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CareSource Update
GPA leaders have continued to assert the need for clarity about several issues concerning psychologists' provision of services to subscribers of the CMO CareSource. The president of CareSource, Georgia market, finally committed that they will pay Psy.D. & Ph.D. providers 100% of the rate paid by traditional Medicaid.  Therefore, the amounts you should be receiving are identical to those published in the Medicaid manual for psychologists.
 
As you are aware, the code 90791 is not in the Medicaid manual, but one practice has been receiving expected fees when billing for this code.  We do not yet know how Neuropsychology Testing Codes will be handled.  If anyone has tried to bill them and received payment, let Dr. Tina Caudill know at dr.tina.caudill@gmail.com. She will be the point person to communicate with CareSource around larger scale issues and will communicate with everyone as I find out more. Otherwise please contact your CareSource Provider Representative or Jessica Schmoll, CareSource Director of Behavior Health, at jessica.schmoll@caresource.com
 
The CareSource website still indicates that none of the outpatient mental health codes require authorization.  However, communication with CareSource executives does suggest that authorization for outpatient therapy codes will be required in the future.  They may stay with the number of units allowed yearly through traditional Medicaid (24 per calender year).  As of now, no authorizations are being required, including for psychological testing, but it appears that are placing a cap on testing (5 units), similar to traditional Medicaid. Dr. Caudill will be talking with the CareSource Medical Director about when and how changes for authorizations will take place.