Approved State Plan Amendments

All state plan amendments approved since 11/19/2015.

2024

24-0010 Payment Driven Patient Model  

24-0011 Hospital Medicaid Financing Program

24-0009 Disproportionate Share Hospitals

24-0006 Rate Increase for PCP, OBGYN, Optometry, LAI

24-0008 Community Behavioral Health Rehabilitation Services (CBHRS) Rate Increase 

24-0004 Dispensing Fee Increase for Independent Pharmacy

24-0003 FQHC Reimbursement for Licensed Professional Counselors, Licensed Marriage and Family Therapists,  and Certified Peer Specialists

24-0005 Adult Dental

24-0002 Expansion of Express Lane Eligibility to Include Childcare and Parental Services, Refugee Cash Assistance, and WIC

24-0001 Outpatient Drugs

23-0011 Value-Based and Outcome-Based Contracting with Pharmaceutical Manufacturers 

23-0009 DRG Grouper from Tricare DRG Version 35 to APR DRG Version 40

2023

21-0014 Disproportionate Share Hospital Methodology

22-0003 PRTF Per Diem Rate Adjustments

22-0006 Behavioral Support Aides

22-0007 Disproportionate Share Hospital Methodology

22-0008 Eliminate Attestation and Increases Rates for Obstetrics/Gynecology (OB/GYN)

22-0009 Update Nursing Home Rates to 2020 Medicaid Cost Report

22-0010 Private 911 Ground Ambulance Upper Payment Limit (UPL) Program

22-0013 Increase Rate for LTAC and IRF

22-0014 Nursing Home Mechanical Ventilator Care Rate Increase

23-0001 Disaster Relief – Unwinding

23-0003 COVID-19 Treatment

23-0004 COVID Testing

23-0005 COVID-19 Vaccines and Vaccine Administration

23-0006 Pathways 1115 Waiver

23-0007 Blood Pressure Monitors

23-0008 PRTF Rate Increase  

2022

22-0001 Medicaid Disaster Relief

22-0002 Clinical Trials

22-0004 Express Lane Eligibility

22-0004 Approved SPA Page

22-0005 Non Covered Services

22-0011 Dental Rate Increase

2021

21-0002 Georgia's Medicaid Disaster Relief.pdf (11.32MB)

21-0003 Medication Assisted Treatment

21-0004 Hospital Audit Program.pdf (254.58KB)

21-0005 Reimbursement for COVID-19 Vaccines - Disaster Relief SPA (354.64KB)

21-0006 PCP/OBGYN increase to 2020 Medicare Levels

21-0008 Increase Reimbursement for 15 Dental Codes

21-0009 Nursing Home Reimbursement Rate Change

21-0011 Ground Ambulance Supplemental Payment Program

21-0012 Removal of the provision which prohibits a physician from receiving supplemental payments through the Fee-for-Service Physician Upper Payment Limit (UPL) program and the enhanced primary care reimbursement rates simultaneously

21-0013 Third Party Liability-Cost Avoidance

21-0015 Non-Emergency Medical Transportation

21-0016 Lactation Consultants

21-0016 Approval Package for State Plan

2020

20-0001 DUR Support Act

20-0003 Ambulance Upper Payment Limit (UPL) Supplemental Payment Program

20-0008 Silver Diamine Fluoride Reimbursement.pdf (254.61KB)

20-0009 Increased Reimbursement for Ventilator Dependent Nursing Facility Residents.pdf (375.77KB)

20-0010 Primary Care Code 1% Rate Increase

20-0011 Nursing Home Quality Incentive Program.pdf (369.55KB)

2019

19-001 IPPS Phase 3

19-002 LTACH & IRF

19-004 PRTF Rate Increase

19-005 Disproportionate Share Hospital (DSH) Allocation Methodology

19-006 GME Payment for CBSs

19-008 Hospital Provider Fee Extension (HPF)

19-009 Skilled Nursing Facility Rate Increase

19-010 Nursing Home Personal Needs Allowance (PNA) Rate Increase

19-011 Supplemental Payment for Inpatient Services Rendered in Child and Adolescent Behavioral Health Unit

19-012 Per diem Rate Increase for Swing Bed

19-013 NF Vent Dependent Resident Rate Increase

2018

18-001 GA Former Foster Care Children Out of State .pdf  (202.08 KB)

18-002 Supplemental Rebate Agreement Template

18-004 Nursing Home Personal Needs Allowance Rate Increase

18-005 Nursing Home 4.5% Rate Increase

18-006 Nursing Home Liability Insurance Rate Increase

18-007 Newborn Kick Payment for Rural Hospital with a population of less than 35,000

18-009 Commissioner of Human Services waives the first $25,000 of any estate provide

18-010 Hospital Triage Rate Increase

2017

17-001 Outpatient Drug Rule  (1.07 MB)

17-002 Community Behavioral Health Rehabilitation Services  (582.85 KB)

17-003 Nursing Home Ventilator Rate Increase  (1.87 MB)

17-005 - Portable X-ray CT Scan  (250.34 KB)

17-006 Hospital Provider Fee  (792.31 KB)

17-007 Nursing Facility Rate Increase  (675.19 KB)

17-008 Primary Facility Rate Increase HB44.pdf  (246.44 KB)

17-009 Newborn Add on Fee for Rural Counties.pdf  (1.26 MB)

17-010 Nursing Home Rate Increase.pdf  (1.19 MB)

17-012 Nursing Home Ventilator  (642.11 KB)

17-013 Routine Home Care Hospice rates and Service Intensity Add-On rates (335.57 KB)

17-014 School Nurses Administrative Agreement Update (220 KB)

17-015 Autism Enroll BCBA .pdf  (334.97 KB)

2016

16-001 PCP & OBGYN Rate Increase  (1.92 MB)

16-002 CIS Rate Increase  (260.35 KB)

16-003 Rural-Hospital-Add-on-Payment-for-Deliveries  (1.29 MB)

16-004 NH-Vent-Rate-Increase  (1.63 MB)

16-005 NH-Rate-Increase  (1.53 MB)

16-010 Physician UPL

16-015 DPH Newborn Screening Fee Increase  (1.06 MB)

2015

15-001 FQHC_RHC Reimbursement for purchase of LARCs  (99.64 KB)

15-003 Nursing Facilities Rate Increase  (3.8 MB)

15-004 Adult Air Ambulance  (108.76 KB)

15-005 Inpatient Prospective Payment Services  (706 KB)

15-006 Enhanced Primary Care Svc. Payment  (374.65 KB)

15-008 Telehealth and Telemedicine Services  (905.45 KB)

15-009 Express Lane Eligibility  (91.12 KB)

15-010 FQHC_RHC  (136.07 KB)

15-011 IPPS Tricare Grouper  (164.75 KB)

15-012 Transportation Telemedicine Facility Sites (430.17 KB)

Prior to 2015

14-001 Family Planning Services  (157.81 KB)

14-003 Perinatal Case Management  (18.97 MB)

14-006 Georgia Nursing Facilities Rate Increase  (494.56 KB)

13-001 State Governor Review  (215.99 KB)

13-002 Disproportionate Share Hospital Allocation  (416.76 KB)

13-004 Enhanced Primary Care Service Payment  (406.21 KB)

13-008 Concurrent Hospice Care  (365.51 KB)

13-009 Fair Rental Value  (512.64 KB)

13-005 CMS Approval Letter  (318.98 KB)

13-006 CMS Approval Letter  (1.93 MB)

13-007 FQHC_RHC Increase  (182.69 KB)

13-011 Foster Care and Adoption Assistance  (318.76 KB)

13-012 Care Payment for Private Inpatient Hospitals  (137.36 KB)

13-013 Care Payments for Private Outpatient Hospitals  (247.57 KB)

13-014 Pregnancy Related & Postpartum Services  (73.38 KB)

13-015 ABD Medical Coordination  (224.55 KB)

13-016 MAGI Eligibility & Methods Group  (1.56 MB)

13-0017 Establish 2001 _f_ Group  (388.4 KB)

13-018 Eligibility Process Group  (1.71 MB)

13-0019 Non-Financial Eligibility Group  (1.13 MB)

13-0020 MAGI- Based Eligibility groups  (1.43 MB)

13-0021 Eligibility Process  (493.73 KB)

13-022 MAGI Income Methodology  (73.67 KB)

13-023 Residency  (141.61 KB)

13-0024 Citizenship & Immigration Status  (142.09 KB)

13-025 XXI Medicaid Expansion  (73.03 KB)

13-026 Tobacco Cessation Counseling Service  (136.02 KB)

13-027 Inpatient Hospital Prospective Payment Services (395.89 KB)

13-0028 Hospital Presumptive Eligibility  (258.1 KB)

12-001 Medicaid Recovery Audit Program  (428.09 KB)

12-002 Tobacco Cessation  (195.32 KB)

12-003 Nursing Home Reimbursement  (2.52 MB)

12-004 Provider Screening and Enrollment  (417.85 KB)

12-005 Nursing Home Reimbursement (578.15 KB)

11-001 Disproportionate Share Hospitals  (281.15 KB)

11-002 Express Lane Eligibility  (212.8 KB)

11-003 Foreign Payment Prohibition  (97.82 KB)

11-004 Freestanding Birth Centers  (351.44 KB)

11-005 Hospital Acquired Conditions (583.77 KB)

11-006 Disproportionate Share Hospitals  (700.44 KB)

11-007 Community Behavioral Health  (3.24 MB)

11-008 GBHC Termination  (402.54 KB)

10-019 Medicaid Recovery Audit Program  (1.23 MB)