SPECIALIZED THERAPIES SERVICES PROVIDER IN GEORGIA

Fatumata Kaba
Jul 14, 2025
4 min read

Updated: Jan 16

ENHANCING FUNCTIONAL SKILLS, COMMUNICATION, AND MOBILITY THROUGH INDIVIDUALIZED THERAPEUTIC SUPPORTS

Specialized Therapies in Georgia provide individualized therapy services designed to address specific developmental, cognitive, communication, behavioral, or physical needs. These services are authorized under Georgia’s Medicaid Home and Community-Based Services (HCBS) waiver programs and aim to promote independence, skill development, and community integration for individuals with disabilities or chronic health conditions.

1. GOVERNING AGENCIES

Agency: Georgia Department of Community Health (DCH)Role: Oversees Medicaid enrollment, service authorization, and reimbursement for Specialized Therapies

Agency: Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD)Role: Administers waiver-based specialized therapy services for individuals with developmental disabilities

Agency: Centers for Medicare & Medicaid Services (CMS)Role: Provides federal oversight, ensuring therapy services meet Medicaid HCBS standards

2. SPECIALIZED THERAPY SERVICE OVERVIEW

Specialized Therapies include targeted therapeutic services designed to improve a participant’s functional abilities, health, communication skills, behavior, and mobility.

Approved providers may deliver:

Speech-Language Therapy (e.g., improving communication and swallowing function)
Occupational Therapy (e.g., fine motor skills, sensory integration, daily living skills)
Physical Therapy (e.g., gross motor skills, balance, strength, mobility training)
Behavioral Therapy (non-ABA models for emotional regulation and social skills)
Music Therapy (where authorized)
Art Therapy (where authorized)
Specialized Feeding Therapy (for individuals with complex eating or swallowing difficulties)

All services must be authorized through the participant’s Individual Service Plan (ISP) and focused on improving functional outcomes and promoting greater independence.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Georgia Secretary of State
Obtain EIN from the IRS and NPI (Type 2)
Enroll as a Medicaid provider through the Georgia Medicaid Management Information System (GAMMIS)
Complete DBHDD Provider Enrollment for Specialized Therapies
Therapists must hold active Georgia licenses in their respective disciplines (e.g., SLP, OT, PT)
Maintain professional and general liability insurance
Develop policies for therapy service delivery, participant safety, clinical documentation, and HIPAA compliance

4. DBHDD/DCH PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

Submit a Letter of Intent to DBHDD for Specialized Therapy Services
Complete pre-qualification checklist, including business registration, licensing, and insurance verification

Application and Documentation Submission:

Submit Articles of Incorporation, proof of EIN/NPI, therapist licensure verification, insurance certificates, and service delivery models
Provide participant intake forms, therapy assessment templates, treatment plan formats, and progress reporting systems

Program Readiness Review:

DBHDD reviews clinical readiness, therapy planning systems, participant rights protections, and Medicaid documentation compliance

Approval & Medicaid Enrollment:

After DBHDD approval, complete Medicaid enrollment through GAMMIS
Configure billing codes for Specialized Therapy Services based on therapy discipline

5. REQUIRED DOCUMENTATION

Articles of Incorporation or Business License (Georgia Secretary of State)
IRS EIN confirmation
NPI confirmation
Proof of therapist licensure (Georgia Board Licensure for SLP, OT, PT, etc.)
Proof of general and professional liability insurance
DBHDD-Compliant Policy & Procedure Manual including:
- Participant intake, evaluation, and individualized therapy planning procedures
- Service delivery tracking, therapy session documentation, and outcome measurement
- Client rights, HIPAA confidentiality, and grievance handling policies
- Staff credentialing, background screening, and clinical supervision documentation
- Medicaid billing, service authorization tracking, and audit readiness documentation

6. STAFFING REQUIREMENTS

Role: Clinical Supervisor / Therapy Program Manager

Requirements: Active Georgia license in the appropriate therapy discipline (e.g., PT, OT, SLP); supervisory experience preferred; background screening clearance

Role: Licensed Therapists (PTs, OTs, SLPs, etc.)

Requirements: Active Georgia professional licensure; CPR/First Aid certification recommended; background screening clearance

Role: Therapy Assistants (if applicable, such as Certified Occupational Therapy Assistants (COTAs) or Physical Therapy Assistants (PTAs))

Requirements: State licensure/certification as appropriate; background screening clearance

All staff must complete:

HIPAA confidentiality, participant rights, and abuse prevention training
Emergency preparedness and incident response training
Medicaid documentation and service delivery compliance training
Annual continuing education is required to maintain licensure and Medicaid standards

7. MEDICAID WAIVER SERVICES

The following Georgia Medicaid Waivers authorize Specialized Therapy Services:

Comprehensive Supports Waiver Program (COMP)
New Options Waiver Program (NOW)
Independent Care Waiver Program (ICWP) (where authorized for therapy needs)

Approved providers may deliver:

Speech, occupational, and physical therapy interventions
Behavioral therapies (non-ABA) and emotional support therapies
Specialized therapies related to communication, feeding, and sensory integration

8. TIMELINE TO LAUNCH

Phase: Business Formation and Licensing Setup

Timeline: 1–2 weeks

Phase: DBHDD Provider Application and Readiness Review

Timeline: 60–90 days

Phase: Staff Hiring, Credentialing, and Clinical System Setup

Timeline: 30–45 days

Phase: Medicaid Enrollment and Billing Configuration

Timeline: 45–60 days

9. CONTACT INFORMATION

Georgia Department of Community Health (DCH)

Website: https://dch.georgia.gov/

Georgia Medicaid Management Information System (GAMMIS)

Website: https://www.mmis.georgia.gov/

Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD)

Website: https://dbhdd.georgia.gov/

Georgia Composite Medical Board (for Therapist Licensure Verification)

Website: https://medicalboard.georgia.gov/

SPECIALIZED THERAPIES SERVICES PROVIDER IN GEORGIA

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — GEORGIA SPECIALIZED THERAPIES PROVIDER

WCG supports therapy providers and clinics in launching Medicaid-compliant Specialized Therapies under Georgia’s HCBS waiver programs.

Scope of Work:

Business registration and EIN/NPI setup
Medicaid and DBHDD provider enrollment support
Development of Specialized Therapy Services Policy & Procedure Manual
Staff credentialing templates and participant intake documentation
Medicaid billing setup and claims management
Website, domain, and email setup
Therapy assessment templates, treatment planning, and progress monitoring systems
Emergency preparedness, incident reporting, and participant protection plans
Quality assurance and clinical outcome tracking programs
Community networking and referral development strategies