CCSP vs. SOURCE: How Georgia Medicaid Pays for Adult Day Health

Georgia Medicaid pays for adult day health through one waiver with two doors. The Elderly and Disabled Waiver Program (EDWP) is the state's 1915(c) home and community-based waiver, and it contains both the Community Care Services Program (CCSP) and Service Options Using Resources in a Community Environment (SOURCE). Same waiver, same covered Adult Day Health service — but two different member populations and two different referral paths. A center that knows which door a member came through knows who coordinates that member's care, and a center that enrolls correctly can bill for both.

ElderSuite serves adult day care centers nationwide. This piece is Georgia-specific.

One waiver, two programs

EDWP is Georgia's waiver GA.0112, currently approved through November 8, 2027. The state's own consumer pages now use EDWP as the umbrella name and note it was "formerly called the Community Care Services Program," but underneath, CCSP and SOURCE remain distinct tracks.

CCSP is administered by the Georgia Division of Aging Services through the twelve Area Agencies on Aging. Members reach it through the Aging and Disability Resource Connection; screening starts at 866-552-4464. The AAA determines eligibility and coordinates services.

SOURCE is the enhanced case management model. It links a member's primary medical care to their long-term services, with 24-hour access to a case manager and primary care physician. SOURCE referrals run through designated SOURCE case-management organizations — health systems and private agencies — and availability varies by region.

Who qualifies for which

Both programs require age 65 or older or a qualifying disability, plus nursing home level of care. The financial line is what separates them.

SOURCE members must meet SSI Medicaid criteria — full Medicaid.

CCSP reaches further up the income scale. Through the waiver's Medicaid CAP budgeting, EDWP serves Medical Assistance Only members with income up to $2,901 a month (2025 figure), well above the $967 SSI line. Members over the cap can qualify through a Qualified Income Trust, and a member cost share may apply.

One more thing that matters for your enrollment pipeline: EDWP is a budgeted program, limited to a set number of clients statewide. When funding is full, eligible applicants go on a waiting list until a slot opens.

What Adult Day Health pays

Georgia's provider manual defines Adult Day Health as "nursing services, medical supervision, health, therapeutic, and social services activities in a congregate community-based day program."

ADH is reimbursed per half day and per full day, at two acuity levels, with occupational, physical, and speech therapy delivered in ADH priced per visit. The Department of Community Health's amendment notice implementing the state's rate study — required every four years by Senate Bill 610 — set these rates effective July 1, 2024:

• ADH Level 1, half day: old rate $36.89; rate effective 7/1/2024 $50.14
• ADH Level 1, full day: old rate $61.49; rate effective 7/1/2024 $82.49
• ADH Level 2, half day: old rate $46.13; rate effective 7/1/2024 $66.22
• ADH Level 2, full day: old rate $76.86; rate effective 7/1/2024 $108.23
• OT / PT / Speech in ADH, per visit: old rate $48.81; rate effective 7/1/2024 $105.98

That is a 34 to 44 percent increase — the largest ADH rate movement in Georgia in years. The next SB 610 rate study cycle lands around 2027.

Before you bill against these numbers, confirm them against the state's current EDWP fee schedule. The hour thresholds that separate a half day from a full day, and the clinical criteria that separate Level 1 from Level 2, are defined in the EDWP Adult Day Health Services manual — the current version was re-released July 1, 2026 on the Georgia Medicaid provider manuals page.

How a center gets in

License first. DCH's Healthcare Facility Regulation Division licenses Adult Day Centers under Rules chapter 111-8-1, issued under Georgia's Adult Day Center for Aging Adults Licensure Act. The rules distinguish the social model (adult day care) from the medical model (adult day health services) — waiver ADH is the medical model.

Then Medicaid enrollment. EDWP providers enroll with DCH through the Enrollment Wizard at mmis.georgia.gov, and applications are accepted during open enrollment windows in March and September. Expect a credentialing (CVO) review, possibly a site visit, and new provider training before an enrollment decision.

For SOURCE referrals, centers additionally work with the SOURCE case-management organizations serving their region. Historically centers enrolled under CCSP first and then added SOURCE; confirm the current steps with DCH or the SOURCE agency you'd contract with.

Billing: fee for service, from attendance to claim

Adult day health under EDWP is paid fee for service, billed to the Department of Community Health. Three rules do most of the work: every claim must carry the member's service prior authorization, bill only authorized services actually rendered, and file within six months of the date of service.

Electronic claims go out as 837P files, and Georgia Medicaid (payer ID 77034) is an available payer on the Availity clearinghouse — the same clearinghouse ElderSuite submits claims through. That means a Georgia center can run the whole pipeline in one system: daily attendance becomes service documentation, documentation becomes claims, and claims go out electronically. Availity requires a one-time payer enrollment before the first claim goes out. For the full workflow from attendance record to electronic claim, see ElderSuite's Medicaid billing guide.

The compliance backdrop

In March 2023, the HHS Office of Inspector General reviewed 20 of Georgia's roughly 102 adult day health facilities and found noncompliance with federal waiver and state requirements at all 20 — 312 instances in total. Waiver audits land on documentation: daily attendance, service records that match what was authorized, and files that support every billed unit. If your documentation would survive that review today, the rate table above is yours to keep.

Where to check

• DCH's EDWP fact sheet and waiver pages
• The EDWP General Services and Adult Day Health Services manuals on the Georgia Medicaid provider manuals page
• Adult Day Center licensing rules, GAC 111-8-1
• CCSP screening through your Area Agency on Aging: 866-552-4464