Clinical policies are one set of guidelines used to assist in administering health plan benefits, either by prior authorization or payment rules. The CMOs authorize and reimburse services through provider networks found here: Amerigroup: https://www.myamerigroup.com/ga/georgia-home.html, Wellcare: https://www.wellcare.com/Georgia, Peach State: https://www.pshpgeorgia.com/, Care Source: https://www.caresource.com/ga/, The National Suicide Prevention Lifeline is a United States-based suicide prevention network of 161 crisis centers that provides a 24/7, toll-free hotline available to anyone in suicidal crisis or emotional distress. <> Please note that the reimbursement rate sheets (R-32) are in alphabetical order. The analysis of any legal or medical billing is dependent on numerous specific facts including the factual situations present related to the patients, the practice, the professionals and the medical services and advice. Press Enter or Space to expand a menu item, and Tab to navigate through the items. If you are on a personal connection, like at home, you can run an anti-virus scan on your device to make sure it is not infected with malware. Before sharing sensitive or personal information, make sure youre on an official state website. Clinical Payment Policy | Georgia Medicaid | Peach State Health Plan Medicaid reimbursement rates and associated policy of this program are found here: Provider Manuals. FY 2021 revised rates inclusive of 18.37% Growth and Quality Incentive. If the screening is missed, it may be performed during a catch-up visit using modifier EP and HA or UA. Georgia Medicaid Coverage of Therapy Services Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. . Policies in the Peach State Health PlanPayment Policy Manual may have either a Peach State Health Planor a Centene heading. Speech Therapy and Language Disorder Rehabilitation GEORGIA MEDICAID MM-0714 Effective Date: 10/01/2020 Outpatient Speech Therapy and Language Disorder Rehabilitation B. 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. How you know. They are routinely updated to promote accurate coding and policy clarification. 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 All policies found in the Peach State Health PlanPayment Policy Manual apply with respect to Peach State Health Planmembers. x[o9?@Z&s8,fvIyPl-y$Eo*^F%-jcuS\EF?D?x*W1%Q~S{O_y"xWE}z>FwRWR,~\^/>-/RO}WJ:}Vw^FQ+(lvP,Y6G}YQ^b|8>bw%[ggQ-.qh OHay_ R,~p]/z-,/z. E\Y?>Jvubzu{D|q,[-n;+wc`l^/[tzEO~yQ-B~nv{ Bxx:#(T~e ZZ. Find clinical tools and information about working with CareSource. Hand pulling book from library archive shelf. Other policies (e.g., clinical policies) or contract terms may further determine whether a technology, procedure or treatment that is not addressed in the Payment Policy Manual is payable by Peach State Health Plan.
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