CMS audit

Georgia Medicaid posted a link on messages Friday about proceeding with an audit that CMS is conducting nationwide. 

Below is the letter as an example for you to see what it looks like if they pull a claim you file between July 2024 thru June 2025.  On the letter it will instruct you which patient and date medical records need to be submitted. Also the statement that shows what documents are expected to be turned in. 

As I've stated to many I work with, you always need an Rx, test scores, and plan of care for the initial intake of a patient. Test scores on a plan of care every 6 months for any patient who has continued therapy. For those who receive referrals from BCW, check to see if your BCW has obtained an Rx. 

If you work with another specialty, I highly recommend you look at the document "Provider Required Document List" on the link: Instructions for record submissions for all categories: (cms.gov)

For more information, you can visit this website: 

Providers | CMS