Georgia - Behavioral Health Services — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-09

The Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) and the Department of Community Health (DCH) jointly approve providers delivering behavioral health assessment, therapy, and crisis response under the Comprehensive Supports Waiver Program (COMP), New Options Waiver (NOW), and Adult Core Services. Applicants must submit a Letter of Intent (LOI) exclusively during designated Open Enrollment periods managed by the Georgia Collaborative ASO and prove a minimum of one year of immediate prior experience delivering identical or similar community-based behavioral health services.

Agencies cannot bypass the experience requirement by subcontracting the entirety of an approved service package. Successful DBHDD certification and site visit approval must precede the formal Medicaid enrollment application submitted through the Georgia Medicaid Management Information System (GAMMIS).

1. Service Definition and Scope

Georgia defines these services under the Adult Core Services Benefit Package and the COMP/NOW waivers, encompassing psychiatric treatment, family outpatient services, service plan development, and crisis response.

Providers may also seek designation as a Certified Community Behavioral Health Clinic (CCBHC) to provide integrated behavioral health and co-occurring intellectual/developmental disability (I/DD) care management.

• Adult Core Services: Includes family counseling, family training, and psychiatric treatment.
• COMP/NOW Waivers: Medicaid Home and Community-Based Services (HCBS) waivers supporting individuals with developmental disabilities in community settings.
• CCBHC Designation: Requires specialized staff capacity for target populations and active use of a comprehensive Electronic Health Record (EHR).
• Telemedicine: Permitted to address behavioral health care professional shortage areas or specialized practice needs (e.g., ASL-fluent therapists).

2. Regulatory and Oversight Agencies

DBHDD serves as the operating agency, managing provider certification, site visits, and day-to-day waiver operations. DCH acts as the State Medicaid Agency, overseeing final Medicaid enrollment and reimbursement.

The Georgia Collaborative ASO manages the initial Letter of Intent (LOI) process, New Provider Enrollment Forums, and provider training on behalf of DBHDD.

• Department of Behavioral Health and Developmental Disabilities (DBHDD): https://dbhdd.georgia.gov/
• Department of Community Health (DCH): https://dch.georgia.gov/
• Georgia Collaborative ASO: https://www.georgiacollaborative.com/
• Georgia Medicaid Management Information System (GAMMIS): https://www.mmis.georgia.gov/

3. Gatekeeping Prerequisites: Who Can Even Apply

Georgia strictly controls the intake of new behavioral health providers through scheduled Open Enrollment periods. LOIs submitted outside of these specific windows are automatically rejected.

New applicants must demonstrate existing operational history, while existing providers seeking expansion must meet strict audit score thresholds.

• Open Enrollment Windows: LOIs are only accepted during specific periods announced by the Georgia Collaborative ASO; no applications are accepted year-round.
• Prior Experience Requirement: Applicants must provide evidence of delivering identical or similar community-based behavioral health services for a minimum of one year immediately prior to LOI submission.
• Subcontracting Prohibition: Applicants cannot meet the one-year experience requirement by subcontracting the entirety of an approved service to another organization.
• Accreditation: Applicants must provide a copy of an accreditation certificate and survey report from a recognized accrediting body at the time of LOI submission.
• Audit Scores (Existing Providers): Must have achieved a score of 80% or greater on their two most recent External Review Organization (ERO) audits to be considered for expansion.

4. Licensure and Certification Requirements

Providers must obtain DBHDD certification, which involves a review of the agency's adherence to the "Core Requirements for Providers." Local business licenses are also strictly enforced.

Facilities providing substance use disorder services must obtain specific facility licenses from the Department of Community Health's Healthcare Facility Regulation (HFR) division.

• DBHDD Certification: Required for all direct service providers of mental illness, developmental disabilities, or addictive diseases services.
• Local Business License: A current city or county business license or permit must be submitted for each location at the time of LOI submission.
• Secretary of State Registration: Must provide a copy of the current Georgia Secretary of State Registration and any "DBA" or Trade Name Registration.
• DATEP License: A Drug Abuse Treatment & Education Program (DATEP) license is required for each location if applying for Substance Use Disorder Specialty Services.
• HFR Licensure: All residential SUD treatment programs must be licensed by DCH Healthcare Facility Regulation.

5. Medicaid Provider Enrollment

Medicaid enrollment is a two-phase process. Providers cannot apply directly to DCH for Medicaid billing privileges until they have successfully passed the DBHDD LOI and site visit phases.

Once DBHDD approves the application and site visit, the provider is invited to complete the formal DCH online application via GAMMIS.

• Phase 1 (LOI): Submission of the BH Agency Provider LOI via the Georgia Collaborative ASO portal.
• Phase 2 (DBHDD Application): Completion of the DBHDD New Provider Application upon invitation.
• DCH Application: Submitted through GAMMIS only after DBHDD approval and site visit clearance.
• Denial Penalty: If the DCH application is denied, the applicant must wait one full year before submitting another LOI during a subsequent open enrollment period.

6. Staffing, Training and Background Checks

Agencies must employ licensed clinical leadership and maintain specific staffing ratios based on the services provided. CCBHCs have additional requirements for medical directors and peer support staff.

All staff must undergo criminal history background checks, and the state utilizes the Georgia Bureau of Investigation's systems for clearance.

• Clinical Director: Must submit a current resume and professional license at the time of application.
• Medical Director: CCBHCs require a Psychiatrist certified by the American Board of Psychiatry and Neurology.
• Peer Support Staff: CCBHCs must include Certified Peer Specialists (CPS), CPS-AD, CPS-P, and CPS-Y.
• Background Checks: Required for all staff; the state is transitioning toward continuous "Rap Back" monitoring through the Georgia Criminal Information Center.

7. Documentation, Policies and Records

DBHDD requires highly specific formatting for application materials. Failure to adhere to physical or digital formatting rules results in immediate rejection.

Providers must maintain comprehensive policies aligning with the DBHDD Provider Manual for Community Behavioral Health Providers.

• LOI Formatting: Hardcopy LOI information must arrive in a typed, organized, section-tabbed notebook format.
• Handwritten Documents: Strictly prohibited; any handwritten application documents will not be accepted.
• Electronic Health Record (EHR): CCBHCs must actively use a comprehensive EHR system.
• Staffing Plan: Agencies must maintain a documented staffing plan for each service component of care.

8. Billing, Rates and Claims

Reimbursement is managed by DCH through GAMMIS. All waiver participant services require prior approval before claims can be submitted.

Rates and procedure codes are published in the Medicaid Provider Manuals for COMP, NOW, and Community Behavioral Health Services.

• Prior Approval (PA): All waiver services require PA by DBHDD, which must be entered into GAMMIS before billing.
• Claims System: All claims are processed through the Georgia Medicaid Management Information System (GAMMIS).
• Provider Manuals: Billing rules are detailed in the Part II Policies and Procedures Manual for Community Behavioral Health Rehabilitation Services (CBHRS).
• Business Hours: Core Service providers must demonstrate availability in evenings or weekends to allow access for consumers who work or attend school.

9. Approval Sequence and Timeline

The approval sequence is strictly linear, beginning with mandatory attendance at a forum, followed by the LOI, DBHDD application, site visit, and finally DCH enrollment.

The entire process spans several months, heavily dependent on the timing of the Open Enrollment windows.

• Step 1: Register and attend a New Provider Enrollment Forum presented by the Georgia Collaborative ASO.
• Step 2: Submit the BH Agency Provider LOI during the open enrollment period.
• Step 3: Receive an invitation to apply and submit the DBHDD New Provider Application.
• Step 4: Pass the DBHDD Regional Field Office site visit.
• Step 5: Complete the DCH online application via GAMMIS.
• Step 6: Attend DBHDD New Provider Orientation upon final DCH approval.

10. Common Denials and Survey Findings

Applications are frequently denied at the gatekeeping stage due to failure to follow strict submission rules or lacking the required operational history.

During site visits and audits, agencies often face citations for inadequate documentation or failing to meet staffing credentials.

• Timing Denials: LOIs submitted before or after the exact Open Enrollment period are rejected.
• Formatting Denials: Submission of handwritten documents or failing to use the required section-tabbed notebook format.
• Experience Denials: Failing to prove one full year of immediate prior experience delivering identical services.
• Audit Failures: Existing providers scoring below 80% on their ERO audits are denied expansion.
• Subcontracting Violations: Attempting to use a subcontractor's experience to meet the one-year operational requirement.

11. Key Contacts and Resources

Primary resources for prospective providers include the DBHDD licensure division, the Georgia Collaborative ASO for enrollment forms, and GAMMIS for Medicaid manuals.

Providers should regularly monitor these portals for announcements regarding Open Enrollment dates and policy updates.

• DBHDD Licensure Information: https://dbhdd.georgia.gov/be-connected/licensure-information
• Georgia Collaborative ASO Provider Enrollment: https://www.georgiacollaborative.com/providers/enrollment/
• Georgia Collaborative ASO Forms: https://www.georgiacollaborative.com/providers/forms/
• GAMMIS Provider Manuals: https://www.mmis.georgia.gov/portal/PubAccess.Provider%20Information/Provider%20Manuals/tabId/54/Default.aspx

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