Applied behavior analysis (ABA) providers serving Georgia’s Medicaid population are bracing for major cuts after CareSource Georgia, a Medicaid care management organization (CMO), sent a letter announcing providers will be reimbursed at 80% of the current Georgia Medicaid fee schedule starting in early May.
Georgia ABA providers working with the Medicaid CMO are now facing a difficult decision: accept the rate cut or face contract termination.
Sources tell BHB that this move is particularly challenging amid Georgia’s turbulent managed care landscape. Of the three current CMOs, two lost their contract bids and are on the way out, with CareSource being the only one with a renewed contract. One of the CMOs with a lapsing contract has begun terminating providers, while the other started blanket prepayment reviews in late 2024. The three new CMOs that have won bids are set to begin in July, but have not yet provided guidance.
The environment means that CareSource is the main CMO still reimbursing ABA providers.
“CareSource is focused on improving the health and well-being of our members across Georgia by helping them access high-quality and affordable care. As part of this commitment, we thoughtfully manage the Medicaid funds entrusted to us by our state and federal regulators,” a spokesperson for CareSource told Behavioral Health Business.
“We recently notified certain providers in our Georgia network of adjustments to reimbursement for applied behavior analysis therapy services. These updates align with actions being taken by Medicaid programs nationwide to responsibly manage public resources as demand for these services grows. We remain committed to ensuring members have access to the essential services they need.”
While a number of Medicaid programs have cut ABA rates, what is happening here is unusual, as most of the cuts come from the state level, not the CMO or MCO level.
“Georgia just increased their rate in 2025 for ABA services,” Brett Blevins, a serial entrepreneur in the behavioral health space and former CEO of Commonwealth ABA, told BHB. “So this is probably very surprising to most providers, and there’s really no way to be prepared for a 20% rate cut, because the wage market in the environment of ABA in Georgia is pretty well established. So to get a 20% rate cut, the only way to survive is to drastically cut salaries and wages for folks.”
Across the country, ABA providers are seeing rate reductions. For example, Indiana has proposed rate cuts and a lifetime cap on hours. Nebraska Medicaid, which once had some of the highest rates in the nation, also announced steep rate cuts earlier this year.
“I think it’s like with anything that the pendulum went really far one way, with the spend increasing so drastically,” Blevins said. “Now the pendulum is swinging back almost too hard in the other direction, a lot of these states are just trying to get a grasp on the spend.”