Georgia Medicaid’s Autism Manual Gets July 2025 Update: What Providers Need to Know

Every quarter, the Georgia Department of Community Health makes adjustments to its Autism Spectrum Disorder (ASD) Services manual. The July 1, 2025 update may not be as sweeping as prior revisions, but there are key changes that every ABA provider, billing manager, and clinical director should review. Here's what you need to know:

Secure Signatures & Policy Reference Updates

• Secure Electronic Signatures: Section 602.3.4 now specifies that only secure electronic signatures are compliant. This adds an extra layer of scrutiny for those using e-signature platforms, ensure yours meets the definition in Part I of the Medicaid manual.

• Appendix D Updated: It now points to Section 602.3.4 instead of the broader 602.3, providing more precise citation guidance.

Clarifications on Retroactive Coverage

• Retroactive Prior Authorizations (PAs): Section 701.1.1 now includes expanded guidance on both retroactive eligibility and retro PAs. This could help providers better advocate for clients who had lapses or delays in coverage.

School Setting Guidance Expanded

• Caregiver Training in Schools: Section 804.10 adds language supporting the delivery of caregiver training within the school setting.

• Training School Personnel: Section 804.12’s commentary now acknowledges the need for school personnel training as part of caregiver services.

• Exclusion Removed: Appendix D removes the prior restriction that prohibited training school personnel. This opens up a clearer path for collaboration between BCBAs and educators, especially for learners with significant behavior support needs.

Insufficient Progress? Be Ready to Show Your Work

• New Language in Section 804.1: Providers must now clearly document how lack of client progress is addressed. This means including phase change lines and data-based decisions in school behavior support plans per Appendix D expectations.

Data & Documentation

• Updated Data Requirements (Section 803.5): Ongoing authorizations must now include current and aligned data, even for goals that haven’t been formally introduced. If you’re submitting a request for continuing services, make sure your probe data is up to date, nothing more than 2 months old.

Appendix Streamlining

• Appendix E Consolidation: Sections C and H have been merged for clarity.

• Service Schedule Placement: The service schedule in Appendix D has been moved to the first page for easier access.

Why This Matters

While many of these changes are technical, they reflect Georgia Medicaid's ongoing push for:

• Stronger clinical documentation,

• Integrated caregiver and school collaboration,

• More rigorous standards for demonstrating medical necessity.

If you're a provider delivering services through the Georgia Medicaid Autism benefit, now is the time to review your documentation workflows, caregiver training policies, and electronic signature compliance to align with these mid-year updates.