Georgia Medicaid Telehealth Coverage (2026): DEA Rule, Audio-Only, RPM

Telehealth coverage inside Georgia Medicaid did not begin with the COVID-19 pandemic, but it changed permanently because of it. Before March 2020, Medicaid telehealth in Georgia existed as a narrow set of synchronous video visits delivered mostly from rural clinics to academic medical centers. After March 2020, federal flexibilities reshaped what was possible, and after the public health emergency ended, Congress, the Centers for Medicare and Medicaid Services (CMS), the Drug Enforcement Administration (DEA), the Substance Abuse and Mental Health Services Administration (SAMHSA), and the Georgia Department of Community Health (DCH) made permanent a substantial subset of those flexibilities. The current state of Georgia Medicaid telehealth coverage is broader than it has ever been, more permissive on audio-only visits than it has ever been, and more flexible on originating sites than it has ever been. This guide explains the federal framework, Georgia's statutes and DCH policies, the three Care Management Organizations that administer Medicaid managed care, the modalities of telehealth covered, the service categories that telehealth supports, the DEA Final Rule of 2024 on controlled substance prescribing, the interstate licensure compacts that enable cross-state practice, and the practical steps members and providers need to follow to access telehealth visits.

Why This Guide Exists

For families navigating eldercare, chronic disease management, behavioral health treatment, prenatal care, pediatric care, and substance use recovery, understanding what Georgia Medicaid telehealth covers and how to access it is no longer optional. It is one of the principal ways Georgia Medicaid members receive care. This guide translates the federal statutory and regulatory framework, the Georgia statutes and DCH policies, the three Care Management Organizations, the modalities of telehealth covered (audio-video synchronous, audio-only telephone, store-and-forward asynchronous, remote patient monitoring), the service categories telehealth supports (primary care, behavioral health, substance use disorder treatment, maternal health, pediatrics, geriatrics, specialty consults, tele-stroke, tele-NICU, tele-psychiatry, school-based telehealth), the controlled substance prescribing rules under the DEA Final Rule of 2024, and the interstate licensure compacts that enable cross-state practice. Six worked examples illustrate how the rules apply to real Georgia Medicaid members.

The Federal Telehealth Framework

Medicare's Section 1834(m) Origin Point

The original federal telehealth payment framework was created in 2000 by the Balanced Budget Refinement Act, which added Section 1834(m) to the Social Security Act. Section 1834(m) authorized Medicare to pay for telehealth services delivered via real-time audio-video communication when the patient was physically present at an approved originating site, typically a physician office, hospital, Critical Access Hospital, rural health clinic, federally qualified health center, dialysis center, skilled nursing facility, or community mental health center. The patient had to be located in a rural Health Professional Shortage Area or a county outside a Metropolitan Statistical Area. The distant site provider had to be a physician, physician assistant, nurse practitioner, clinical nurse specialist, certified registered nurse anesthetist, certified nurse midwife, clinical psychologist, clinical social worker, registered dietitian, or nutrition professional, depending on the service.

CMS implemented Section 1834(m) through regulations that set the definitions, originating site rules, distant site provider list, and the annual telehealth code list. CMS publishes an updated Medicare telehealth services list each year through the Physician Fee Schedule rulemaking process. The Medicare Improvements for Patients and Providers Act of 2008 expanded the originating site list and added geographic flexibility for certain services. The Bipartisan Budget Act of 2018 further expanded telehealth for end-stage renal disease, acute stroke evaluation, and Medicare Advantage plan flexibility. The 21st Century Cures Act of 2016 included telehealth provisions and directed CMS to study additional flexibility.

For most of the period from 2000 through 2019, Medicare telehealth grew slowly. The originating-site restrictions and limited code list meant that telehealth represented a small share of Medicare claims. That changed with the COVID-19 public health emergency.

The CARES Act and COVID-19 Public Health Emergency

The Coronavirus Aid, Relief, and Economic Security Act of 2020 (CARES Act) contained sweeping telehealth provisions for Medicare. Provisions waived the Section 1834(m) geographic and originating-site restrictions for the duration of the public health emergency, allowing patients to receive telehealth from any location including their home. Federally qualified health centers and rural health clinics were permitted to serve as distant site providers, and audio-only telehealth was permitted for the first time at federal level for a range of services.

CMS issued a State Health Official Letter outlining Medicaid telehealth flexibilities during the COVID-19 public health emergency. Most states, including Georgia, adopted broad expansion of audio-video and audio-only telehealth immediately. The HHS Office for Civil Rights announced enforcement discretion for HIPAA-noncompliant telehealth platforms during the PHE, allowing providers to use consumer applications like Zoom, FaceTime, and Skype to deliver care. That enforcement discretion expired in 2023.

Medicaid utilization of telehealth surged in 2020 and 2021. Behavioral health and substance use disorder treatment in particular shifted heavily to telehealth as patients faced barriers to in-person care. Audio-only telephone visits became the dominant modality for many primary care follow-up and behavioral health visits, particularly for older adults, low-income patients without reliable broadband, and rural patients without video-capable devices.

Permanent Extensions After the Public Health Emergency

The Consolidated Appropriations Act of 2023 extended Medicare telehealth flexibilities and made permanent several flexibilities: tele-mental health services from the patient's home, hospice telehealth recertification, and audio-only behavioral health from the patient's home. The Consolidated Appropriations Act of 2024 extended remaining Medicare telehealth flexibilities into 2025. Subsequent extension activity has continued; consult the current CMS Medicare Telehealth list and congressional action for the operative expiration windows for non-permanent flexibilities.

In Medicaid, the picture is different. Medicaid telehealth has always been more flexible than Medicare telehealth because federal Medicaid statute does not specifically mention telehealth. CMS has treated telehealth as a delivery mode rather than a distinct service, granting states broad flexibility under their State Plans to cover telehealth. The CMS State Medicaid Director Letter from December 2018 clarified this flexibility and encouraged states to use telehealth for expanded access. Georgia DCH used this flexibility to adopt and then retain expansive telehealth coverage post-PHE.

Controlled Substances and the Ryan Haight Act

The Ryan Haight Online Pharmacy Consumer Protection Act of 2008 generally requires an in-person evaluation before controlled substance prescribing via telemedicine, with several enumerated exceptions including a Special Registration framework for telemedicine controlled substance prescribing.

During the COVID-19 public health emergency, the DEA waived the in-person evaluation requirement for all Schedule II through V controlled substances. Practitioners could initiate buprenorphine for opioid use disorder, stimulants for ADHD, and other controlled substances without ever seeing the patient in person, provided they conducted a synchronous audio-video evaluation. This flexibility expanded access to medications for opioid use disorder dramatically.

The Mainstreaming Addiction Treatment (MATE) Act, included in the Consolidated Appropriations Act of 2023, eliminated the DEA X-waiver requirement for buprenorphine prescribing. Before the MATE Act, practitioners had to complete training and obtain a special DEA registration (the X-waiver) to prescribe buprenorphine for opioid use disorder. After the MATE Act, any DEA-registered practitioner with Schedule III prescribing authority can prescribe buprenorphine for OUD without additional special registration.

The DEA Final Rule of 2024 on Telemedicine Controlled Substances

The DEA Final Rule of 2024, published in late 2024 with phased implementation through 2025, made permanent a substantial subset of the COVID-era telemedicine flexibilities for controlled substances. The Final Rule establishes:

• Audio-video buprenorphine initiation: Permanent. Any DEA-registered practitioner with Schedule III authority can initiate buprenorphine for opioid use disorder via audio-video telemedicine without a prior in-person evaluation.
• Audio-only buprenorphine maintenance: Permanent for established patients (patients with a prior in-person evaluation or audio-video evaluation with the prescribing practitioner or another practitioner in the same practice).
• Schedule III through V controlled substances: May be prescribed via audio-video telemedicine with state law compliance.
• Schedule II controlled substances (stimulants, oxycodone, etc.): Generally require in-person evaluation before telehealth prescribing, with limited exceptions for OUD-specific medications.
• Patient location: Must be physically in the United States at the time of the telemedicine visit. Cross-border prescribing is generally prohibited.
• Pharmacy verification: Pharmacies must verify the prescription and the practitioner's authority; patient identification is verified through standard pharmacy ID requirements.

The SAMHSA Final Rule of 2024 revising 42 CFR Part 8 made permanent a parallel framework for methadone in Opioid Treatment Programs: audio-video initiation is permitted, and audio-only is permitted for established patients when audio-video is unavailable.

Federal Interstate Licensure Compacts

Telehealth crosses state lines in ways that traditional in-person care does not. A psychologist licensed only in Georgia cannot provide ongoing therapy to a patient who has temporarily moved to Florida unless the psychologist holds a Florida license or is operating under a compact authority. The federal interstate licensure compacts solve this problem for several professions:

• Interstate Medical Licensure Compact (IMLC): Provides expedited licensure for physicians and physician assistants. A physician applies to the IMLC Commission, designates a State of Principal License, and can obtain expedited licenses in other compact states.
• Nurse Licensure Compact (NLC): Provides a multi-state license for registered nurses and licensed practical nurses. A nurse with a primary residency in a compact state holds a multi-state license valid across all compact states.
• PSYPACT (Psychology Interjurisdictional Compact): Enables telehealth and temporary in-person practice for psychologists across participating states.
• Counseling Compact: Enables multi-state practice for Licensed Professional Counselors.
• Social Work Licensure Compact: Ratified across initial member states, with activation depending on Commission rulemaking.
• Audiology and Speech-Language Pathology Interstate Compact (ASLP-IC): For audiologists and speech-language pathologists.
• Physical Therapy Compact (PT Compact): For physical therapists and physical therapist assistants.
• Occupational Therapy Licensure Compact (OT Compact): For occupational therapists and occupational therapy assistants.

For Georgia Medicaid members, the practical consequence is that providers in compact-member states can serve Georgia patients via telehealth more easily than non-compact providers. This matters especially for specialty consults like child psychiatry, where the workforce is concentrated in a few states. For current member-state counts, check each compact's commission page.

HIPAA, Privacy, and Security

The Health Insurance Portability and Accountability Act (HIPAA) governs the privacy and security of protected health information. Telehealth platforms must comply with HIPAA, including end-to-end encryption, access controls, audit trail, and Business Associate Agreements between providers and platform vendors. OCR enforcement discretion during the COVID-19 PHE allowed providers to use consumer platforms like Zoom Free and FaceTime; that discretion ended in 2023. Providers must now use HIPAA-compliant platforms. Georgia also has state privacy protections, and recording a telehealth visit without consent violates Georgia's two-party consent rule.

Georgia Medicaid Telehealth Framework

Statutory Authorities

Georgia's telehealth practice is governed primarily by the Georgia Medical Practice Act provisions on telemedicine, a coverage parity statute that requires state-regulated commercial insurers to cover telehealth services on the same basis as in-person services, and the Georgia Telemedicine Act, which established statutory definitions and standards for telehealth practice including remote patient monitoring. The parity statute does not bind self-insured ERISA plans, but it does bind state-regulated individual and group health insurance plans. Medicaid follows similar parity in DCH policy. For the operative Georgia code citations and effective dates, consult the current Georgia Composite Medical Board Rule on telemedicine and the Georgia General Assembly telehealth statutes.

Regulatory Implementation

The Georgia Composite Medical Board adopted a rule governing telemedicine. The rule requires that the physician-patient relationship be established with informed consent, that the standard of care be maintained, and that prescribing through telemedicine comply with applicable law including the federal Ryan Haight Act and DEA rules. The Georgia Board of Nursing issued telehealth rules covering Advanced Practice Registered Nurses, Registered Nurses, and Licensed Practical Nurses. APRN prescriptive authority via telehealth is permitted within the APRN's scope of practice and protocol agreement with a delegating physician. The Georgia Board of Pharmacy issued rules for telepharmacy and remote dispensing.

DCH publishes the Medicaid Telehealth Provider Manual, which sets coverage rules, billable codes, place-of-service requirements, modifiers, and reimbursement rates for Medicaid telehealth. The Department of Behavioral Health and Developmental Disabilities (DBHDD) publishes its own Telehealth Policy governing behavioral health and SUD telehealth.

Managed Care Implementation

Georgia Medicaid managed care is administered through three Care Management Organizations: Amerigroup Community Care, CareSource, and Peach State Health Plan. WellCare is no longer a separate Georgia Families Medicaid CMO; a 2024 reprocurement proposing a different slate is in a bid-protest phase with no announced go-live date, and the current three-CMO contracts have reportedly been extended through about June 30, 2027. A substantial majority of Georgia Medicaid members are enrolled in one of these three CMOs (the exception is the Aged, Blind, and Disabled fee-for-service population and certain other carve-outs). All three CMOs cover telehealth across the same scope as Georgia Medicaid fee-for-service. Each CMO maintains a provider directory that identifies telehealth-enabled clinicians, and each operates a 24/7 nurse advice line that members can use to triage symptoms and connect to a telehealth provider.

Telehealth Modalities Covered Under Georgia Medicaid

Audio-Video Synchronous (Live)

Audio-video synchronous telehealth replicates the in-person visit through real-time video. The provider sees and hears the patient, and the patient sees and hears the provider. This is the standard modality for most telehealth visits and is covered across primary care, behavioral health, substance use treatment, specialty consults, prenatal care, pediatric care, geriatric care, and urgent care. Place-of-service code 02 (telehealth provided other than in the patient's home) or 10 (telehealth provided in the patient's home) is appended to the claim, along with modifier 95 to indicate synchronous telehealth.

Audio-Only Telephone

Audio-only telephone visits are a smaller share of telehealth coverage but are critical for patients without reliable broadband, video-capable devices, or comfort with video technology. Audio-only telehealth has been particularly important for older adults, rural patients, and low-income patients. Pre-COVID audio-only coverage was limited; during the public health emergency it expanded broadly. The 2024 federal and state rules made audio-only permanent for behavioral health, substance use disorder treatment (especially buprenorphine maintenance), and limited primary care follow-up with established patients. Modifier 93 is typically appended to indicate audio-only delivery. Documentation must demonstrate that audio-video was unavailable or that the patient declined video.

Store-and-Forward (Asynchronous)

Store-and-forward telehealth captures information (image, video, document) and transmits it asynchronously for later review by a provider. Georgia Medicaid coverage is limited to specific specialties: teledermatology for skin lesion review, teleophthalmology for diabetic retinopathy screening, telepathology for slide interpretation, and teleradiology for imaging interpretation. E-consult, the interprofessional consultation model where a primary care physician sends a clinical question to a specialist for asynchronous review, is increasingly covered for cardiology, endocrinology, infectious disease, and rheumatology consults.

Remote Patient Monitoring

Remote Patient Monitoring uses connected devices (blood pressure cuff, glucometer, scale, pulse oximeter, peak flow meter) that transmit data to the provider for review. RPM is reimbursed through a set of CMS Physician Fee Schedule codes covering initial setup and patient education, device-supply with daily recordings or programmed alert transmissions billed per 30-day period (with a minimum-data threshold), and treatment management services per calendar month (clinician review, communication with the patient, treatment modification). Consult the current CMS Physician Fee Schedule for the operative billing codes, time increments, and minimum-data threshold. The provider must establish the order, interpret the data, and use it for clinical decision-making. RPM is most commonly used for hypertension, diabetes, heart failure, COPD, obesity, and postpartum hypertension. Georgia Medicaid CMOs cover RPM, sometimes with prior authorization depending on the plan.

Mobile Health (mHealth)

App-based health management has limited Medicaid coverage in Georgia. Some CMOs offer connected wellness programs through partnerships with vendors, but these are not stand-alone covered benefits.

Georgia Medicaid Telehealth Service Categories

Primary Care

Telehealth in primary care covers chronic disease management (diabetes, hypertension, asthma, COPD), medication management, lab follow-up, care planning, and acute visits for upper respiratory infections, conjunctivitis, urinary tract infections, and rashes. Annual wellness visits generally require an in-person component for vitals and physical exam, but the bulk of follow-up between annual visits can be delivered via telehealth.

Behavioral Health

Telehealth in behavioral health includes psychotherapy, psychiatric diagnostic evaluation, medication management, family therapy, crisis intervention, and group therapy. Audio-video and audio-only are both covered. Tele-psychiatry is particularly important in Georgia given the state's behavioral health workforce shortage and the geographic concentration of psychiatrists in Atlanta and the major urban areas.

Substance Use Disorder and Medication-Assisted Treatment

Substance use disorder treatment via telehealth includes buprenorphine for opioid use disorder (audio-video initiation and audio-only maintenance under the DEA Final Rule of 2024), methadone in Opioid Treatment Programs (audio-video initiation and audio-only maintenance for established patients under SAMHSA's 2024 rule revising 42 CFR Part 8), naltrexone XR injection (telehealth assessment plus in-person injection), counseling and group therapy (audio-video and audio-only), and ASAM-based level-of-care assessments. DBHDD and all three Medicaid CMOs cover SUD telehealth broadly.

Maternal Health

Maternal telehealth includes alternating in-person and telehealth prenatal visits per ACOG guidance for low-risk pregnancy, postpartum visits delivered via telehealth (especially during the 12-month postpartum Medicaid coverage period), tele-lactation consultation with International Board Certified Lactation Consultants, postpartum hypertension monitoring with home blood pressure cuffs and RPM, and tele-mental health for postpartum depression screening and treatment.

Pediatric Care

Well-child visits generally require in-person components for vaccines, growth measurement, and physical exam. Telehealth supplements these visits with behavioral telehealth (especially tele-child-psychiatry, which is critical given the workforce shortage), chronic disease management (asthma, ADHD, diabetes, eczema), and tele-school-based services through School-Based Health Centers and IDEA Part B programs.

Geriatric Care

Telehealth for older adults includes tele-cardiology, tele-endocrinology, tele-rheumatology, telehealth in assisted living facilities and nursing homes (with the facility serving as originating site and the specialist at the distant site), tele-dementia consults at memory clinics, and tele-palliative consultation. The Georgia Medicaid Aged-Blind-Disabled population uses telehealth heavily for specialty consults given the long distances many rural older adults must travel for in-person specialist care.

Tele-Stroke

Tele-stroke is one of the most established and clinically critical telehealth applications. An acute stroke alert at a rural emergency department triggers a tele-stroke consult with a vascular neurologist at a Comprehensive Stroke Center. The neurologist evaluates the patient via audio-video, reviews CT imaging shared electronically, assesses the NIH Stroke Scale, and recommends or contraindicates tissue plasminogen activator (tPA, alteplase) administration. tPA must be administered within the current AHA/ASA-defined time window from last known well; consult current AHA/ASA stroke guidelines for the operative time window and door-to-needle benchmark. Georgia's stroke network includes Comprehensive Stroke Centers at Grady Memorial Hospital, Emory University Hospital, Augusta University Medical Center, Memorial Health (Savannah), Northeast Georgia Medical Center (Gainesville), and WellStar Kennestone Hospital (Marietta), along with Primary Stroke Centers and Acute Stroke Ready Hospitals across the state.

Tele-NICU and Tele-ICU

Tele-NICU provides audio-video consultation between a community hospital nursery and a Level III or IV neonatal intensive care unit. It is used for resuscitation guidance, stabilization decisions, and transfer planning for premature or critically ill newborns. Tele-ICU programs provide adult critical care monitoring and consultation.

School-Based Telehealth

School-Based Health Centers partner with Medicaid CMOs to deliver primary care, behavioral health, and EPSDT screening directly inside Georgia schools. IDEA Part B services (speech-language therapy, occupational therapy, physical therapy, behavioral services) are delivered via telehealth where clinically appropriate. The CMS State Medicaid Director Letter from December 2014, known as the Free Care Reversal, authorized federal Medicaid match for services delivered in schools regardless of whether the service is also provided free to the general population.

Other Specialty Applications

Tele-dental services provide oral health screening and triage, with some pediatric dental programs using store-and-forward for caries detection. Tele-rehabilitation covers physical therapy, occupational therapy, and speech-language pathology via audio-video. Tele-audiology supports hearing assessment and hearing aid programming. Tele-genetics provides genetic counseling for cancer, prenatal, and pediatric indications. Tele-dialysis is used for monthly visits with ESRD patients. Tele-hospice supports palliative consultation in home-based hospice programs.

Georgia Medicaid Audio-Only Telehealth Coverage in Detail

Audio-only telehealth is covered under Georgia Medicaid for specific service categories under specific conditions:

• Behavioral health: Therapy and medication management and crisis services are all covered audio-only, with parity reimbursement under DEA and CMS 2024 permanence rules and Georgia Medicaid policy.
• Substance use disorder and MAT: Buprenorphine maintenance covered audio-only for established patients under the DEA Final Rule of 2024. Initial induction requires audio-video or in-person; subsequent maintenance can be audio-only.
• Primary care: Limited audio-only coverage; mostly for established patients with documented audio-video unavailability or refusal.
• Specialty consults: Generally require audio-video, with limited audio-only follow-up for specific indications.

Documentation must demonstrate the audio-only nature of the visit (modifier 93), the reason for audio-only delivery (audio-video unavailable, patient refused video, technology limitation), and the clinical content of the visit. Some audio-only services are reimbursed at a reduced rate compared to audio-video; behavioral health and SUD audio-only services are reimbursed at parity under 2024 federal and state rules.

DEA Final Rule of 2024 Implementation in Georgia

For Georgia Medicaid members and providers, the DEA Final Rule of 2024 has three principal effects.

First, buprenorphine for opioid use disorder is now permanently available via telehealth. A Georgia Medicaid member with opioid use disorder can begin buprenorphine treatment via audio-video tele-psychiatry without first traveling to an in-person clinic. After initiation, the member can continue monthly maintenance via audio-only telephone calls if audio-video is unavailable. This is a substantial expansion of access compared to the pre-COVID system, where the X-waiver requirement and the in-person evaluation requirement combined to make telehealth-based MAT extremely rare.

Second, Schedule III through V controlled substances may be prescribed via audio-video telemedicine with Georgia law compliance. This includes some sleep aids, some pain medications, and other commonly prescribed Schedule III through V substances.

Third, Schedule II controlled substances generally still require an in-person evaluation before telehealth prescribing. This applies to stimulants for ADHD (methylphenidate, amphetamine salts), short-acting opioids (oxycodone, hydromorphone), and other Schedule II medications. There are limited exceptions for OUD-specific medications. For ADHD patients already established with a clinician through a prior in-person evaluation, continuing stimulant prescriptions via telehealth is generally permitted under DEA rules for established patient relationships, although Georgia's specific implementation can be more restrictive in some cases.

The pharmacy verification requirements continue to apply: pharmacies must verify the prescription and the practitioner's authority, and patient identification is verified through standard pharmacy procedures. Patients must be physically located in the United States at the time of the telemedicine visit.

Originating Site Rules

Under Georgia Medicaid policy, the originating site (the location where the patient is physically located during the telehealth visit) can be:

• The patient's home
• A school
• A clinic or physician office
• A hospital
• A nursing home or assisted living facility
• A community-based setting (a community health center, a senior center, a homeless shelter)
• A residential substance use disorder treatment facility
• A Community Mental Health Center

When the originating site is a hospital, clinic, or other facility (not the patient's home), the facility may bill an originating site facility fee. When the originating site is the patient's home, no facility fee is paid.

State Licensing for Telehealth

A provider delivering telehealth to a Georgia Medicaid member who is physically located in Georgia must hold a Georgia license. This is enforced by the Georgia Composite Medical Board for physicians, the Georgia Board of Nursing for nurses, and other Georgia licensing boards for other professions. The location rule applies at the time of the visit: the relevant question is where the patient is physically located when the telehealth visit occurs.

Cross-state telehealth practice is enabled by the interstate licensure compacts described above. A physician licensed in Florida who is a member of the IMLC can obtain an expedited Georgia license to provide telehealth to Georgia patients. A psychologist licensed in Tennessee who is a member of PSYPACT can provide telehealth to Georgia patients through the PSYPACT Authority to Practice Interjurisdictional Telepsychology (APIT). A nurse with a primary residency in a Nurse Licensure Compact state holds a multi-state license valid for Georgia.

For Georgia Medicaid members who travel out of state (college students attending school in another state, members visiting family for extended periods), the rules are more complex. If the Georgia Medicaid member is physically located outside Georgia at the time of a telehealth visit, the provider must be licensed in the state where the member is physically located. Georgia Medicaid generally requires that members notify DCH if they are out of state for extended periods, as Medicaid eligibility is based on Georgia residency.

Reimbursement Parity and the Three CMOs

Under Georgia's telehealth parity statute, state-regulated commercial insurers must cover telehealth on the same basis as in-person services. Self-insured ERISA plans are not bound by this statute. Georgia Medicaid policy provides similar parity for most synchronous telehealth services with in-person equivalents, although the parity is set by DCH policy rather than statutory mandate.

All three Georgia Medicaid CMOs cover telehealth across the same scope as fee-for-service Medicaid:

• Amerigroup Community Care: Member services 1-800-600-4441. Operates a 24/7 nurse advice line and a telehealth provider directory.
• CareSource Georgia: Member services 1-855-202-0729. Telehealth access through MyCareSource portal and member services.
• Peach State Health Plan: Member services 1-800-704-1484. Operates a 24/7 nurse advice line and supports telehealth scheduling through the member portal.

WellCare is no longer a separate Georgia Families Medicaid CMO; a 2024 reprocurement proposing a different slate is in a bid-protest phase with no announced go-live date, and the current three-CMO contracts have reportedly been extended through about June 30, 2027. Each CMO has its own provider directory listing telehealth-enabled clinicians and its own prior authorization rules for specific services like Remote Patient Monitoring.

Six Worked Examples

Sarah: Type 2 Diabetes Telehealth Plus Remote Patient Monitoring

Sarah is 38 years old, lives in Atlanta, and qualifies for Georgia's Pathways to Coverage program. She is enrolled in Amerigroup Community Care. She has type 2 diabetes and takes metformin and a GLP-1 receptor agonist. Her endocrinologist enrolls her in a telehealth + RPM program. She receives a glucometer, a Bluetooth-enabled blood pressure cuff, and a smart scale. The clinical staff bill the initial setup and patient education code, then bill the monthly device-supply code each month (Sarah transmits the minimum required days of data each month). The endocrinologist conducts monthly audio-video tele-endocrinology visits to review her data and titrate her medications, billing the monthly treatment management service. Over six months, Sarah's A1c improves substantially. The combination of RPM, monthly tele-endocrinology, and Sarah's engagement with self-management produces measurably better outcomes than her prior care pattern of biannual in-person visits with limited interim monitoring.

Marcus: Major Depressive Disorder and Opioid Use Disorder via Tele-Psychiatry

Marcus is 45 years old, lives in Macon, and is enrolled in standard Medicaid through CareSource Georgia. He has a long history of substance use and a history of opioid use disorder. After a near-fatal overdose, Marcus was discharged from Atrium Health Navicent's emergency department with a referral to tele-psychiatry. He initiated buprenorphine for opioid use disorder via an audio-video tele-psychiatry visit, under the DEA Final Rule of 2024 which permanently authorizes audio-video buprenorphine initiation. After the first month, Marcus transitioned to audio-only monthly tele-psychiatry visits for buprenorphine maintenance under the DEA Final Rule's permanent authorization of audio-only maintenance for established patients. His co-occurring major depressive disorder is treated with an SSRI managed through the same monthly tele-psychiatry visits. Marcus also receives weekly tele-cognitive behavioral therapy with a Licensed Professional Counselor through CareSource's behavioral health network. After 12 months of consistent treatment, Marcus has maintained sobriety, returned to work, and reported significant improvement in his depression scores.

Tonya: Prenatal and Postpartum Telehealth

Tonya is 28 years old, lives in Savannah, and qualifies for Pregnancy Medicaid through Peach State Health Plan. She has a low-risk pregnancy and her obstetrician enrolls her in an alternating in-person and telehealth prenatal protocol per ACOG guidance: in-person visits for vital signs, fetal monitoring, and physical exam alternate with telehealth audio-video visits for history-taking, education, and lab review. At 36 weeks, Tonya develops elevated blood pressures during a telehealth visit. The obstetrician enrolls Tonya in a postpartum hypertension RPM program with a home blood pressure cuff. Tonya delivers a healthy newborn at term. During the 12-month postpartum Medicaid coverage period, Tonya receives a tele-lactation consult at one week postpartum with an International Board Certified Lactation Consultant. At six weeks postpartum, a telehealth screening identifies a positive PHQ-9 for postpartum depression. Tonya is initiated on an SSRI via tele-psychiatry. By six months postpartum, Tonya's depression has remitted, her blood pressure has normalized off RPM, and she is exclusively breastfeeding.

Aisha: Pediatric ADHD via Tele-Child-Psychiatry

Aisha is 10 years old, lives in Albany, and is enrolled in PeachCare for Kids through Peach State Health Plan. She has Attention-Deficit/Hyperactivity Disorder diagnosed by her pediatrician at age 7 after an in-person evaluation. Aisha's pediatrician makes a tele-child-psychiatry referral because the nearest in-person child psychiatrist is more than an hour away and has a long waitlist. The tele-child-psychiatrist sees Aisha monthly via audio-video, with her mother participating in every visit. The psychiatrist manages Aisha's stimulant medication, monitors growth and appetite, and adjusts dosing based on school feedback. Schedule II stimulant prescribing for Aisha is permitted via telehealth because her prior in-person evaluation by the pediatrician established the practitioner-patient relationship, and the psychiatrist is now an established practitioner in the same network. School-based telehealth check-ins through her elementary school's School-Based Health Center provide additional behavior monitoring and academic support.

George: Heart Failure Post-Discharge Tele-Cardiology Plus RPM

George is 72 years old, lives in Columbus, and is a dual-eligible Medicare-Medicaid member. He has Medicare primary and Aged-Blind-Disabled Medicaid secondary. He was recently hospitalized at Piedmont Columbus Regional for an acute heart failure exacerbation. At discharge, George is enrolled in a heart failure RPM program through his cardiologist's office: smart scale, Bluetooth blood pressure cuff, and pulse oximeter. He transmits daily weights, blood pressures, and oxygen saturations. His cardiologist conducts weekly tele-cardiology visits for the first month post-discharge, then monthly visits thereafter. During week 2, George's weight rises by four pounds in three days, triggering a clinical alert. The cardiology team increases his furosemide dose and adds a brief audio-only check-in to confirm symptom improvement and adherence. George's weight returns to baseline within five days, and a 30-day hospital readmission is avoided. Over six months, George's New York Heart Association functional class improves, and he is able to return to walking his dog daily.

Diane: Tele-Stroke Acute Care in Rural Athens Area

Diane is 60 years old, lives in a rural community outside Athens, and has been enrolled in the Independent Care Waiver Program for several years. While preparing dinner, Diane experiences sudden left-sided weakness and slurred speech. Her husband calls 911. EMS evaluates Diane on scene, identifies a high probability of acute stroke, and transports her to the nearest community hospital, where the ED activates a stroke alert. Within minutes of Diane's arrival, the ED launches a tele-stroke consultation with a vascular neurologist at Emory University Hospital. The neurologist evaluates Diane via audio-video, reviews her CT head shared electronically (no hemorrhage), assesses her NIH Stroke Scale, and recommends tissue plasminogen activator. tPA is administered within the AHA/ASA-defined treatment window. Diane is transferred to Emory's Comprehensive Stroke Center for further evaluation; CT angiogram is negative for large vessel occlusion, so mechanical thrombectomy is not indicated. After several days of acute care and rehabilitation, Diane is discharged home with minimal residual deficit. Tele-stroke saved Diane's neurological function by enabling tPA delivery in a rural hospital that does not have an on-site vascular neurologist.

Things Commonly Missed About Georgia Medicaid Telehealth

1. Audio-only is permanent for behavioral health and SUD. This is not just a COVID flexibility. The DEA Final Rule of 2024 and CMS permanence rules made audio-only behavioral health and SUD telehealth permanent in Medicare, and Georgia Medicaid follows the same policy.
2. Buprenorphine via telehealth is permanent. The DEA Final Rule of 2024 made audio-video buprenorphine initiation permanent and audio-only buprenorphine maintenance permanent for established patients.
3. Schedule II controlled substances generally require in-person evaluation. Stimulants for ADHD, short-acting opioids, and other Schedule II medications cannot be initiated via telehealth in most circumstances. Established patient relationships with prior in-person evaluations may continue via telehealth.
4. Patient must be physically located in the United States. Cross-border telehealth prescribing is generally prohibited under Ryan Haight.
5. Patient's home is an approved originating site under Georgia Medicaid. Unlike pre-PHE Medicare, Georgia Medicaid permits telehealth from the patient's home, school, clinic, nursing home, or community setting.
6. Provider must be licensed in the state where the patient is physically located. A Georgia-licensed-only provider cannot lawfully treat a patient who has traveled to Florida unless an exception applies.
7. Interstate compacts enable cross-state practice. IMLC, NLC, PSYPACT, Counseling Compact, ASLP-IC, PT Compact, OT Compact, and SW Compact provide multi-state authority for participating practitioners.
8. RPM has minimum-data requirements. Consult current CMS Physician Fee Schedule for the minimum days of data required per 30-day reporting period to bill the device-supply code.
9. Tele-stroke saves outcomes. tPA must be administered within the AHA/ASA-defined window from last known well; tele-stroke at rural hospitals connects to vascular neurologists who can make the tPA decision.
10. School-based telehealth is covered. The Free Care Reversal authorized federal Medicaid match for services delivered in schools.
11. COVID-era flexibilities are partially permanent and partially expiring. Some Medicare flexibilities (audio-only behavioral health, tele-mental health from home) are permanent; others depend on continuing legislation.
12. Cross-state licensure compact membership matters. Providers in compact-member states can more easily serve patients across state lines.
13. Telehealth medical necessity is the same standard as in-person. A telehealth visit must meet the same medical necessity criteria as the equivalent in-person visit.
14. HIPAA compliance is required post-PHE. OCR enforcement discretion ended in 2023; providers must use HIPAA-compliant platforms with end-to-end encryption, access controls, and Business Associate Agreements.
15. Informed consent and ID verification are required. Providers must obtain patient consent for telehealth, verify patient identity, maintain an audit trail, and prohibit unauthorized recording of visits.
16. Audio-only requires documentation. Documentation must demonstrate that audio-video was unavailable or that the patient declined video.
17. Reimbursement parity binds state-regulated insurers but not ERISA plans. Georgia's telehealth parity statute applies to state-regulated commercial insurers; self-insured employer plans governed by ERISA are exempt.
18. Methadone OTP telehealth is governed by SAMHSA, not DEA. The 42 CFR Part 8 framework for Opioid Treatment Programs is separate from the general DEA telemedicine rule.
19. The Georgia Telehealth Resource Center provides free technical assistance. Practices building telehealth programs can access free consultation through the Georgia Telehealth Resource Center.
20. Georgia's two-party consent law applies. Recording a telehealth visit without all-party consent violates Georgia's wiretapping statute.

Frequently Asked Questions

A few more common questions families ask:

What kinds of visits can I have via telehealth on Georgia Medicaid? Georgia Medicaid covers telehealth across primary care, behavioral health, substance use treatment, maternal care, pediatric care, geriatric care, and specialty consults including cardiology, dermatology, endocrinology, neurology, psychiatry, and pulmonology. The modalities covered include audio-video synchronous visits, audio-only telephone visits (for behavioral health, SUD, and limited primary care), store-and-forward asynchronous review (for dermatology, ophthalmology, pathology, radiology), and Remote Patient Monitoring for chronic disease management.

What if I travel out of state and need a telehealth visit? If you are physically located outside Georgia at the time of the telehealth visit, your provider must be licensed in the state where you are physically located, or your provider's compact authority must extend to that state. Georgia Medicaid eligibility is based on Georgia residency, so extended out-of-state absences should be reported to DCH.

Does Georgia Medicaid pay the same for telehealth as in-person? For most synchronous audio-video telehealth services, Georgia Medicaid policy provides parity with in-person rates. Georgia's telehealth parity statute mandates parity for state-regulated commercial insurers. Medicaid follows similar parity in DCH policy. Audio-only services are reimbursed at parity for behavioral health and SUD under 2024 rules; other audio-only services may be reimbursed at reduced rates.

What if I do not have reliable internet or a video-capable device? Audio-only telephone telehealth is covered for behavioral health, substance use treatment, and limited primary care. Your provider should document that audio-video was unavailable. CMOs also operate 24/7 nurse advice lines that can triage symptoms and connect you to a telehealth visit. The Georgia Telehealth Resource Center provides technical assistance for both patients and providers.

How do I find a Georgia Medicaid telehealth-enabled provider on my CMO? Each of the three Georgia Medicaid CMOs (Amerigroup Community Care, CareSource, Peach State Health Plan) maintains a provider directory that identifies telehealth-enabled clinicians. Call member services to ask for a telehealth provider in your specialty, or check the CMO's online provider directory.

Is my telehealth visit private and secure? Yes, provided your provider uses a HIPAA-compliant platform. The Office for Civil Rights enforcement discretion for non-compliant platforms during the COVID-19 public health emergency ended in 2023. Providers must now use platforms with end-to-end encryption, access controls, audit trail, and Business Associate Agreements. Recording a telehealth visit without all-party consent violates Georgia's two-party consent law.

Can my child have telehealth visits for ADHD or autism? Yes. Tele-child-psychiatry is covered by all three CMOs and is particularly important given Georgia's child psychiatry workforce shortage. Initial diagnostic evaluation for ADHD or autism may require an in-person component for full assessment. Established patient stimulant prescriptions for ADHD may continue via telehealth under DEA rules for established patient relationships, although Georgia implementation can vary. Tele-school-based services through School-Based Health Centers also support pediatric mental health.

How to Access Georgia Medicaid Telehealth Coverage

The practical steps for a Georgia Medicaid member to access telehealth are:

1. Identify your CMO. If you are enrolled in Medicaid managed care, your CMO is Amerigroup Community Care, CareSource, or Peach State Health Plan. Your member ID card lists your CMO. If you are in fee-for-service Medicaid (mostly Aged, Blind, and Disabled), DCH manages your benefits directly.
2. Choose a telehealth-enabled provider. Use your CMO's provider directory or call member services to find a primary care physician, behavioral health clinician, or specialist who offers telehealth visits.
3. Schedule the visit. Most providers schedule telehealth through their patient portal, by phone, or through the CMO's online scheduling tool. Some 24/7 telehealth services (especially behavioral health crisis services) accept walk-in virtual visits.
4. Prepare for the visit. Ensure you have a video-capable device (smartphone, tablet, computer with webcam), a reliable internet connection, and a quiet private space. If audio-video is unavailable, audio-only telephone visits may be an option for covered services.
5. Conduct the visit. The provider will verify your identity, confirm your physical location (must be in Georgia or in a state where the provider has compact authority), obtain informed consent for telehealth, and conduct the visit. Take notes on diagnoses, medications, and follow-up plans.
6. Pick up prescriptions. Prescriptions can be sent electronically to your pharmacy. Some controlled substance prescriptions may have additional verification requirements at the pharmacy.
7. Follow up. Schedule any required follow-up visits (in-person or telehealth), labs, imaging, or specialist consults. RPM enrollment, if applicable, will include a device setup visit and patient education.

If you need help navigating telehealth, your CMO's member services line and the Georgia Telehealth Resource Center provide free assistance.

Crisis and Urgent Telehealth Services

For behavioral health crises, Georgia Medicaid members can call the Georgia Crisis and Access Line (GCAL) at 1-800-715-4225 or the 988 Suicide and Crisis Lifeline. GCAL provides 24/7 telephone triage, telehealth crisis intervention, and dispatch of mobile crisis teams when needed. Behavioral Health Crisis Centers and Crisis Stabilization Units across the state provide alternatives to emergency department visits for psychiatric crises.

For non-emergency medical concerns, all three Georgia Medicaid CMOs operate 24/7 nurse advice lines. These lines can triage symptoms, recommend a level of care, and connect members to telehealth visits where appropriate.

Final Notes for Georgia Medicaid Members

Georgia Medicaid's telehealth coverage today is the product of two and a half decades of federal and state policy evolution, accelerated and reshaped by the COVID-19 public health emergency. The result is a coverage framework that supports virtual care across primary care, behavioral health, substance use treatment, maternal care, pediatric care, geriatric care, specialty consults, tele-stroke, tele-NICU, tele-psychiatry, school-based services, and remote patient monitoring. The framework is anchored federally by Section 1834(m) of the Social Security Act, the CARES Act of 2020, the Consolidated Appropriations Acts of 2023 and 2024, the MATE Act of 2022, the DEA Final Rule of 2024, the Ryan Haight Act, and HIPAA. It is implemented in Georgia through the Georgia Medical Practice Act, the telehealth parity statute, the Georgia Telemedicine Act, the DCH Medicaid Telehealth Provider Manual, the DBHDD Telehealth Policy, and the contracts with the three Care Management Organizations.

The system is not perfect. Audio-only coverage remains limited for primary care. Schedule II controlled substance prescribing remains constrained by federal in-person evaluation rules. Cross-state telehealth is limited to compact-member providers. Broadband access in rural Georgia continues to lag urban areas, restricting audio-video access for some patients. And the post-PHE policy environment continues to evolve, with Medicare flexibilities depending on continuing congressional extensions.

But for Georgia Medicaid members and the providers who serve them, telehealth is no longer experimental, no longer marginal, and no longer pandemic-only. It is a permanent, well-defined, federally supported, and state-implemented set of coverage rules that millions of families rely on every month.

Learn More

• Georgia Medicaid Covered Services
• Georgia Medicaid Behavioral Health Coverage
• Georgia Medicaid Substance Use Disorder Treatment
• Georgia Medicaid Managed Care Plans
• Georgia Medicaid Prior Authorization Process
• Georgia Medicaid Pregnancy Coverage

Find personalized help navigating Georgia Medicaid telehealth coverage at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.