enable it in order to use the full functionality of our website. These proprietary policies are not a guarantee of payment. 1 0 obj This area of the Billing and Reimbursement site provides information on the major aspects of Medicaid related to audiology and speech-language pathology services, including audiology and speech-language pathology requirements and information for school based professionals. American Speech-Language-Hearing Association, Medicaid Toolkit: What Audiologists Need to Know, Federal Public Health Emergency Updates for 2022, Certain Health Care Providers May Be Subject to New COVID Vaccination Requirements, Reimbursement of Telepractice Services: Considerations for Audiologists and SLPs, ASHA's Coding, Reimbursement,& Advocacy Modules, State Children's Health Insurance Program, ASHA Reimbursement Products & Web Seminars, Health Insurance Portability & Accountability Act (HIPAA), Interprofessional Education / Interprofessional Practice, State Advocates for Reimbursement (STARs) Network (one of the. Georgia Medicaid offers benefits on a Fee-for-Service (FFS) basis or through managed care plans. <> Speech Therapy and Language Disorder Rehabilitation GEORGIA MEDICAID MM-0714 Effective Date: 10/01/2020 Outpatient Speech Therapy and Language Disorder Rehabilitation B. As Georgias Behavioral Health Authority, DBHDD provides services through a network of community providers. InterQual is a nationally recognized evidence-based decision support tool. CPT codes are copyright 1995-2022American Medical Association. aJY $,0V #hE2!FF!&`B+4fC&%@ c cTh State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. Certified Home Health Agency Rates Revised SFY 2023 Hospital Provider Fee Payment Schedule - Updated 11/15/22. Clinical policies are one set of guidelines used to assist in administering health plan benefits, either by prior authorization or payment rules. PDF 74.88 KB - January 05, 2022 Division/Office. <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> 3a, Col 003, line 019: 36) Capital Related - Buildings & Fixtures (All Agencies Statewide) Sch. The Reimbursement Rates Sheets for FYE June 30, 2021, are located below. Before sharing sensitive or personal information, make sure youre on an official state website. The Department of Community Health (DCH) administers Medicaid reimbursement and associated policy for mental health treatment and services through partnership with The Department of Behavioral Health and Developmental Disabilities (DBHDD). Therefore, when crisis intervention services are billed with modifier U1, U2, U3, U4 or U5 and modifier U6, U7 or GT are not also appended, the crisis intervention services (H2011) will be recommended for denial. Monday to Friday, 08:00 a.m. - 05:00 p.m. All in Eastern Time Zone. Under the FFS model, Georgia pays providers directly for each covered service received by a Medicaid beneficiary. Please note that the reimbursement rate sheets (R-32) are in alphabetical order. Therapy Comply does not claim copyright over US Federal and State materials. Peach State Health Plan utilizes InterQualcriteria for those medical technologies, procedures or pharmaceutical treatments for which a Peach State Health Planclinical policy does not exist. 04/01/2023. These services are provided by speech-language-pathologists Hand pulling book from library archive shelf. The goals of this endeavor will be implemented. An official website of the State of Georgia. %PDF-1.7 % doctor, request an ID Card and more. Background Speech language pathology services include the diagnosis and treatment of speech and language disorders. Resources for Audiologists Medicaid Toolkit: What Audiologists Need to Know Community providers of behavioral health services can be accessed by contacting The Georgia Crisis and Access Line (GCAL) at 800-715-4225 or via the web by visiting www.mygcal.com . All policies found in the Peach State Health Plan Clinical Policy Manual apply to Peach State Health Plan members. Behavioral Health Services | Georgia Medicaid % Therefore, enteral nutrition supplies are recommended for denial when billed without modifier NU. Physical, Occupational, and Speech Therapy Services (PDF) CP.MP.49: June 30, 2021: . The three segments identify the labeler, the product, and the commercial package size. hbbd```b`` Members also have access to compliance and billing support. Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. Community providers of behavioral health services can be accessed by contacting The Georgia Crisis and Access Line (GCAL) at 800-715-4225 or via the web by visiting www.mygcal.com. How you know. Open the pdf and scroll down to the Provider R-32 you need and print. Use the portal to pay your premium, 455 0 obj <> endobj c. In turn, the plan pays providers for all of the Medicaid services a beneficiary may require that are included in the plans contract with the state.
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