Georgia Medicaid and Medicaid CMOs

Frequently Asked Questions

Understanding your Georgia Medicaid and Medicaid CMO Speech Therapy Benefits

Recipients of Georgia Medicaid, Medicaid via Katie Beckett Waiver (TEFRA Waiver), or Georgia Medicaid CMOs (Caresource, Amerigroup, and Peach State) can have Speech Therapy, Feeding Therapy, and AAC therapy covered as part of their plan so long as the child's needs meet the requirements of medical necessity for each of the plans. At Simplicity, we are in network with Medicaid and accept the Katie Beckett waiver or TEFRA waiver. We are also in network with two of the three (Caresource and Amerigroup) current Medicaid CMOs as well as all of the up-and-coming CMOs for Georgia Families: Humana, Molena, United Healthcare, and Caresource.

  • What Medicaid Plans does Simplicity accept?

    We are currently in network with all Medicaid plans except the Peach State CMO.  This includes Medicaid, Katie Beckett Medicaid (otherwise known as TEFRA Medicaid), Caresource, and Amerigroup.

  • What if I have Medicaid through Peach State?

    There are a few options if your child has a Peach State Health Plan. 


    First, you should use the "Find a Provider" feature of their website to see if a provider near you accepts Peach State.


    If you cannot find a provider in your area that can adequately serve your child's needs, then we can submit a request to Peach State to bill as a Non-network provider for your child's therapy. There is a likelyhood that Peach State will decline if it sees other providers in your area.


    Lastly, you can opt to change your health plan using the online portal that Georgia Families as long as you meet their requirements. HERE IS THE LINK TO GEORGIA FAMILIES.

    Following this process will allow you to select a new Medicaid CMO, and typically the new plan becomes active the first day of the next month.

  • Do I need to pay anything if I have Medicaid or a Medicaid CMO?

    Generally, no.


    Most plans will cover Speech Therapy, Feeding Therapy, AAC Therapy, and their respective evaluations entirely as long as there is care is appropriate for the child.  Some of the CMOs do have small copays for services based on your agreement with them. Simplicity will collect those copays at the time of service.


    It is against the law for a practice to charge a Medicaid recipient any fees that are not strictly allowed by Medicaid. This includes cancellations and no-show fees.