ABA insurance and Medicaid coverage in Georgia
Last researched October 21, 2026
Who pays for ABA in Georgia, and what a practice has to do to bill them. Coverage details here come from statutes and agency pages we read, not from payer marketing.
Autism insurance mandate
- State mandate for autism coverage
Yes, the research found a state autism coverage law.
- Statute
O.C.G.A. 33-24-59.10 ('Ava's Law'), subsection (b) as amended by SB 118 (effective January 1, 2019)
- Age limits
Coverage for autism spectrum disorders for an individual covered under the policy who is 20 years of age or under (per the codified text of O.C.G.A. 33-24-59.10).
- Annual cap
As of 2026-10-21, the codified text permits a policy to limit ABA coverage to $35,000.00 per year. Coverage may not include any limits on the number of visits. Under subsection (b)(2), the covering entity determines medical necessity of ABA coverage using established criteria. Separately, a licensed physician or psychologist may be required to demonstrate continuing necessity at least annually.
- Excludes self-funded employer plans
It depends.
- Notes
The age limit, annual dollar amount, visit-limit prohibition and January 1, 2019 effective date are supported by the codified text on Justia. The self-funded plan exclusion applies to self-funded ERISA employer plans, as supported by the insurance regulator. Do not generalize it to every governmental or other self-funded arrangement. The statute is commonly referred to as Ava's Law (Georgia Senate publication).
Medicaid ABA coverage
- Medicaid covers ABA
We could not verify this yet - check with Georgia Department of Community Health (DCH), Division of Medical Assistance Plans.
- Program
Adaptive Behavior Services (ABS), under the Autism Spectrum Disorder (ASD) Services benefit
- Agency
Georgia Department of Community Health (DCH), Division of Medical Assistance Plans
- Provider enrollment
- https://www.mmis.georgia.gov/portal/Default.aspx?tabid=26
Sources (7)
- Part II Policies and Procedures for Autism Spectrum Disorder (ASD) Services, Georgia DCH Division of Medical Assistance Plans, version October 1, 2026
- GAMMIS Provider Manuals (Autism Spectrum Disorder Services, current policy manual, release date 10/01/2026)
- Autism Spectrum Disorder Services fee schedule, posted 10/08/2025
- Autism Spectrum Disorder, Georgia Medicaid (coverage effective January 1, 2018; Adaptive Behavior Services)
- GAMMIS Provider Enrollment
- ASD FAQs for Providers, Georgia Department of Community Health (posted; effective-language January 1, 2018)
- Guidance for Meeting RBT Requirements During the 2026 Transition, Behavior Analyst Certification Board
Payers named in our research
Names come from the research behind this page. Appearing here does not mean a payer is accepting new providers or that networks are open. Always confirm directly with the payer.
Medicaid managed care plans
- Amerigroup Community Care - Georgia Families CMO listed on medicaid.georgia.gov.
- CareSource - Georgia Families CMO listed on medicaid.georgia.gov.
- Peach State Health Plan - Georgia Families CMO listed on medicaid.georgia.gov (Centene).
How to enroll
- Start at the state Medicaid provider enrollment page: https://www.mmis.georgia.gov/portal/Default.aspx?tabid=26.
- Ask each commercial payer you want to bill for its credentialing application and timeline. We have not verified payer timelines.
- Confirm which staff types the payer reimburses, including whether technicians must hold the RBT credential. See BT vs RBT in Georgia.
Related guides for Georgia
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