Effective July 1, 2025, GA Medicaid introduced a new formal group/billing enrollment requirement for all billing providers to complete. This enrollment links rendering providers (individual NPIs) to a centralized billing group NPI. While this may sound like the structure of your current payee ID/account, please know that it is different; the current payee ID/account does not have an affiliated NPI associated with it. Failure to complete this process by the deadline, January 1, 2026, will result in claim denials.
Client Overview
Group/Billing Enrollment is a required process through the GAMMIS portal that establishes a billing entity (group NPI) and formally affiliates individual rendering providers to that group. Even if your group is already set up as a payee in the system, you must complete this new enrollment for claims to be accepted after January 1, 2026.
Any organization that submits Medicaid professional claims under a group or billing NPI must complete this new enrollment. This includes provider groups that currently receive payment under a payee ID but have not submitted a Group/Billing application through the new process.
- In GAMMIS, navigate to ‘Enrollment Wizard’ under the ‘Provider Enrollment’ section.
- Select ‘Group/Billing’ under the Enrollment Type.
- Provide group-level demographic and ownership information.
- Add rendering provider Medicaid IDs.
- If more than 30 providers need to be affiliated, you may opt to check the box to authorize automatic affiliations based on recent remittance data.
Caution: The auto-affiliation may not capture all active providers. Manual review is strongly recommended post-approval. It may be advisable to manually enter each ID during the application process.
Each billing NPI will need a separate group billing enrollment. If you have multiple billing NPIs but only one payee ID, you can connect that payee ID to multiple group/billing enrollments. However, you cannot associate one billing NPI with multiple group/billing enrollments. Billing NPIs can only be used for one application; payee IDs can be used for multiple applications.
You’ll be asked to upload the below documents at the end of the application.
- Current Business License
- GA Secretary of State Certificate of Existence
Georgia Medicaid has not released detailed guidance on processing timelines, linkage confirmation, or claim routing behavior once group enrollment is active. Providers should monitor their GAMMIS portal for application status updates and ensure affiliations are reflected correctly prior to 2026.
*SHP processed one application prior to creating this guide; it took approximately 2 weeks for the application to complete.
Claims submitted after January 1, 2026, without a valid group enrollment and provider affiliations will be rejected. This will result in payment delays, administrative burdens, and back-end corrections across your revenue cycle.
If you are not contracted for our Provider Enrollment services, please contact Gainwell Technologies Provider Services at (800) 766-4456 or visit the Enrollment section of the GAMMIS portal at mmis.georgia.gov.
Group/Billing Provider Enrollment/Claims Processing Frequently Asked Questions (FAQs)
CMS* requires the billing provider’s NPI to be captured on the claim. Currently in Georgia, when the rendering provider enrolls, only some Payee information is collected, such as the Tax ID. The Payee’s NPI is not collected during a rendering provider’s enrollment. By enrolling Group/Billing Providers, the billing provider’s NPI and Payee will be collected, and rendering providers will be affiliated to their Group/Billing providers.
Note: For Group/Billing provider enrollment, most groups will already have an active Payee Medicaid ID. The Payee Medicaid ID may be found on the remittance advice on the top right corner listed as the PAYEE ID.
*Per CMS, 42 CFR § 431.107 Required provider agreement Section (5)(ii) states: Include its NPI on all claims submitted under the Medicaid program.
It is NOT optional for Providers that:
- Submit professional claims
- Are part of a clinic or group practice
- Submit claims where the Rendering Provider NPI is different than the Billing Provider NPI
The claim must be submitted with a Billing Provider’s NPI that is enrolled in Georgia Medicaid.
No. DBHDD Facility Providers and FQHC Providers do NOT need to enroll a group. There is no change for their enrollment OR claims submission.
Yes. A Group/Billing provider Medicaid ID must be enrolled for each service location address.
NO: If all the types/specialties have the same Payee and same Billing NPI, enroll the group under ONE Medicaid ID and choose the highest level (i.e., Physician) Group Type and Specialty when enrolling.
YES: If each type/specialty has their own Payee and/or Billing NPI, enroll each type/specialty.
Yes. A rendering provider may be affiliated with multiple Group/Billing Providers. The claim will be submitted with the appropriate Group/Billing provider’s NPI to reflect the correct Payee and service location address.
Yes. Group/Billing providers will need to revalidate.
No. The Group/Billing providers will need to end-date the affiliation to the terminated provider.
Yes. Within the Group/Billing enrollment application, on the Group Affiliation panel, there is an option to request auto-affiliation. The Group/Billing provider confirms they are a large entity. Instead of entering their members manually, the group authorizes the system to auto-affiliate their members/individual providers based upon payee and recent claims activity.
The existing Payee Medicaid ID must be entered on the application to request auto-affiliation. The Payee Medicaid ID may be found on the remittance advice on the top right corner listed as the PAYEE ID.
Georgia Medicaid will pay the based claim on the Rendering Provider ID, Tax ID and Payee information.
Once the group is enrolled and their billing NPI is specified on the claim, claims will deny if the claim’s Rendering provider is NOT affiliated to the group.
On January 1, 2026, the claim will deny if the Billing NPI is not enrolled.