Georgia - Personal Emergency Response System — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-09

The Georgia Department of Community Health (DCH) funds Personal Emergency Response System (PERS) services primarily through the Elderly and Disabled Waiver Program (EDWP), which encompasses the Community Care Services Program (CCSP) and Service Options Using Resources in a Community Environment (SOURCE) waivers. Providers supply installed or wearable electronic monitoring devices connected to a 24-hour response center to ensure the safety of waiver participants who live alone or are at high risk of falls.

Georgia does not issue a distinct healthcare facility license for PERS providers through its Healthcare Facility Regulation division. Instead, the mandatory structural precondition for operating is completing the state-mandated CCSP Provider Pre-Enrollment Training before an application can even be submitted. Following this training, applicants must submit a fee-for-service Medicaid enrollment application through the Georgia Medicaid Management Information System (GAMMIS) and pass primary source verification through Verisys, the state's designated Credentialing Verification Organization (CVO).

1. Service Definition and Scope

In Georgia Medicaid waiver programs, a Personal Emergency Response System (PERS) is defined as an electronic device that enables individuals at high risk of institutionalization to secure help in an emergency. The system connects to the participant's telephone line or operates via cellular signal, routing emergency calls to a 24-hour response center.

The service scope includes the initial delivery, installation, and testing of the equipment, as well as ongoing monthly monitoring. Providers are responsible for ensuring the equipment functions correctly, replacing defective units, and maintaining active communication protocols with local emergency services and the participant's designated emergency contacts.

• Target Population: Medicaid waiver participants who live alone, are alone for significant parts of the day, or have no regular caregiver and are at risk of falls or medical emergencies.
• Equipment Standards: Devices must be Underwriters Laboratories (UL) approved and comply with Federal Communications Commission (FCC) regulations.
• Response Center: Must operate 24 hours a day, 7 days a week, 365 days a year with trained dispatch staff.
• Maintenance: Providers must repair or replace defective equipment within 24 hours of notification.
• Testing: Systems must be tested monthly to ensure continuous connectivity and functionality.

2. Regulatory and Oversight Agencies

The Georgia Department of Community Health (DCH) serves as the single state Medicaid agency, overseeing provider enrollment, credentialing, and claims payment through its Medical Assistance Plans division. DCH contracts with a centralized Credentialing Verification Organization to vet all incoming providers.

The Georgia Department of Human Services (DHS), Division of Aging Services (DAS), operates the Community Care Services Program (CCSP) on behalf of DCH. DAS manages the pre-enrollment training requirements and ongoing programmatic compliance for CCSP waiver providers.

• Georgia Department of Community Health (DCH): Administers Medicaid and oversees provider enrollment (https://dch.georgia.gov/).
• Georgia Medicaid Management Information System (GAMMIS): The official portal for provider enrollment and claims (https://www.mmis.georgia.gov/).
• DHS Division of Aging Services (DAS): Manages the CCSP waiver program and provider training (https://aging.georgia.gov/).
• Verisys: The NCQA-certified Credentialing Verification Organization (CVO) contracted by DCH to perform primary source verification (https://verisys.com/).

3. Gatekeeping Prerequisites: Who Can Even Apply

Georgia does not require a Certificate of Need (CON) or a specific state healthcare license to operate as a PERS provider. There are no closed networks or moratoria currently blocking new PERS applicants in the fee-for-service waiver programs.

The mandatory structural precondition for CCSP waiver participation is attendance at the CCSP Provider Pre-Enrollment Training. DCH and DAS will not process a Medicaid enrollment application for CCSP services unless the applicant holds a valid certificate of completion from this training.

• Pre-Enrollment Training: Mandatory attendance at the CCSP Provider Pre-Enrollment Training hosted by the Division of Aging Services.
• National Provider Identifier (NPI): Applicants must obtain an active NPI from the NPPES registry before applying.
• Business Licensure: Must hold a valid local city or county business license/occupational tax certificate in Georgia.
• Out-of-State Providers: Out-of-state monitoring centers may apply if they meet all equipment and response standards and hold appropriate business registration to operate in Georgia.

4. Licensure and Certification Requirements

Because PERS is an equipment and monitoring service rather than direct hands-on medical care, the DCH Healthcare Facility Regulation (HFR) division does not issue a specific license for this provider type. Providers operate under standard commercial business regulations.

Instead of a state facility license, the state relies on national equipment certifications and Medicaid credentialing standards. The monitoring center must utilize equipment that meets strict safety and telecommunications standards.

• HFR Exemption: No state facility license is required from the DCH Healthcare Facility Regulation division.
• UL Certification: All PERS base units and wearable buttons must be Underwriters Laboratories (UL) listed for home healthcare signaling equipment.
• FCC Compliance: Equipment must comply with Part 15 and Part 68 of the Federal Communications Commission (FCC) rules.
• Secretary of State Registration: Corporate entities must be registered and in good standing with the Georgia Secretary of State.

5. Medicaid Provider Enrollment

Prospective providers must submit their enrollment application online through the GAMMIS portal using the Enrollment Wizard. The application serves as a single source for fee-for-service Medicaid enrollment.

Once submitted, the application is routed to Verisys, the state's CVO, which conducts a formal review of qualifications, background checks, and ownership disclosures. Providers must respond promptly to any requests for additional documentation from the CVO to avoid application abandonment.

• GAMMIS Portal: All applications must be initiated through the Provider Enrollment menu at https://www.mmis.georgia.gov/.
• Provider Type: Applicants must select the appropriate atypical or waiver provider type designated for CCSP/SOURCE emergency response services.
• Application Fee: Providers must pay the federal Medicaid/Medicare application fee (unless waived due to prior Medicare enrollment) during the GAMMIS process.
• Ownership Disclosure: Complete disclosure of all individuals or entities with 5% or more ownership or controlling interest is required per 42 CFR Part 455.
• CVO Credentialing: Verisys performs primary source verification of all business documents and liability insurance.

6. Staffing, Training and Background Checks

While PERS providers do not deploy nursing staff, they must maintain strict standards for the personnel who install the equipment in participants' homes and the dispatchers who answer emergency calls.

All staff interacting with waiver participants or their data must undergo criminal background checks. Response center staff must be trained in emergency triage, communicating with elderly and disabled populations, and coordinating with Georgia's local 911 dispatch centers.

• Background Checks: State and national fingerprint-based criminal background checks are required for all staff entering participant homes.
• Dispatcher Training: Response center personnel must complete documented training on emergency protocols and waiver participant communication.
• Installer Identification: Field staff must wear clear, visible photo identification badges when visiting a participant's home for installation or maintenance.
• Language Access: The response center must have protocols or translation services available to assist non-English speaking participants.

7. Documentation, Policies and Records

PERS providers must maintain comprehensive records of equipment deployment, testing, and emergency incidents. These records are subject to audit by DCH, DAS, or their designated care management agencies.

Providers must execute a written agreement with each participant detailing how the system works, the participant's responsibilities for testing, and the provider's maintenance obligations.

• Participant Agreement: A signed document outlining service terms, emergency contacts, and equipment care instructions.
• Installation Logs: Records documenting the date of installation, equipment serial numbers, and the participant's signature confirming receipt and training.
• Monthly Testing Records: Automated or manual logs proving that each deployed unit is tested at least once a month.
• Incident Reports: Detailed logs of every emergency button press, including the time of the call, the dispatcher's action, and the outcome.
• Record Retention: All Medicaid service and billing records must be retained for a minimum of five years.

8. Billing, Rates and Claims

PERS services are billed directly to Georgia Medicaid through the GAMMIS portal using standard HCPCS codes. Services must be prior-authorized by the participant's waiver case manager before installation occurs.

Reimbursement is divided into a one-time installation fee and a recurring monthly monitoring fee. Providers cannot bill for the monthly service if the equipment was non-functional or if the participant was institutionalized for the entire month.

• Prior Authorization: A valid prior authorization from the CCSP or SOURCE case management agency is required before billing.
• Installation Code: Billed using HCPCS code S5160 (Emergency response system; installation and testing).
• Monthly Monitoring Code: Billed using HCPCS code S5161 (Emergency response system; service fee, per month).
• Claim Submission: Claims are submitted electronically via the GAMMIS portal or through an approved clearinghouse.
• Rate Publication: Current fee schedules are published quarterly on the GAMMIS portal under the Provider Information section.

9. Approval Sequence and Timeline

The approval process begins with securing a spot in the CCSP Provider Pre-Enrollment Training, which is offered periodically by the Division of Aging Services. After completing the training, the provider gathers their business licenses and equipment certifications.

The provider then submits the GAMMIS application. The CVO credentialing process typically takes 45 to 90 days, depending on the completeness of the application and the speed of background check returns. Once approved, DCH issues a Medicaid Provider Number.

• Step 1: Attend the mandatory CCSP Provider Pre-Enrollment Training.
• Step 2: Obtain an NPI and secure local business licenses.
• Step 3: Submit the online enrollment application and pay the fee via GAMMIS.
• Step 4: Upload all required documents for Verisys CVO review.
• Step 5: Receive the Medicaid Provider Number and welcome letter via the GAMMIS portal.

10. Common Denials and Survey Findings

Medicaid enrollment applications are frequently denied or delayed due to administrative errors, such as failing to upload the CCSP training certificate or providing incomplete ownership disclosures.

During post-enrollment audits, providers most commonly face recoupment of funds for failing to document monthly equipment tests or failing to repair defective units within the required 24-hour timeframe.

• Missing Training Certificate: Application rejected if the CCSP Pre-Enrollment Training certificate is not attached.
• Incomplete Disclosures: Delays caused by failing to list all board members or owners with 5% or more interest.
• Lapsed Testing: Audit findings for missing documentation of the required monthly system tests.
• Delayed Maintenance: Citations for failing to replace broken equipment within 24 hours of a participant's report.
• Missing Prior Authorization: Claims denied because the provider billed before the case manager authorized the service.

11. Key Contacts and Resources

Providers should utilize the official state portals for all enrollment and billing activities. The GAMMIS website is the central hub for Medicaid interactions, while the Division of Aging Services provides waiver-specific guidance.

For credentialing status updates, providers can check the GAMMIS portal or contact the HP Provider Call Center.

• Georgia Medicaid Management Information System (GAMMIS): https://www.mmis.georgia.gov/
• Georgia Department of Community Health (DCH) Providers Page: https://dch.georgia.gov/providers
• DHS Division of Aging Services (DAS): https://aging.georgia.gov/
• Verisys (CVO Information): https://verisys.com/
• HP Provider Call Center: 1-800-766-4456 (for GAMMIS and credentialing inquiries).

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