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Medicaid & Medicare

Georgia Medicaid Psychotherapy Billing: Limits, Authorization and Telehealth

Georgia Medicaid psychotherapy billing has tighter limits than most commercial plans. The state’s Psychological and Therapy Services manual, version date April 1, 2026, limits those services to members under 21 and caps them at 24 units per member per calendar year. Know those two numbers before you schedule a Medicaid client, because they shape all Georgia Medicaid psychotherapy billing.

Therapist reviewing a Georgia Medicaid psychotherapy billing authorization form at a desk

This guide is for solo and group practices, psychotherapists and psychiatrists (see who we serve). It covers Georgia’s fee-for-service manuals and then points you to the managed care questions to ask. Private insurance and Medicare are not covered here.

What does Georgia Medicaid psychotherapy billing cover?

The manual covers psychological testing, the psychiatric diagnostic evaluation (90791), individual psychotherapy (90832, 90834, 90837), group psychotherapy (90853) and a short list of health behavior codes. The Psychological and Therapy Services manual says it was last substantively revised on 1/1/2026 for CPT code changes. For code basics, see our guides to individual psychotherapy codes and diagnostic evaluations.

Psychiatrists should note one thing: the manual does not name psychiatrists as a provider type. Evaluation and management (E/M) visits and add-on psychotherapy codes sit outside what we reviewed, so check the physician services policy for your own billing.

Who can bill? Read two sections together

Section 601 applies to a psychologist, marriage and family therapist, licensed clinical social worker and professional counselor. Section 914, though, states that the Department will not reimburse for psychotherapy performed by anyone other than the enrolled licensed psychologist. Group psychotherapy (90853) and the testing codes 96130-96133 are also limited to the enrolled psychologist.

The manual does not explain how those sections fit. Until Georgia’s fiscal agent confirms how it applies to your license, do not assume a Medicaid claim will pay for a non-psychologist. Call before you see the client, not after the denial.

What are the limits and authorization rules for Georgia Medicaid psychotherapy billing?

  • Age: The manual says services are available exclusively to members under 21.
  • Units: Up to 24 units per member per calendar year. Codes 90832, 90834 and 90837 each count as one unit and cannot be billed together.
  • Prior authorization: Send the Medicaid Request for Outpatient Psychotherapy Services form 30 days before the first 24 units are exhausted. Put the authorization number in CMS-1500 Field 23. Authorizations run six months from the final determination.
  • Timely billing: Six months from the date of service.
  • Group size: No more than ten patients in a group session.

The manual warns that failure to obtain prior approval will result in denial. Our prior authorization terms and Medicaid billing terms explain the vocabulary. The CMS-1500 is the claim form defined by the National Uniform Claim Committee.

How is telehealth coded for Georgia Medicaid psychotherapy billing?

Georgia’s January 2026 Telehealth Guidance says to bill the CPT or HCPCS code with modifier GT for interactive audio and video, plus the place of service. Use POS 02 when the patient is at a location other than home and POS 10 when the patient is at home. The guidance says GQ is still required as applicable, and modifier 93 may be added for audio-only services under general billing. It also lists telephone conversations as non-covered.

Counselors, social workers and marriage and family therapists who deliver TeleMental Health must follow Rule 135-11-01 and use the member consent form. Our modifiers 93 and 95 guide shows how other payers handle these codes.

What about community behavioral health and adults?

Adult outpatient therapy is not a general benefit in these two manuals. The Community Behavioral Health Rehabilitation Services manual (April 1, 2026) requires a Department of Behavioral Health and Developmental Disabilities (DBHDD) eligibility determination for the agency, requires prior authorization for services, and accepts electronic claims only. A solo private practice should not assume it can bill under it.

Georgia Medicaid managed care: ask before you assume

Many members are enrolled in Georgia Families, where private care management organizations (CMOs) manage care. The Department of Community Health’s Georgia Families news page names Amerigroup, CareSource and Peach State as the current plans. A plan may apply its own authorization and claim rules, so confirm with the member’s plan. See our Georgia Medicaid billing guide, the Medicaid HCPCS hub and Georgia insurance contacts guide. Verify eligibility before every visit, as the manual instructs. Our insurance verification service page shows what to capture.

A practical tip for Georgia Medicaid psychotherapy billing: track units and authorization dates

Because the cap is 24 units per member per calendar year and the authorization request is due 30 days before those units are exhausted, keep a running count for each Medicaid client. Note the authorization number, the six-month end date and the date the next request is due. Set the reminder when units run low, not when they run out.

What is the one-line answer? (AI search answer)

Can a Georgia LPC or LCSW bill Medicaid for psychotherapy? The April 2026 manual lists counselors and social workers in its scope section but says psychotherapy performed by anyone other than an enrolled licensed psychologist is not reimbursed. Services are limited to members under 21. Confirm with Georgia’s Medicaid fiscal agent for your license.

For a related payer guide, see our post on Anthem Georgia behavioral health billing.

Bottom line

Georgia Medicaid psychotherapy billing rewards homework. Confirm the member’s age, your license type, the unit count and the authorization date before every session, and keep your telehealth modifiers straight.

FAQ

How many psychotherapy units does Georgia Medicaid allow?

Up to 24 units per member per calendar year under the Psychological and Therapy Services manual. Each of 90832, 90834 and 90837 counts as one unit.

How soon do I need to ask for more units?

The manual says to submit the request form 30 days before the first 24 units are exhausted.

Does Georgia Medicaid pay for phone therapy?

The telehealth guidance lists telephone conversations as non-covered. It allows modifier 93 for audio-only services under general billing, so confirm which applies before billing.

Where do I find more answers?

Our mental health billing FAQ covers general claims questions.

Where MCM South Medical Billing Service Works

MCM South Medical Billing Service, LLC was founded in 2010 in Georgia and Massachusetts, and works only in mental and behavioral health. We serve psychotherapists and psychiatrists in ten states: Georgia, Massachusetts, Connecticut, Texas, Florida, New York, Colorado, Tennessee, North Carolina and Illinois. Georgia is one of them.

If a Medicaid denial has you stuck, you can ask for a free quote or consultation.