Georgia

Last updated 04/29/2025

Consent Requirements

The referring health care practitioner must obtain written consent from the eligible Georgia Medicaid member prior to rendering service. The consent must state that the member agrees to participate in the telehealth-based service. Copies of this form (refer to Appendix A) should be in the medical record of both the originating and distant site providers. The consent form must include a description of the risks, benefits and consequences of telehealth and be included in the member’s medical record. Providers may utilize a consent form other than the one attached to this guide; however, it must, at a minimum, contain the same requirements, standards and information listed on the member consent form in Appendix A.

If the member is a minor child, a parent/guardian must present the child for telehealth services and sign the consent form unless otherwise exempted by state or federal law. The parent/guardian need not attend the telehealth session unless attendance is therapeutically appropriate.

There will be no dissemination of any member images or information to other entities without written consent from the member.

For CBHRS, the Telehealth Member Consent Form for each member is outlined in the Telehealth Guidance Document and must be utilized.Special considerations in the use of electronic-facilitated treatment must include informed consent of the individual served, authorization through the process of Individualized Recovery Plans, educational components in assessment and service delivery which indicates ongoing agreement with the treatment method and under what circumstances electronic communications may and may not be used.

Prior to an initial telehealth service, the practitioner who delivers the service to a GA Medicaid Member shall ensure that the telehealth member consent form is provided to the member and signed.  See manual for specific requirements.

In school-based settings, the parent or legal guardian of the client provides consent prior to the service being provided.

SOURCE: GA Dept. of Community Health GA Medicaid Telehealth Guidance Handbook, p. 6, 8-9, 15, 22 & 26 (Apr. 1, 2025).  GA Dept. of Community Health, GA Medicaid Community Behavioral Health and Rehabilitation Services, p. 42 (Apr. 1, 2025).  (Accessed Apr 2025).

Prior to an initial telehealth service, the rendering provider must obtain a signed consent form from the GA Medicaid Member.

The member must be aware of their otpions to refuse the telehealth service at any time without affecting the right to future care or treatment and without risking the loss of covered Medicaid services.

SOURCE:  GA Medicaid Telemedicine Guidance Presentation (Dec. 18, 2024).  (Accessed Apr. 2025).

Comprehensive Supports Waiver Program (COMP) & New Options Waiver Program

Adult Occupational Therapists, Adult Physical Therapists, Speech and Language Therapists, Adult Nutrition providers, Behavior Support Service providers and Supported Employment providers wishing to use telehealth modalities to deliver evaluation or treatment services must obtain valid signed consent from the individual or the legal decision-maker.

SOURCE: GA Dept of Community Health, Division of Medicaid, New Options Waiver Program, (Apr. 1, 2025). (Accessed Apr. 2025).

Last updated 04/24/2025

Definitions

Telehealth is the use of medical information exchange from one site to another via electronic communications to improve a patient’s health status.

Telehealth is the use of two-way, real-time intereactive communication equipment to exchange the patient’s information from one site to another via an eelctronic communication system.

(CCHP NOTE: We believe the previous sentence contains a typo and that the first use of the term “telehealth” was meant to be “telemedicine”.)

SOURCE: GA Dept of Community Health, Telemedicine Guidance Presentation (December 18, 2024). (Accessed Apr. 2025).

Telemedicine is the use of medical information exchange from one site to another via electronic communications to improve patient’s health status. It is the use of two-way, real time interactive communication equipment to exchange the patient information from one site to another via an electronic communication system. This includes audio and video communications equipment.

Closely associated with telemedicine is the term “telehealth,” which is often used to encompass a broader definition of remote healthcare that does not always involve clinical services. Telehealth is the use of telecommunication technologies for clinical care (telemedicine), patient teachings and home health, health professional education (distance learning), administrative and program planning, and other diverse aspects of a health care delivery system.

SOURCE: GA Dept. of Community Health, Physician Services Manual, p. 148 (Apr. 1, 2025). (Accessed Apr. 2025).

Telehealth is the use of medical information exchange from one site to another via electronic communications to improve patient’s health status. It is the use of two-way, real time interactive communication equipment to exchange the patient information from one site to another via an electronic communication system. This includes audio and video communications equipment. Closely associated with telehealth is the term “telehealth,” which is often used to encompass a broader definition of remote healthcare that does not always involve clinical services. (CCHP NOTE: We believe the previous sentence contains a typo and that the first use of the term “telehealth” was meant to be “telemedicine”.) Telehealth is the use of telecommunications technologies for clinical care (telehealth), patient teachings and home health, health professional education (distance learning), administrative and program planning, and other diverse aspects of a health care delivery system.

Telehealth is a broad definition of remote healthcare that does not always involve clinical services. Telehealth can be used in telecommunications technologies for patient education, home health, professional health education and training, administrative and program planning, and other diverse aspects of a health care delivery system.

Telehealth involves the use of two-way, real time interactive communication equipment to exchange medical/clinical information between a healthcare practitioner and the member from one site to another via a secure electronic communication system. This includes audio and video communications equipment designed to facilitate delivery of healthcare services in a face-to-face interactive, though distant, engagement.

TeleMental Health is a term defined by Ga. Comp. R. & Regs. R. 135-11-01. and is applicable only to Licensed Social Workers, Professional Counselors and Marriage & Family Therapists when either 1) practicing telehealth as defined above, or 2) providing telephonic intervention when allowable via DCH/DBHDD guidelines). Per this rule and regulation, there are specific practice guidelines and mandatory training pertaining to what is identified as TeleMental Health. Providers shall adhere to these rules and regulations when TeleMental Health is provided by one of these named practitioners.

SOURCE: GA Dept. of Community Health, GA Medicaid Telehealth Guidance Handbook, p. 5, 6, 8, (April 1, 2025). (Accessed Apr. 2025).

Telehealth is a broad definition of remote healthcare that does not always involve clinical services. Telehealth can be used in telecommunications technologies for patient education, home health, professional health education and training, administrative and program planning, and other diverse aspects of a health care delivery system.

Tele-Mental Health is utilized for licensed practitioners under the guidance of the Georgia Secretary of State’s office (Social Workers, Professional Counselors and Marriage & Family Therapists), there are specific practice guidelines and mandatory training pertaining to what is identified as Tele-Mental Health. Providers are encouraged to ensure these guidelines are followed for all members receiving services provided by licensed practitioners impacted by the Georgia Secretary of State’s office.

SOURCE:  GA Community Behavioral Health Rehabilitation Services Manual p. 41 (Apr. 1, 2025) (Accessed Apr. 2025).

Telemedicine is the use of medical information exchanged from one secured site to another via electronic communications to improve a patient’s health. Electronic communication means the use of interactive telecommunications equipment that includes, at a minimum, audio and video equipment permitting two-way, real time interactive communication between the patient, and the physician or practitioner at the distant site (defined in the DBHDD Behavioral Health Provider Manual, Glossary).

SOURCE: GA Department of Behavioral Health & Developmental Disabilities, Provider Manual for Community Behavioral Health Providers (Apr.  1, 2025), p. 391 (Accessed Apr 2025).

Last updated 04/26/2025

Email, Phone & Fax

Non-covered Services Modalities

• Telephone conversations.
• Electronic mail messages.
• Facsimile.
• Video cell phone interactions.
•  The cost of telehealth equipment and transmission.
• Failed or unsuccessful transmissions.
• Services rendered via a webcam or internet-based technologies (i.e., Skype, Tango, etc.) that are not part of a secured network and do not meet HIPAA encryption compliance.

SOURCE: GA Dept. of Community Health, GA Medicaid Telemedicine Guidance Handbook, p. 9-10 (Apr. 1, 2025). (Accessed Apr. 2025).

Don’ts When Conducting a Telehealth Visits

• Telephone Conversations
• E-mail
• Video cell phone interactions
• Services rendered via a webcam or internet-based technologies (i.e., Skype, Tango, etc.) that are not part of a secured netework and do not meet HIPAA encryption compliance.

SOURCE: GA Medicaid: Telemedicine Guidance Presentation (December 18, 2024). (Accessed Apr. 2025).

Behavioral Health Clinical Consultation

Interprofessional telephone consultation and certain other services are covered, see manual.

SOURCE: FY 24 – Quarter 2 Provider Manual for Community Behavioral Health Providers, p. 22 & 130. (Apr. 1, 2025), (Accessed Apr. 2025).

Traditional/Enhanced Elderly and Disabled Waiver (EDWP) Traditional/Enhanced Case Management

Some case management and screening services may be provided telephonically.

SOURCE: GA Department of Community Health, Division of Medicaid, Policies and Procedures for Elderly and Disabled Waiver EDWP – (CCSP) Traditional/Enhanced Case Management, p. 42. (Apr. 1, 2025).  (Accessed Apr. 2025).

Federally Qualified Health Centers

Except for services that meet the criteria for a TCM visit, telephone or electronic communication between a physician and a patient, or between a physician and someone on behalf of a patient, are considered physicians’ services and are included in an otherwise billable visit. They do not constitute a separately billable visit.

Telephone or electronic communication between a CP or CSW and a patient, or between such practitioner and someone on behalf of a patient, are considered CP or CSW services and are included in an otherwise billable visit

SOURCE: GA Department of Community Health, Division of Medicaid, Federally Qualified Health Centers Services and Rural Health Clinic Services, p. 21, 25 (Apr. 1, 2025). (Accessed Apr. 2025).

Community Behavioral Health and Rehabilitation Services

While some CBHRS services allow telephonic interactions, telephonic interventions do not qualify as telemedicine.

SOURCE: GA Department of Community Health, Division of Medicaid, Community Behavioral Health and Rehabilitation Services, p.  41  (Apr. 1, 2025).  (Accessed Apr. 2025).

Comprehensive Supports Waiver Program

Telephone calls and store and forward (asynchronous) modalities are not allowed for billable therapy evaluation and services.

SOURCE: GA Dept. of Community Health, Division of Medicaid, Comprehensive Supports Waiver Program Chapters 1300-3700. p. 18 (Apr. 1, 2025).  (Accessed Apr. 2025).

Psychology and Therapy Services

Non-covered services include telephone referrals and consultations.

SOURCE: GA Dept. of Community Health, Division of Medicaid, Psychology and Therapy Services, p. 10. (Apr. 1, 2025).  (Accessed Apr. 2025).

New Options Waiver

Therapists are expected to use synchronous audio/video technology for telehealth sessions. Telephone calls and store and forward (asynchronous) modalities are not allowed for billable therapy evaluation and services.

Behavior Support Service Professionals must use two-way, real time [synchronous] interactive communication to exchange clinical/behavioral information with the individual, staff, or family from one site to another via a secure electronic communication system. Providers should have an action plan should technology fail. Telephone calls and store and forward (asynchronous) modalities are not allowed for billable behavior support services. The transmission of the individual’s behavioral or medical information from an originating site to the behavior support service provider at a distant site without the presence of the individual is not allowed for billable behavior support services.

SOURCE: GA Dept. of Community Health, New Options Waiver Program, p. 16, 22, 28, 38 (Apr. 1, 2025).  (Accessed Apr. 2025).

Last updated 04/25/2025

Live Video

POLICY

The use of a telecommunications system may substitute for an in-person encounter for professional office visits, pharmacologic management, limited office psychiatric services, limited radiological services and a limited number of other physician fee schedule services. See the telehealth guidelines for program specific policies.

SOURCE: GA Dept. of Community Health, Physician Services Manual, p. 148 (Apr. 1, 2025). (Accessed Apr. 2025).

Medicaid covered services are provided via telehealth for eligible members when the service is medically necessary, the procedure is individualized, specific, and consistent with symptoms or confirmed diagnosis of an illness or injury under treatment, and not in excess of the member’s needs.

SOURCE: GA Dept. of Community Health, GA Medicaid Telehealth Guidance Handbook, p. 5 (Apr. 1, 2025). GA Dept of Community Health, GA Medicaid Telemedicine Guidance Presentation (December 18, 2024). (Accessed Apr. 2025).

ELIGIBLE SERVICES/SPECIALTIES

An interactive telecommunications system is required as a condition of payment. The originating site’s system, at a minimum, must have the capability of allowing the distant site provider to visually examine the patient’s entire body including body orifices (such as ear canals, nose and throat). The distant site provider should also have the capability to hear heart tones and lung sounds clearly (using a stethoscope) if medically necessary and currently within the provider’s scope of practice. The telecommunication system must be secure and adequate to protect the confidentiality and integrity of the information transmitted.

SOURCE: GA Dept. of Community Health, Physician Services Manual, p. 148 (Apr. 1, 2025). GA Dept. of Community Health, GA Medicaid Telehealth Guidance Handbook, p. 5 (Apr. 1, 2025).(Accessed Apr. 2025).

Claims for telehealth services must use the appropriate CPT or HCPCS code for the professional service. The GT modifier is required as applicable, and/or the use of either POS 02 or POS 10. POS 02 will indicate Telehealth services that were utilized at a location other than at the patient’s home. The GQ modifier is still required as applicable. By coding and billing with the covered telehealth procedure code, providers are certifying that the member was present at an eligible originating site when you furnished the telehealth service. Telehealth services provided by the Distant Site providers must also bill with the appropriate CPT and/or HCPS code with the POS code 02 for timely payment. POS 10 will indicate Telehealth services were provided in the patient’s home. CPT modifier ‘‘93’’ can be appended to claim lines, as appropriate, for services furnished using audio only communications technology. Interactive audio and video telecommunications must be used, permitting real time communications between the distant site provider or practitioner and the member.

SOURCE: GA Dept. of Community Health, GA Medicaid Telehealth Guidance Handbook, p. 7-8, 9 (Apr. 1, 2025). (Accessed Apr. 2025).

Telehealth is not a separate medical specialty. Products and services related to telehealth are often part of a larger investment by health care institutions in either information technology or the delivery of clinical care. When an enrolled provider determines that medical care can be provided via electronic communication with no loss in the quality or efficacy of the member’s care, telehealth services can be performed.

Medicaid covered services are provided via telehealth for eligible members when the service is medically necessary, the procedure is individualized, specific, and consistent with symptoms or confirmed diagnosis of an illness or injury under treatment, and not in excess of the member’s needs

An interactive telecommunications system is required as a condition of payment. The originating site’s system, at a minimum, must have the capability of allowing the distant site provider to visually examine the patient’s entire body including body orifices (such as ear canals, nose, and throat). Depending upon an enrolled provider’s specialty and scope of practice, the distant provider should also have the capability to hear heart tones and lung sounds clearly (using stethoscope) if medically necessary and currently within the provider’s scope of practice. The telecommunication system must be secure and adequate to protect the confidentiality and integrity of the information transmitted.

Providers may not bill for services or charge a fee for missed appointments. Cost associated with the
use of technology or data transmission are not covered under Medicaid and cannot be charged to the
member.

See telehealth manual for list of eligible telehealth services and codes for specific programs.

Non-Covered Service Modalities:

1. Telephone conversations.
2. Electronic mail messages.
3. Facsimile.
4. Services rendered via a webcam or internet-based technologies (i.e., Skype, Tango, etc.) that are not part of a secured network and do not meet HIPAA encryption compliance.
5. Video cell phone interactions.
6. The cost of telehealth equipment and transmission.
7. Failed or unsuccessful transmissions.

SOURCE: GA Dept. of Community Health, GA Medicaid Telehealth Guidance, p. 5, 9-10  (Apr. 1, 2025). (Accessed Apr. 2025).

Covered Services:

• Autism
• Dental
• Dialysis
• Nursing Facility Specialized Services
• Community Behavior Health Rehab Services
• E/M
• Healthcheck
• CIS/CISS

See presentation slide deck for specific CPT codes.

SOURCE: GA Dept. of Community Health, GA Medicaid: Telemedicine Guidance Presentation (December 18, 2024). (Accessed Apr. 2025).

Nursing Facilities 

Though not available in all areas of the State, Medicare-funded mental health services are currently provided to nursing home residents via telehealth (telemedicine), face-to-face visits by providers in the nursing home, and nursing home resident visits to psychiatric/mental health clinics/offices for those individuals able to travel outside the nursing facility. See manual for codes.

Those residents whose interest is best served by receiving mental health services in the nursing
facility or in a nearby telemedicine site can receive services in either of those locations, with the
practitioner using out-of-clinic or telemedicine procedure codes.

SOURCE: GA Dept. of Community Health, GA Medicaid Telehealth Guidance Handbook, p. 20 (Apr. 1, 2025) & GA Dept. of Community Health, Division of Medical Assistance, Part II Policies and Procedures for Nursing Facility Services, p. 150, 155 (Apr. 1, 2025). (Accessed Apr. 2025).

Teledentistry

Teledentistry is a combination of telecommunications and dentistry involving the exchange of clinical information and images over remote distances for dental consultation and treatment planning. The State allows for these services within the current Part II Policies and Procedures Manual for Dental Services.

See dental services manual for teledentistry codes.

SOURCE: GA Dept. of Community Health, Division of Medical Assistance, Part II Policies and Procedures for Dental Services, p. 61-62 (Apr. 2025). GA Dept. of Community Health, GA Medicaid Telehealth Guidance Handbook, p. 16-17 (Apr. 1, 2025). (Accessed Apr. 2025).

GT modifier to be used in conjunction with the appropriate codes for Telemedicine following full
implementation of HIPAA compliance (see “Telemedicine Consultations.”).

SOURCE: GA Dept. of Community Health, Division of Medical Assistance, Part II: Policies and Procedures: Oral Maxillofacial Surgery Services (Apr. 1, 2025), p. 34.  (Accessed Apr. 2025).

Autism Spectrum Disorder Services

Practitioners of Autism Spectrum Disorder (ASD) services can use telehealth to assess, diagnose and provide therapies to patients. Prior authorization is required for all Medicaid-covered adaptive behavior services, behavioral assessment and treatment services (not telehealth specific). See manual for eligible codes.

SOURCE: GA Dept. of Community Health, GA Medicaid Telehealth Guidance Handbook, p. 12-13 (Apr. 1, 2025). (Accessed Apr. 2025).

Community Behavioral Health and Rehabilitation Services (CBHRS)

The Departments of Community Health and Behavioral Health and Developmental Disabilities have authorized telemedicine to be used to provide some services in the CBHRS program.  See Behavioral Health and Development Disabilities manual for more detailed information.

SOURCE: GA Dept. of Community Health, GA Medicaid Telehealth Guidance Handbook, p. 6, 15-16 (Apr. 1, 2025). GA Department of Community Health for CBHRS, p.41 (Apr. 1, 2025). GA Dept. of Behavioral Health & Developmental Disabilties, Provider Manual for Community Behavioral Health Providers (Apr. 1, 2025).  (Accessed Apr. 2025).

Those residents whose interest is best served by receiving mental health services in the nursing facility or in a nearby telemedicine site can receive services in either of those locations, with the practitioner using out-of-clinic or telehealth/telemedicine procedure codes.

SOURCE: GA Dept. of Community Health, Division of Medical Assistance, Part II Policies and Procedures for Community Behavioral Health Rehabilitation Services, p. 26, (Apr. 1, 2025). (Accessed Apr. 2025).

Dialysis Services

The Centers for Medicaid and Medicare Services (CMS) has added Dialysis Services to the list of services that can be provided under Telehealth. The distant site/physician providing the service via a telecommunications
system will bill using Place of Service 02 to indicate Telehealth.See manual for list of eligible CPT codes.

SOURCE: GA Dept. of Community Health, GA Medicaid Telemedicine Guidance Handbook, p. 17 (Apr. 1, 2025). (Accessed Apr. 2025).

School Based Services

Telehealth benefits are allowed if all the following criteria are met:

• The provider is an authorized health-care provider enrolled in Georgia Medicaid
• The client is a child who is receiving the service in a primary or secondary school-based setting
• The parent or legal guardian of the client provides consent before the service is provided.

Speech Language Pathology Services involve the identification of children with speech and/or language disorders, diagnosis and appraisal of specific speech and/or language disorders, referral for medical and other professional attention necessary for the rehabilitation of speech and/or language disorders, provision of speech or language services for the prevention of communicative disorders. The speech language pathologist must bill for time spent in hands on activities or via telehealth services with the student. This includes time spent assisting the student with learning to use adaptive equipment and assistive technology.

See manual for eligible CPT/HCPCS speech, audiology and physical therapy codes.

SOURCE: GA Dept. of Community Health, GA Medicaid Telehealth Guidance Handbook, p. 22-25 (Apr. 1, 2025). (Accessed Apr. 2025).

The rendering provider serving as the telemedicine distant site should report the E/M office visit code (992xx) along with the GT modifier (including any other applicable modifiers), the appropriate POS, and the ICD-10 diagnosis code(s). See manual for more details.

SOURCE: GA Dept. of Community Health, EPSDT Health Check Program , p. 61 (Apr. 1, 2025).  (Accessed Apr. 2025).

Durable Medical Equipment Services

A face-to-face encounter may be made through the use of telehealth technology by reporting the appropriate E&M code.

SOURCE: GA Dept. of Community Health, GA Medicaid Durable Medical Equipment Services Manual, p. 36  (Apr. 1, 2025). (Accessed Apr. 2025).

Elderly and Disabled Waiver EDWP Traditional/Enhanced Case Management

Members must be seen by their PCP annually, either in the office of the PCP or via Telehealth with the SNS provider RN performing the call.

SOURCE: GA Dept of Community Health, Division of Medicaid, Policies and Procedures for Elderly and Disabled Waiver EDWP – (CCSP) Traditional/Enhanced Case Management (Oct. 1, 2024), p. 32.  (Accessed Apr. 2025).

EDWP (CCSP and Source) Skilled Nursing Services by Private Home Care Providers

Registered Nurse Responsibilities include facilitating telehealth visits with the member and the member’s PCP.

SOURCE:  GA Dept of Community Health, Division of Medicaid, Policies and Procedures for EDWP (CCSP and SOURCE): General Services (Apr.1, 2024), p. 211-212; Skilled Nursing Services by Private Home Care Providers (Apr. 1, 2025), p. 7, 9-15.; (Accessed Apr. 2025).

Department of Community Health

The Department of Community Health (DCH) will allow medically necessary services to be rendered via telehealth. Each billed procedure code must be submitted with the usual program modifier(s). Place of service code 02 must be added to the allowed procedure codes to indicate the services are related to telehealth services.

SOURCE: GA Dept of Community Health: Early Intervention Case Management Program, p. 24 (Apr. 1, 2025).  (Accessed Apr. 2025).

Children’s Intervention Services

The Department of Community Health will allow some speech therapy, therapy and audiology services to be rendered via telehealth.  See manual for appropriate codes.

SOURCE: GA Dept. of Community Health, Division of Medicaid, Children’s Intervention Services p. 39 (Apr. 1, 2025), GA Dept. of Community Health Childrens Intervention School Services (Apr. 1, 2025), p. 26, 33-34 (Accessed Apr. 2025).

Comprehensive Supports Waiver Program (COMP)

All components of Adult Occupational Therapy, Adult Physical Therapy, Speech and Language Therapy, Adult Nutrition Services,  Interpreter Services can be safely provided via telehealth modalities according to prevailing best practice standards published by the American Speech and Language Hearing (Occupational or Physical Therapy) Association and in accordance with the Georgia license requirements under O.C.G.A. § 43-44-7. Therapists are expected to use synchronous “in real time” audio/video technology for telehealth sessions. Telephone calls and store and forward (asynchronous) modalities are not allowed for billable therapy evaluation and services.

Payment is not made for feeding and swallowing evaluation and treatment via any telehealth modality. (Adult Speech and Language).

Some components of Behavior Supports Services can be provided via a telehealth modality to supplement in-person service delivery. The following components are the only components that are allowable for a telehealth option:

• Indirect assessment component for functional behavior assessment;
• Follow up or refresher staff training for behavior support plans;
• Additional fidelity monitoring of plan implementation and oversight;
• Distant site observations of the individual for the purposes of consultation, modeling, and recommendations for interventions to staff/caregivers in real time;
• Team meetings for the purpose of gathering feedback related to behavior support plans effectiveness; and
• Review of data analysis summaries and behavior graphing.

See manual for more details.

SOURCE: GA Dept. of Community Health, Comprehensive Supports Waivers Program (COMP) Chapters 1300-3700 (Apr. 1, 2025), GA Dept. of CommunityHealth, New Options Waiver Program (NOW) (Apr. 1, 2025).  (Accessed Apr. 2024).

New Options Waiver

Therapists are expected to use synchronous audio/video technology for telehealth sessions. Telephone calls and store and forward (asynchronous) modalities are not allowed for billable therapy evaluation and services.

Behavior Support Service Professionals must use two-way, real time [synchronous] interactive communication to exchange clinical/behavioral information with the individual, staff, or family from one site to another via a secure electronic communication system. Providers should have an action plan should technology fail. Telephone calls and store and forward (asynchronous) modalities are not allowed for billable behavior support services. The transmission of the individual’s behavioral or medical information from an originating site to the behavior support service provider at a distant site without the presence of the individual is not allowed for billable behavior support services.

SOURCE: GA Dept. of Community Health, New Options Waiver Program, p. 16, 22, 28, 38 (Apr. 1, 2025).  (Accessed Apr. 2025).

When indicated, the health risk screening tool (HRST) and Nursing assessment that inform the initial and annual level of care determination may be completed in person or via a telehealth modality.

SOURCE: GA Dept. of Community Health, Comprehensive Support Waiver Program & New Options Waiver, p. 47 (April 1, 2025).  (Accessed Apr. 2025).

Independent Care Waiver Services

Counseling and Behavioral Management services are available to members needing treatment for personal, social or behavioral disorders to maintain and improve effective functioning. Counseling services can be provided via telehealth with or without a visual component.

SOURCE: GA Dept. of Community Health, Independent Care Waiver Services (Apr. 1, 2025), p. 90 & 95.  (Accessed Apr. 2025).

Tobacco Cessation

Effective, January 1, 2017, the Tobacco Cessation Counseling services codes 99406 and 99407 were updated to include Telehealth Services, billing guidance: POS 02 (telehealth not in patient home) and 10 (telehealth in patient home), modifiers 93 (audio only) and 95 (realtime interactive audio and video), GT (telehealth services) and GQ (telecommunication).

SOURCE: GA Dept. of Community Health, Physician Services Manual, p. 47 (Apr. 1, 2025). (Accessed Apr. 2025).

ELIGIBLE PROVIDERS

The consulting provider must be an enrolled provider in Medicaid in the state of Georgia and must document all findings and recommendations in writing, in the format normally used for recording services in the member’s medical records.  The provider at the distant site must obtain prior approval when services require prior approval.  Both the originating site and distant site must document and maintain the member’s medical records. The report from the distant site provider may be faxed to the originating provider.

SOURCE: GA Dept. of Community Health, GA Medicaid Telehealth Guidance Handbook, p. 8 (Apr. 1, 2025). (Accessed Apr. 2025).

Autism Spectrum Disorder Services

Practitioners of ASD services can use telehealth to assess, diagnose and provide therapies to patients.  Providers must hold either a current and valid license to practice Medicine in Georgia, hold a current and valid license as a Psychologist as required under Georgia Code Chapter 39 as amended, or hold a current and valid Applied Behavior Analysis (ABA) Certification. In addition to licensed Medicaid enrolled Physicians and Psychologists, Georgia Medicaid will enroll Board Certified Behavioral Analysts (BCBAs) as Qualified Health Care Professionals (QHCPs) to provide ASD treatment services. The BCBA must have a graduate-level certification in behavior analysis. Providers who are certified at the BCBA level are independent practitioners who provide behavior-analytic services. In addition, BCBAs supervise the work of Board-Certified Assistant Behavior Analysts (BCaBAs), and Registered Behavior Technicians (RBTs) who implement behavior-analytic interventions.

SOURCE: GA Dept. of Community Health, GA Medicaid Telehealth Guidance Handbook, p. 12 (Apr. 1, 2025). (Accessed Apr. 2025).

Community Behavioral Health and Rehabilitation Services

See manual for eligible practitioner types and levels for CBHRS.

SOURCE: GA Dept. of Community Health, GA Medicaid Telehealth Guidance Handbook, p. 16 (Apr. 1, 2025). (Accessed Apr. 2025).

Teledentistry

Licensed dentists and dental hygienists are eligible providers.

SOURCE: GA Dept. of Community Health, GA Medicaid Telehealth Guidance Handbook, p. 16 (Apr. 1, 2025). (Accessed Apr. 2025).

Federally Qualified Health Center (FQHC)/Rural Health Center (RHC)

FQHCs and RHCs can serve as the originating or distant site. They cannot bill an originating site fee and distant site fee for telehealth services on the same encounter.

SOURCE: GA Dept. of Community Health, GA Medicaid Telehealth Guidance Handbook, p. 17 (Apr. 1, 2025) & GA Dept. of Community Health, Policies and Procedures for Federally Qualified Health Center Services and Rural Health Clinic Services, p. 26, (Apr. 1, 2025). (Accessed Apr. 2025).

Nursing Facility Specialized Services

See manual for eligible providers and levels.

SOURCE: GA Dept. of Community Health, GA Medicaid Telehealth Guidance Handbook, p. 20 (Apr. 1, 2025). (Accessed Apr. 2025).

Advanced Nurse Practitioner & Nurse Midwifery Services

GT modifier must be used in conjunction with the appropriate codes for Telemedicine following full implementation of HIPAA compliance (see “Telemedicine Consultations.”).

SOURCE: GA Dept. of Community Health, GA Medicaid Division, Advanced Nurse Practitioner Services (Apr. 1, 2025), p. 18.  GA Dept. of Community Health, GA Medicaid Division, Nurse Midwifery Services, p. 12 (Apr, 1, 2025).  (Accessed Apr. 2025).

School-Based Settings (Local Education Agencies)

Telehealth services are allowed in school-based settings upon enrollment into COS 600.  The following requirements must be met:

• The provider is an authorized health-care provider enrolled in Georgia Medicaid
• The client is a child who is receiving the service in a primary or secondary school-based setting
• The parent or legal guardian of the client provides consent before the service is provided

Telehealth services provided in a school-based setting are also a benefit if the referring provider delegates provision of services to a nurse practitioner, clinical nurse specialist, physician assistant, or other licensed specialist as long as the above-mentioned providers are working within the scope of their professional license and within the scope of their delegation agreement with the provider.

The school must enroll as a Health Check Provider in order to bill the telehealth originating site facility fee.

LEAs must submit an Attestation Form for the provision of telehealth services.

SOURCE: GA Dept. of Community Health, GA Medicaid Telehealth Guidance Handbook, p. 22 (Apr. 1, 2025).(Accessed Apr. 2025).

ELIGIBLE SITES

Originating sites are paid an originating site facility fee for telehealth services as described by HCPCS code Q3014 with a payment of $20.52. Hospitals are eligible to receive reimbursement for a facility fee for telehealth when operating as the originating site. Claims must be submitted with revenue code 780 (telehealth) and type of bill 131. There is no separate reimbursement for telehealth serves when performed during an inpatient stay, outpatient clinic or emergency room visit or outpatient surgery, as these are all-inclusive payments.

SOURCE: GA Dept. of Community Health, GA Medicaid Telehealth Guidance Handbook, p. 8 (Apr. 1, 2025). (Accessed Apr. 2025).

Ambulance Providers

They may serve as originating sites and the ambulance may bill a separate origination site fee. They are not authorized to provide distant site services.

Limitation (Emergency Ambulance Services Handbook): Emergency ambulance services are reimbursable only when medically necessary. The recipient’s physical condition must prohibit use of any method of transportation except emergency for a trip to be covered. See Emergency Ambulance Handbook for more specific information.

SOURCE: GA Dept. of Community Health, GA Medicaid Telehealth Guidance Handbook, p. 11 (Apr. 1, 2025). & Emergency Ambulance Services Handbook, p. 20-21 (Apr. 1, 2025). (Accessed Apr. 2025).

Community Behavioral Health and Rehabilitation Services

Member may be located at home, schools and other community-based settings or at traditional sites named in the Department of Community Health Telehealth Guidance.  See manual for detailed instructions explanation for when and which type of practitioner can bill for telehealth services.

Traditional sites include:

• Physician and Practitioner’s Offices;
• Hospitals;
• Rural Health Clinics;
• Federally Qualified Health Centers;
• Local Education Authorities and School Based Clinics;
• County Boards of Health;
• Emergency Medical Services Ambulances; and
• Pharmacies.

SOURCE: GA Dept. of Community Health, GA Medicaid Telehealth Guidance Handbook, p. 18 (Apr. 1, 2025). (Accessed Apr. 2025).

Teledentistry

Teledentistry codes are available to bill for benefits in the Public Health setting. Public health setting per telehealth practice acts includes the following:

• Federally Qualified Health Clinics (FQHCs)
• School-based health clinics (SBHCs)
• Community Health Centers (CHCs)
• Rural health clinics
• Local health departments or agencies
• Post-secondary educational institutions (Dental schools, Residency programs)
• Skilled nursing facilities
• Senior centers
• Family violence shelters
• Juvenile Justice System programs
• Volunteer community health setting

SOURCE: GA Dept. of Community Health, Polices & Procedures II: Dental Services p. 61 (Apr. 1, 2025). (Accessed Apr 2025).

Federally Qualified Health Center (FQHC)/Rural Health Center (RHC)

FQHCs and RHCs can serve as originating sites and are paid an originating site facility fee. They cannot bill an originating site fee and distant site fee for telehealth services on the same encounter.

SOURCE: GA Dept. of Community Health, GA Medicaid Telehealth Guidance Handbook, p. 17 (Apr. 1, 2025). & GA Dept. of Community Health, Policies and Procedures for Federally Qualified Health Center Services and Rural Health Clinic Services, p. 26, (Apr. 1, 2025). (Accessed Apr. 2025).

Dialysis Services

Dialysis facilities are eligible originating sites for dialysis services.

SOURCE: GA Dept. of Community Health, GA Medicaid Telemedicine Guidance Handbook, p. 17 (Apr. 1, 2025).  & GA Dept. of Community Health, GA Medicaid Dialysis Services Handbook, p. 16. (Apr. 1, 2025) (Accessed Apr  2025).

Nursing Facility Specialized Services

Nursing facilities can be eligible sites for nursing facility specialized services.

SOURCE: GA Dept. of Community Health, GA Medicaid Telehealth Guidance Handbook, p. 20 (Apr. 1, 2025). & GA Dept. of Community Health, Nursing Facility Services, p. 155. (Apr. 1, 2025). (Accessed Apr. 2025).

School-Based Settings (Local Education Agencies)

Telehealth services are allowed in school-based settings upon enrollment into COS 600.  The following requirements must be met:

• The provider is an authorized health-care provider enrolled in Georgia Medicaid
• The client is a child who is receiving the service in a primary or secondary school-based setting
• The parent or legal guardian of the client provides consent before the service is provided

Telehealth services provided in a school-based setting are also a benefit if the referring provider delegates provision of services to a nurse practitioner, clinical nurse specialist, physician assistant, or other licensed specialist as long as the above-mentioned providers are working within the scope of their professional license and within the scope of their delegation agreement with the provider.

The school must enroll as a Health Check Provider in order to bill the telehealth originating site facility fee.

LEAs must submit an Attestation Form for the provision of telehealth services.

SOURCE: GA Dept. of Community Health, GA Medicaid Telehealth Guidance Handbook, p. 22-23 (Apr. 1, 2025)., GA Dept. of CommunityHealth, Childrens Intervention School Services (Apr. 1, 2025), p. 7. (Accessed Apr. 2025).

LEAs enrolled as Health Check providers to serve as telemedicine originating sites only will be allowed to bill the telemedicine originating site facility fee (procedure code Q3014). The LEA provider should report procedure code Q3014 along with the EP and GT modifiers, POS 03, and the appropriate ICD-10 diagnosis code(s). The diagnosis code(s) should be the same diagnosis code(s) listed on the distant site (rendering) provider’s claim.

SOURCE: GA Dept. of Community Health, EPSDT Health Check Program , p. 61 (Apr. 1, 2025).  (Accessed Apr. 2025).

GEOGRAPHIC LIMITS

No Reference Found

FACILITY/TRANSMISSION FEE

Cost associated with the use of technology or data transmission are not covered under Medicaid and cannot be charged to the member.

Originating sites are paid an originating site facility fee.  Hospitals are eligible to receive reimbursement for a facility fee for telehealth when operating as the originating site. There is no separate reimbursement for telehealth serves when performed during an inpatient stay, outpatient clinic or emergency room visit or outpatient surgery, as these are all-inclusive payments.

SOURCE: GA Dept. of Community Health, GA Medicaid Telehealth Guidance Handbook, p. 7-8 (Apr. 1, 2025). (Accessed Apr. 2025).

Community Behavioral Health and Rehabilitation Services

Originating fees (as referenced in some of the other Georgia Medicaid programs) are not offered for telemedicine when utilized in the CBHRS category of service. Telemedicine costs are attributed to the services intervention rates.

SOURCE: GA Dept. of Community Health: Community Behavioral Health and Rehabilitation Services, p. 41 (Apr. 1, 2025),  GA Dept. of Community Health, GA Medicaid Telehealth Guidance Handbook, p. 16 (Apr. 1, 2025). (Accessed Apr. 2025).

School-Based Settings (Local Education Agencies)

LEAs that enroll as Health Check providers to serve as telehealth originating sites only will be allowed to bill the originating site facility fee. The telehealth originating facility fee is reimbursed at the current DEFAULT rate.

SOURCE: GA Dept. of Community Health, GA Medicaid Telemedicine Guidance Handbook, p. 22 (Apr. 1, 2025).  &  GA Dept. of CommunityHealth, Childrens Intervention School Services (Apr. 1, 2025), p. 9. (Accessed Apr 2025).

Ambulance Providers

Originating Sites (HCPCs Q3014): Originating site means the location of an eligible Medicaid beneficiary at the time the service being furnished via a telecommunications system occurs. Originating sites are reimbursed at 84.645% of the 2012 Medicare fee schedule.

SOURCE: GA Dept. of Community Health, GA Medicaid Telemedicine Guidance Handbook, p. 11 (Apr. 1, 2025). & Emergency Ambulance Services Handbook p. 20 (Apr. 1, 2025). (Accessed Apr. 2025).

Dialysis Services

The originating facility/site (Dialysis Facility) will bill with the revenue code and procedure codes listed in the manual.

SOURCE: GA Dept. of Community Health, GA Medicaid Telemedicine Guidance Handbook, p. 17 (Apr. 1, 2025). & GA Dept. of Community Health, GA Medicaid Dialysis Services Handbook, p. 16 (Apr. 1, 2025). (Accessed Apr. 2025).

FQHC/RHC

FQHCs and RHCs that serve as an originating site for telehealth services are paid an originating site facility fee.

FQHCs and RHCs cannot bill an originating site fee and distant site fee for telehealth services on the same encounter.

SOURCE: GA Dept. of Community Health, GA Medicaid Telehealth Guidance Handbook, p. 17 (Apr. 1, 2025).   GA Dept. of Community Health, GA Medicaid Federally Qualified Health Centers and Rural Health Clinics p. 26 (Apr. 1, 2025), p. 26.  (Accessed Apr 2025).

EPSDT Services – Health Check Program

LEAs enrolled as Health Check providers to serve as telemedicine originating sites only will be allowed to bill the telemedicine originating site facility fee (procedure code Q3014).

SOURCE: GA Dept. of Community Health, EPSDT Services – Health Check Program, p. 61. (Apr. 1, 2025). (Accessed Apr. 2025).

Last updated 04/29/2025

Miscellaneous

The referring provider must be the member’s attending physician, practitioner, or provider in charge of their care. The request must be documented in the member’s record. The physician or practitioner providing the referral must provide pertinent medical information and/or records to the distant site provider via a secure transmission. Notwithstanding the foregoing, referrals for evaluation of physical, mental, or sexual abuse may be made by an appropriate agency or group, including but not limited to, law enforcement or social services agencies.

Both the originating site and distant site must document and maintain the member’s medical records. The report from the distant site provider may be faxed to the originating provider. Additionally, all electronic documentation must be available for review by the Georgia Department of Community Health, Medicaid Division, Division of Program Integrity and all other applicable divisions of the department.

All transactions must utilize an acceptable method of encryption adequate to protect the confidentiality and integrity of the transmission information.

SOURCE: GA Dept. of Community Health GA Medicaid Telehealth Guidance Handbook, p. 8-9 (Apr. 1, 2024). (Accessed Apr 2025).

All enrolled providers, rendering services through the use of Telemedicine or Telehealth must possess the required credentials and be legally allowed to practice within the state of Georgia. All enrolled providers must be credentialed by DCH’s Centralized Credentialing Verification Organization (CVO) or through a delegated credentialing arrangement with a Care Management Organization (CMO).

In-state physicians providing services through the use of Telemedicine/Telehealth must have admitting privileges at a Georgia hospital or an arrangement with a local physician who has admitting privileges.

Out of state physicians providing services via Telehealth must have an arrangement with a local physician who has admitting privileges or a local hospitalist.

Each individual practitioner providing services through the use of Telemedicine/Telehealth is required to maintain professional liability insurance in the amount of $1 million per occurrence/$3 million per aggregate. Shared policies are prohibited and will not be accepted. Umbrella and/or Excess Coverage policies will be accepted if the policy indicates professional liability (malpractice) coverage is included. Umbrella policies must include professional liability insurance in the amount of $1 million per occurrence/$3 million per aggregate for each individual practitioner. The umbrella policy must list each individual practitioner by name and clearly state that the $1m/$3m umbrella reflects individual limits (not shared).

SOURCE:  GA Dept. of Health, Out-of-State Telehealth Provider Enrollment Presentation Powerpoint (Mar. 2024), slide 4. 8, 11 (Accessed Apr 2025).

Prescribing Medications Via Telehealth:

Providers may prescribe medications through the use of Telemedicine/Telehealth. All prescribers, whether in-state or out-of-state, must have and use his or her unique Drug Enforcement Administration (DEA) registration number to authorize controlled substance prescriptions. DEA regulations require practitioners to obtain a separate DEA registration in each state in which he or she prescribes controlled substances.

Accordingly, out of state practitioners, must obtain a Georgia DEA registration number if prescribing controlled substances to Georgia Medicaid and PeachCare for Kids members who are located within the state of Georgia.  Out-of-state practitioners, who do not prescribe controlled substances to Georgia Medicaid and PeachCare for Kids members within the state of Georgia are not required to have a Georgia DEA registration number.

Ordering, Prescribing, and Referring (OPR) Requirements for Telehealth Services:

• The physician or non-physician practitioner who wrote the order, prescription or referral must be enrolled in Medicaid as either a participating Medicaid provider or as an OPR provider and his or her NPI number must be included on the claim.
• The provider’s NPI number must be for an individual physician or non-physician practitioner (not an organizational NPI).
• The physician or non-physician practitioner must be of a specialty type that is eligible to order, prescribe, or refer.

Professional Liability Insurance Requirements for Providers Rendering Services via Telehealth:

Each individual practitioner providing services through the use of Telemedicine/Telehealth is required to maintain professional liability insurance in the amount of $1 million per occurrence/$3 million per aggregate. Shared policies are prohibited and will not be accepted.  Umbrella and/or Excess Coverage policies will be accepted if the policy indicates professional liability (malpractice) coverage is included. Umbrella policies must include professional liability insurance in the amount of $1 million per occurrence/$3 million per aggregate for each individual practitioner.  The umbrella policy must list each individual practitioner by name and clearly state that the $1m/$3m umbrella reflects individual limits (not shared).

SOURCE: GA Department of Community Health, Provider Messages (All Providers) Sept. 16, 2022. (Accessed Apr 2025).

Elderly and Disabled Waiver Program (CCSP/Community Services)

Provider/member telehealth communication in EDWP will involve a camera telehealth modality encrypted (end to end encryption) software product with established business agreement that protects PHI (protected health information). PHI is information about health status, provision of health care, or payment for health care that is created or collected by a covered entity and can be linked to a specific individual. Applicant/member or Provider with access to landline phone (one way) can be utilized in place of the software requirement. Landline/non internet use is appropriate (copper wires that carry their own power and work during blackouts). Calls not involving billable service work requires I phone or Android encryption cell settings use or landline. Use of electronic health records, member portal access or app use are to be encrypted (end to end encryption) with business agreement as well.

SOURCE: GA Dept. of Health Elderly and Disabled Waiver Program General Services, p. 19 (Apr. 1, 2025).  (Accessed Apr. 2025).

Last updated 04/29/2025

Out of State Providers

The Georgia Composite Medical Board is authorized to administer the compact in this state. Under the compact, physicians must meet certain requirements, including: possess a full and unrestricted license to practice medicine in a Compact state; possess specialty certification or be in possession of a time unlimited specialty certificate; have no discipline on any state medical license; have no discipline related to controlled substance; not be under investigation by any licensing or law enforcement agency; have passed the USMLE or COMLEX within three attempts; and have successfully completed a graduate medical education (GME) program. License to practice medicine obtained through this compact will be issued by the State’s Medical Composite Board. Providers should see the Georgia Composite Medical Board for additional information.

SOURCE: GA Dept. of Community Health GA Medicaid Telehealth Guidance Handbook, p.7 (Apr. 1, 2025). (Accessed Apr. 2025).

All enrolled and rendering providers must:

• Have the required credentials and be legally allowed to practice within the state of Georgia.
• Be credentialed by DCH’s Centralized Credentialing Verification Organization (CVO) or through a delegated credentialing arrangement with a Care Management Organization (CMO).
• Hold the Appropriate Georgia license or permit (this includes a Telemedicine License, Temporary License or Emergency Practice Permit) certificate, approval, registration or other form of permission issued by an entity other than the Department of Community Health (DCH), as required by law.
• Act within the scope of his or her practice as defined by federal and state laws, rules, and regulations.
• Understand that Telemedicine/Telehealth services shall be subject to utilization review and auditing requirements.
• Maintain documentation of all services provided with /telemedicine/Telehealth in accordance with DCH policy.

SOURCE: GA Medicaid Telemedicine Guidance Presentation (December 18, 2024).  (Accessed Apr. 2025).

All enrolled providers, rendering services through the use of Telemedicine or Telehealth must possess the required credentials and be legally allowed to practice within the state of Georgia.  All enrolled providers must be credentialed by DCH’s Centralized Credentialing Verification Organization (CVO) or through a delegated credentialing arrangement with a Care Management Organization (CMO).

All individual practitioners must possess the appropriate Georgia license (this includes a Telemedicine License, Temporary License or Emergency Practice Permit), permit, certificate, approval, registration, or other form of permission issued by an entity other than the Department of Community Health (DCH), which form of permission is required by law.  All enrolled individual practitioners must act within the scope of his or her practice as defined by federal and state laws, rules, and regulations.

Telemedicine/Telehealth services shall be subject to utilization review and auditing requirements.

Providers must maintain documentation of all services provided through the use of Telemedicine/Telehealth in accordance with DCH policy.

SOURCE: GA Department of Community Health, Provider Messages (All Providers) Sept. 16, 2022. (Accessed Apr 2025).

Last updated 04/29/2025

Overview

Georgia Medicaid reimburses for live video under some circumstances. Store-and-forward is not reimbursable as interactive telecommunications is a condition of payment; however, GA Medicaid will reimburse for the technical component of x-rays, ultrasounds, etc. as well as store-and-forward teledentistry.  A new law requires GA Medicaid to cover continuous glucose monitoring but there is limited reference specific to telehealth. Some interprofessional audio consultation codes are covered for some behavioral health services.

Last updated 04/25/2025

Remote Patient Monitoring

POLICY

Pilot Program to Reduce Infant and Maternal Mortality

SOURCE: GA State Statute Section 49-4-159.2. (Accessed Apr. 2025).

CONDITIONS

• The recipient has been diagnosed with diabetes mellitus by a treating practitioner;
• The recipient’s treating practitioner has concluded that the recipient or the recipient’s  caregiver has had sufficient training in using a continuous glucose monitor as evidenced   by the provision of a prescription therefor; and
• The recipient:
  • Is treated with at least one daily administration of insulin; or 
  • Has a history of problematic hypoglycemia with documentation of at least one of  the following: 
    • Recurrent level 2 hypoglycemic events (glucose less than 54 mg/dL (3.0 mmol/L))   that persist despite two or more attempts to adjust medication, modify the diabetes   treatment plan, or both; or 
    • A history of a level 3 hypoglycemic event (glucose less than 54 mg/dL  (3.0 mmol/L)) characterized by altered mental or physical state requiring third-party   assistance for treatment for hypoglycemia.

PROVIDER LIMITATIONS

No Reference Found

OTHER RESTRICTIONS

No Reference Found

Last updated 04/25/2025

Store and Forward

POLICY

GA Medicaid defines asynchronous or “store-and-forward” as the “transfer of data from one site to another through the use of a camera or similar device that records (stores) an image that is sent (forwarded) via telecommunication to another site for consultation. Asynchronous communication does not include telephone calls, images transmitted via fax machines and text messages without visualization of the patient (electronic mail).

SOURCE: GA Dept. of Community Health, GA Medicaid Telemedicine Guidance Handbook, p. 5 (Apr 1, 2025). (Accessed Apr. 2025).

Certain teledentistry codes can be delivered via store-and-forward.

Department of Public Health (DPH) Districts and Boards of Health Dental Hygienists shall only perform duties under this protocol at the facilities of the DPH District and Board of Health, at school-based prevention programs and other facilities approved by the Board of Dentistry and under the approval of the District Dentist or dentist approved by the District Dentist.

SOURCE: GA Dept. of Community Health, GA Medicaid Telemedicine Guidance Handbook, p. 17 (Apr. 1, 2025). & Part II Policies and Procedures for Dental Services, p. 61 (Apr. 1, 2025). (Accessed Apr. 2025).

ELIGIBLE SERVICES/SPECIALTIES

Teledentistry

The State allows reimbursement for one specific teledentistry store-and-forward code.  See manual for approved code.

SOURCE: GA Dept. of Community Health, GA Medicaid Telemedicine Guidance Handbook, p. 17 (Apr. 1, 2025). & Part II Policies and Procedures for Dental Services, p. 61 (Apr. 1, 2025). (Accessed Apr. 2025).

GEOGRAPHIC LIMITS

No Reference Found

TRANSMISSION FEE

The originating site fee (billed as D9996) associated with a real-time teledentistry exam is supposed to cover the asynchronous sending of information by a dental hygienist to a dentist for review.

SOURCE: GA Dept. of Community Health, GA Medicaid Telemedicine Guidance Handbook, p. 17 (Apr. 1, 2025). & Part II Policies and Procedures for Dental Services, p. 61 (Apr. 1, 2025). (Accessed Apr. 2025).