SFY 2025 Upper Payment Limit (UPL) Nursing Home - 2nd Interim Payment
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This memorandum outlines the Department of Community Health's issuance process, timeline, and requirements for the State Fiscal Year (SFY) 2025 nursing home Upper Payment Limit (UPL) second interim payments affecting Georgia Medicaid-eligible nursing home providers.
No material clinical or coverage changes in this revision.
Payment Conditions & Eligibility
Payment Conditions
Conditions for issuance of the UPL payment:
ALL of the following
- Intergovernmental Transfer payment is received by noon on Thursday, October 9, 2025.
- Completed Notice of Intent To Form is submitted via DocuSign by an authorized provider representative (DocuSign access available before October 3, 2025).
- Provider has a valid bank account on file in the Georgia Medicaid Management Information System (GAMMIS) to receive ACH payment.
- Payment subject to final UPL calculation; CMS may adjust the UPL calculation positively or negatively.
Effect of missed requirements
- If the Intergovernmental Transfer payment is not received by the October 9, 2025 noon deadline, the associated UPL payment will not be made.
Deadlines, Codes, and Key Dates
| No billing or clinical procedure codes referenced in this memorandum. |
Required Provider Steps
Submit Intergovernmental Transfer by noon on Oct 9, 2025
Providers must submit an Intergovernmental Transfer by noon on Thursday, October 9, 2025. If the Transfer Payment is not received by the deadline, the associated UPL payment will not be made.
- Deadline: by noon on Thursday, October 9, 2025
- Consequence: associated UPL payment will not be made if transfer is not received by the deadline
Submit Notice of Intent To Form via DocuSign by authorized representative
Complete and submit the Notice of Intent To Form via DocuSign using the provided link; DocuSign access is available before October 3, 2025. The Notice should only be completed by an authorized provider representative.
- Access the form in DocuSign before October 3, 2025
- Form must be completed and submitted by an authorized provider representative
Key Terms
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