CPT codes are copyright 1995-2022American Medical Association. \ w|p&buSa!HTNH8zEl&~taFZ>qy|Zu_i-gF7*K_xhM |ykr\5fOy6wAT)+EhK4 9IOfUFJ?!A9Hkz Gv&v>QeIY1.?yL.Tv?{!% Before sharing sensitive or personal information, make sure youre on an official state website. Background Speech language pathology services include the diagnosis and treatment of speech and language disorders. NC Medicaid Contact Center Enrollment Forms Please enable Cookies and reload the page. Wellcare uses cookies. 5vo{mn{4ym+Bn!=X\ + L|_%IhX%6]]J+cma7|Wcg((?&wzsC5Q{1;PU8?|_v?W?Zb q Georgia Medicaid offers benefits on a Fee-for-Service (FFS) basis or through managed care plans. These reimbursement policies apply to our Georgia Medicaid plans. hbbd```b`` The Reimbursement Rates Sheets for FYE June 30, 2021, are located below. Provider Fee Payment | Georgia Department of Community Health If you are at an office or shared network, you can ask the network administrator to run a scan across the network looking for misconfigured or infected devices. Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. Division of Health Benefits. 1 0 obj According to Georgia Medicaid guidelines, the children's intervention services reported with certain modifiers are limited to the assigned units for that modifier or modifier combination that are included in the Policies and Procedures Manual for Children's Intervention Services. Georgia Medicaid offers benefits on a Fee-for-Service (FFS) basis or through managed care plans. Call Us. WellCare Health Plans is committed to continuously improving its claims review and payment processes. They include, but are not limited to claims processing guidelines referenced by the Centers for Medicare and Medicaid Services (CMS), Publication 100-04, Claims Processing Manual for physicians/non-physician practitioners, the CMS National Correct Coding Initiative policy manual (procedure-to-procedure coding combination edits and medically unlikely edits), Current Procedural Technology guidance published by the American Medical Association (AMA) for reporting medical procedures and services, health plan clinical policies based on the appropriateness of health care and medical necessity, and at times state-specific claims reimbursement guidance. aJY $,0V #hE2!FF!&`B+4fC&%@ c cTh 0 Additionally, monaural hearing aids, when billed, must be reported with modifier RT or LT and are limited to one unit per side in a three-year period. Orthotic and Prosthetic Fee Schedule - PDF. Under managed care, Georgia pays a fee to a managed care plan for each person enrolled in the plan. Georgia Medicaid Coverage of Therapy Services. 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). Guidance on therapy services covered through Georgia Medicaid and other important compliance issues such as enrollment, billing, audits, and managed care. States have great flexibility in how Medicaid payments are made to . 558.5. Toll Free: (877) 423-4746.