Georgia - Speech & Language Service — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-09

The Georgia Department of Community Health (DCH) and the Department of Behavioral Health and Developmental Disabilities (DBHDD) administer Speech and Language Services through the state plan and the NOW and COMP Medicaid waivers. Providers must first obtain a Speech-Language Pathologist license from the Georgia State Board of Speech-Language Pathology and Audiology before applying for Medicaid enrollment through the GAMMIS portal.

Approval requires passing a nationwide fingerprint background check mandated by O.C.G.A. 43-44-6(a)(14) and completing centralized Credentialing Verification Organization (CVO) review for any Care Management Organization (CMO) participation. Agencies employing SLPs to serve waiver participants must secure a DBHDD Letter of Approval prior to initiating the DCH Medicaid enrollment process.

1. Service Definition and Scope

In Georgia, Speech and Language Services encompass the evaluation, diagnosis, and treatment of communication, cognitive, and swallowing disorders. Under the NOW and COMP waivers, these services are categorized as Adult Speech Therapy Services and are designed to maintain or improve functional abilities for individuals with intellectual and developmental disabilities.

Services must be medically necessary and ordered by a physician. Providers deliver interventions in clinical settings, homes, or community environments depending on the specific Medicaid program or waiver authorization.

• Target Population: Medicaid beneficiaries and NOW/COMP waiver participants requiring communication or swallowing interventions.
• Covered Modalities: Expressive and receptive language therapy, augmentative and alternative communication (AAC) evaluations, and dysphagia treatment.
• Waiver Service Name: Adult Speech Therapy Services (under NOW/COMP).
• Exclusions: Services deemed strictly educational or experimental are not reimbursable under Georgia Medicaid.

2. Regulatory and Oversight Agencies

The Georgia Secretary of State's Professional Licensing Boards Division issues the foundational professional license. The Department of Community Health (DCH) manages Medicaid enrollment, while the Department of Behavioral Health and Developmental Disabilities (DBHDD) oversees waiver-specific provider networks.

Care Management Organizations (CMOs) manage benefits for specific Medicaid populations and require centralized credentialing through the state's designated vendor.

• Licensing Board: Georgia State Board of Speech-Language Pathology and Audiology (https://sos.ga.gov/board-speech-pathology-and-audiology).
• Medicaid Authority: Georgia Department of Community Health (https://dch.georgia.gov).
• Waiver Administrator: Department of Behavioral Health and Developmental Disabilities (https://dbhdd.georgia.gov).
• Enrollment Portal: Georgia Medicaid Management Information System (GAMMIS) (https://www.mmis.georgia.gov).
• CMO Credentialing: Centralized CVO via GAMMIS (https://www.mmis.georgia.gov).

3. Gatekeeping Prerequisites: Who Can Even Apply

Georgia requires individual practitioners to hold an active, unencumbered state license before initiating Medicaid enrollment. For providers intending to bill under the NOW/COMP waivers, DBHDD network enrollment is a strict prerequisite; DCH will reject waiver Medicaid applications lacking DBHDD pre-approval.

Organizational providers must establish a physical operating location in Georgia. Virtual offices or P.O. Boxes are explicitly prohibited for practice locations and will trigger immediate application rejection.

• Professional Licensure: Active Georgia SLP license required prior to GAMMIS application.
• Waiver Pre-Approval: DBHDD Letter of Approval required for NOW/COMP waiver provider enrollment.
• NPI Requirement: Type 1 NPI for individuals and Type 2 NPI for organizational providers must be active on the NPPES registry.
• Location Requirement: Must possess a physical operating location; virtual addresses trigger GAMMIS rejection.

4. Licensure and Certification Requirements

The Georgia State Board of Speech-Language Pathology and Audiology licenses SLPs via Examination, Endorsement, or ASHA Certification (CCC-SLP). Applicants must submit a notarized application, official transcripts, and proof of clinical experience or ASHA certification.

All applicants must undergo a nationwide fingerprint background check. Incomplete applications are administratively withdrawn after 60 days, requiring a new application and fee.

• Application Fee: $120 (includes a $10 mail-in processing fee).
• Statutory Authority: O.C.G.A. Title 43, Chapter 44.
• ASHA Pathway: Submission of ASHA Verification of Certification (CCC-SLP) bypasses separate clinical experience documentation.
• Endorsement Pathway: Requires direct license verification from all states where the applicant holds or held a license.
• Continuing Education: Proof of CE compliance required for license renewal.

5. Medicaid Provider Enrollment

Providers enroll through the GAMMIS portal using the Enrollment Wizard. DCH classifies outpatient therapy clinics as Moderate Risk, requiring site visits, while individual practitioners are typically Limited Risk.

Upon submission, GAMMIS generates an Application Tracking Number (ATN) used for all status inquiries. Georgia mandates a strict 3-year re-enrollment cycle for all Medicaid providers.

• System of Record: GAMMIS Enrollment Wizard.
• Application Tracking: GAMMIS generates an Application Tracking Number (ATN) required for all status inquiries.
• Risk Classification (Individuals): Limited Risk, requiring license verification, OIG LEIE, and SAM.gov checks.
• Risk Classification (Clinics): Moderate Risk, requiring unannounced pre-enrollment or post-enrollment site visits.
• Application Fee: $750 for institutional providers (physicians and non-physician practitioners are exempt).
• Re-enrollment Cycle: Georgia mandates Medicaid re-enrollment every 3 years.

6. Staffing, Training and Background Checks

Georgia law mandates strict background screening for all licensed SLPs. Waiver providers must also complete DBHDD-specific training modules regarding incident reporting and participant rights.

Agencies must continuously monitor staff against federal exclusion databases to ensure Medicaid compliance.

• Fingerprint Mandate: Nationwide fingerprint background check required under O.C.G.A. 43-44-6(a)(14).
• Ownership Screening: 5% or greater owners of High-Risk agencies require fingerprint-based criminal background checks.
• Waiver Training: DBHDD requires completion of Relias learning modules for NOW/COMP providers.
• Exclusion Checks: Monthly screening against OIG LEIE and SAM.gov required for all billing staff.

7. Documentation, Policies and Records

DCH and DBHDD require comprehensive documentation to support medical necessity and service delivery. Records must align exactly with the provider's GAMMIS profile and state licensing records.

Providers must maintain a master credentialing file and update GAMMIS with any demographic or licensure changes using the Change of Information Form.

• Credentialing File: License name, number, and expiration date must exactly match Georgia state records on the GAMMIS application.
• Corporate Documents: W-9 form, Articles of Incorporation, and Ownership and Controlling Interest Disclosure (42 CFR 455.104).
• Clinical Records: Must include physician orders, comprehensive SLP evaluations, and individualized treatment plans.
• Record Retention: Medicaid records must typically be retained for a minimum of five years from the date of service.

8. Billing, Rates and Claims

SLP services are billed using standard CPT codes for evaluation and therapeutic interventions. Claims are submitted directly to DCH via GAMMIS for Fee-For-Service or to the respective Care Management Organizations (CMOs) for managed care members.

Prior authorization is required for most therapeutic interventions beyond the initial evaluation.

• Billing Portal: GAMMIS for FFS claims; individual CMO portals for managed care claims.
• Common Codes: 92521-92524 for evaluations; 92507 for speech/language treatment.
• Prior Authorization: Required for most therapeutic interventions beyond the initial evaluation via the Georgia Medicaid centralized PA system.
• Taxonomy Match: Provider taxonomy code on claims must match the specialty designation on the GAMMIS application.

9. Approval Sequence and Timeline

The end-to-end process begins with professional licensure, followed by DBHDD approval (if applicable), and concludes with DCH Medicaid enrollment and CMO credentialing. Timelines vary based on risk level and application completeness.

Individual practitioners typically experience faster processing times compared to organizational providers requiring site visits.

• Licensure Processing: Varies, but incomplete applications are withdrawn after 60 days.
• FFS Enrollment: Limited risk individual practitioner applications typically process within 15 business days.
• Site Visits: Moderate risk providers face variable delays pending unannounced site visits.
• Welcome Packet: Welcome Letter and PIN Letter arrive 5 to 7 business days post-approval.
• CMO Credentialing: Centralized CVO credentialing adds additional processing time before network participation begins.

10. Common Denials and Survey Findings

Application rejections frequently stem from data mismatches between state licensing boards, NPPES, and GAMMIS. Post-enrollment, providers face recoupments for failing to maintain active prior authorizations or lapsing on re-validation.

Failure to respond to site visit requests or background check instructions promptly will result in application denial.

• Name Mismatches: GAMMIS rejections occur when the license name does not exactly match state records.
• TIN Errors: W-9 Tax Identification Number mismatches cause federal database verification failures.
• Address Errors: Using a P.O. Box or virtual address instead of a physical operating location triggers denial.
• Lapsed Re-enrollment: Failure to complete the 3-year re-enrollment cycle results in Medicaid Provider Number deactivation.
• Background Check Delays: Failure to register for the fingerprint check promptly stalls Board licensure.

11. Key Contacts and Resources

Providers must utilize official state portals and contact centers for application tracking and policy updates. The GAMMIS portal and the Secretary of State's website are the primary hubs for SLP providers.

The Application Tracking Number (ATN) is required for all status inquiries with the Medicaid Call Center.

• Georgia State Board of Speech-Language Pathology and Audiology: 404-424-9966, https://sos.ga.gov/board-speech-pathology-and-audiology
• GAMMIS Provider Portal: https://www.mmis.georgia.gov
• Gainwell Technologies (Medicaid Call Center): 1-800-766-4456
• Georgia Department of Community Health (DCH): https://dch.georgia.gov
• Department of Behavioral Health and Developmental Disabilities (DBHDD): https://dbhdd.georgia.gov

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