The Katie Beckett Waiver in Georgia

If your child has autism in Georgia, there’s aMedicaid program you should know about that many families have never heard of.It is called the Katie Beckett Waiver, and for the right family, it can be thedifference between drowning in therapy bills and finally being able to accessthe care your child needs.
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The basics: Katie Beckett allows your child toqualify for Medicaid based on their own medical needs, not your family income.That means even families who earn far above standard Medicaid income limits canpotentially get full Medicaid coverage for their child, including coverage thatcan dramatically expand access to ABA therapy and other services.
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This guide walks through what the program is,who qualifies, why it matters for autism families specifically, and exactly howto apply in Georgia in 2026.
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What Is the Katie Beckett Waiver?
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The Katie Beckett Waiver (also called the TEFRAWaiver, the Deeming Waiver, or Katie Beckett Medicaid) is a federal Medicaidpathway created in 1982 under the Tax Equity and Fiscal Responsibility Act(TEFRA). It is named after Katie Beckett, a child whose family fought to bringher home from years of hospital care after Medicaid would not cover home-basedservices.
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In Georgia, the program is administered by theGeorgia Department of Community Health (DCH) through the Centralized KatieBeckett Medicaid Team.

The most important thing to understand is whatmakes Katie Beckett different from regular Medicaid:

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  Regular Medicaid considers parental income when determining eligibility for a child.
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  Katie Beckett Medicaid waives parental income from the eligibility calculation. The state only considers the child’s own income and resources, which for most children is zero.

This is why Katie Beckett is sometimes calledthe “Deeming Waiver.” It waives the rule that “deems” parental income to thechild.

If your child qualifies, they get the sameMedicaid coverage as any other Medicaid recipient in Georgia. That coverage canstack on top of your private insurance as secondary coverage, often picking upcosts that private insurance does not.
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Why Katie Beckett Matters for Autism Families

For Atlanta families with a child on the autismspectrum, Katie Beckett can change the financial picture for ABA therapy inseveral meaningful ways.

1. Coverage of services private insurancelimits. Georgia’s Ava’s Law caps ABA coverage onstate-regulated insurance plans at $35,000 per year. For a child receiving 30+hours per week of intensive ABA, that cap can be hit by mid-year. Medicaid as asecondary insurance can cover costs that exceed the cap or that privateinsurance otherwise denies.
2. Lower out-of-pocket costs.Even with insurance, families often face copays, coinsurance, and deductiblesthat add up to thousands of dollars per year. Medicaid as secondary typicallypicks up much of this.
‍3. Access to services private insurance does notcover. Speech therapy, occupational therapy, durablemedical equipment, certain therapies, and in-home nursing care through programslike GAPP (Georgia Pediatric Program) become accessible once a child hasMedicaid.
4. A safety net if you change jobs or loseinsurance. Once your child has Medicaid through KatieBeckett, that coverage remains in place even if your employment situationchanges.
5. Expanded provider options.Some providers who do not accept your private insurance may accept Medicaid,opening more options for your child’s care.

For families who are paying significantout-of-pocket costs for autism services, or who are being told by insurancethat they have hit annual limits, Katie Beckett is often the single mostimpactful resource available.
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Who Qualifies for Katie Beckett in Georgia?

1. Age requirement
Your child must be under age 19. (Some sourceslist 18, but Georgia’s current program covers children up to age 19.)

2. Disability determination
Your child must qualify as disabled underSection 1614 of the Social Security Act. This is the same standard used for SSI(Supplemental Security Income).

3. Institutional level of care
This is the part that trips up most families.Your child must require a level of care that would qualify them for placementin a hospital, nursing facility, or intermediate care facility for individualswith intellectual disabilities (ICF-IID), even though they are being cared forat home.

For autism families specifically, this means:

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  An autism diagnosis on its own is generally not enough.
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  The state needs to see that your child requires intensive, near-constant care due to behavioral, medical, cognitive, ordevelopmental needs.
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  Documentation often requires a recent psychological evaluation with specific testing showing significant impairments in adaptive functioning.
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  Co-occurring diagnoses (intellectual disability,severe behavioral challenges, communication impairments, medical complexities)often strengthen the case.

This is why many autism families who apply withonly an ASD diagnosis are initially denied. The system was originally designedfor medically fragile children, and autism applications require carefuldocumentation of the level of care your child requires.

4. Financial criteria
The child’s own income must be below SSI limits. For nearly all children, this is not an issue since children typically have no income.

5. Cost effectiveness
The state must determine that caring for the child at home is no more expensive than institutional care would be. For mostautism cases, this is straightforward.

Realistic Expectations Before You Apply

Before we walk through how to apply, here ishonest information about what to expect.
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Step 5: Red Flags to Walk Away From

Some things should end the conversationimmediately.

The application process is long.Most families take 2 to 4 months to gather all the required documentation. Thestate’s review process after submission can take another 60 to 90 days. Planfor a 4 to 6 month total timeline from start to finish.
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Many initial applications are denied.This is especially common for autism cases. Denials are often based oninsufficient documentation showing institutional level of care. An appeal orresubmission with stronger documentation often succeeds.
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Documentation is the make-or-break factor.The Medical Review Team is reviewing paper. They cannot see your child. What iswritten in your evaluations, your physician statements, and your applicationpacket is what determines the outcome.

Outside help can make a big difference.Georgia has several organizations and consultants who specialize in helpingfamilies through this process. Parent to Parent of Georgia offers free guidanceand webinars. There are also paid specialists with high success rates. We listresources at the end of this post.

Approval is not forever. Asof 2025, approved cases are now valid for a minimum of two years, which is animprovement from prior annual reviews. Renewals are still required.

How to Apply for Katie Beckett in Georgia: Step by Step

Step 1: Confirm your child has the necessary diagnoses and evaluations
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Before you start the application, make sure you have:

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  A formal autism spectrum disorder diagnosis froma qualified clinician (developmental pediatrician, psychologist, psychiatrist)
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  A recent psychological evaluation (within 3years, ideally within 1 year). For autism cases, this should include adaptivebehavior assessment (Vineland or similar), cognitive assessment, and cleardocumentation of functional impairments
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  Documentation of all co-occurring conditions
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  Recent medical records from your child’spediatrician and any specialists

If your psychological evaluation is older than 1 year, strongly consider updating it before applying. Outdated evaluations areone of the top reasons applications are denied.

Step 2: Apply for SSI first (and expect to be denied)

Most Georgia Katie Beckett applications beginwith applying for SSI through the Social Security Administration. Becauseparental income disqualifies most middle-income families from SSI, you willlikely receive a denial letter. That denial is part of the documentation packetfor Katie Beckett.

Apply at www.ssa.gov or by calling the SocialSecurity Administration. Save your denial letter.

Step 3: Obtain the Katie Beckett application packet

You can get the application:‍
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  Online: Download from medicaid.georgia.gov or apply through Georgia Gateway atgateway.ga.gov
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  By phone: Call the Centralized Katie Beckett Medicaid Team at 678-248-7449
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  In person: Atany local Division of Family and Children Services (DFCS) office
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  Medicaid Application (Form 94)
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  Third Party Liability Questionnaire (DMA-285)
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  Various supplemental forms requestinginformation about your child’s medical condition and care needs

Applications are available in English andSpanish. Forms were updated most recently in January 2025.

Step 4: Gather supporting documentation

This is the longest and most important step.Plan to spend several weeks collecting:

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  Medical records from all providers (pediatrician, specialists, therapists)
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  Psychological evaluation with adaptive behavior testing
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  Functional Behavior Assessment if available
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  IEP or 504 plan if your child is school-age
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  Documentation from therapists describing your child’s needs and current services
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  Physician statement addressing level of care
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  Records of medications, equipment, and any specialized care needs
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  Daily care log describing what a typical day requires (this is often overlooked but verypersuasive)

The more clearly your documentation paints apicture of a child requiring intensive, round-the-clock care, the stronger yourapplication.

Step 5: Submit your completed application

You can submit your application through any ofthese methods:

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  Online: ThroughGeorgia Gateway at www.gateway.ga.gov
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  Mail: 2211 Beaver Ruin Road, Suite 150, Norcross, GA 30071
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  Fax: 678-248-7459
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  In person:Any local DFCS office

Note: The previous P.O. Box address is no longerin use as of June 2024.

In April 2026, Georgia launched the KatieBeckett portal at katiebeckettportal.dch.georgia.gov, which lets familiesupload documents, track application status, and complete checklists online.Once your application is received, you should receive an email withinstructions to set up your portal account.

Step 6: Respond promptly to any requests

After submission, the Medical Review Teamreviews your application. They may request additional documentation. Respondquickly. Delayed responses can result in your application being closed.

Step 7: Receive a determination

You will receive a written notification ofapproval or denial by mail.

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  If approved: Medicaid coverage typically backdates to the first of the month in which you applied. Your child can begin using benefits immediately.
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  If denied: You have 30 days to appeal. Do not give up. Many initial denials are overturnedon appeal with stronger documentation.

What to Do If You Are Denied

Denials are common, especially for autism cases.If you receive a denial:
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1. Read the denial letter carefully. It will tell you specifically why your application was denied.
2. Request a hearing within 30 days.This is your formal appeal right.
3. Consider getting help. As pecial needs attorney or experienced advocate can significantly improve your chances on appeal.
4. Strengthen your documentation. Most successful appeals include additional evaluations, more detailed physicianstatements, or thorough daily care logs.
5. Look at other options. Ifyour child is denied Katie Beckett, they may qualify for other Georgia programsincluding the NOW (New Options Waiver) or COMP (Comprehensive Supports)waivers, though these have their own eligibility criteria and waitlists.

Resources for Georgia Families

Several organizations specialize in helping Georgia families navigate Katie Beckett:
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Parent to Parent of Georgia offers free webinars walking through the application process step by step, including a sample completed application. This is one of the best freeresources available.
Centralized Katie Beckett Medicaid Team can answer specific questions about your application at 678-248-7449.
Independent advocates charge a fee but can save significant time and stress. Several well-knownspecialists in Georgia have very high approval rates.
Special needs attorneysspecialize in appeals if you have been denied.

How My Team ABA Supports Families Applying for Katie Beckett

As an ABA provider serving Atlanta and thesurrounding Georgia metro, we work with many families navigating Katie Beckettapplications. While we cannot complete the application for you, we can help inseveral ways:

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  Providing detailed documentation of your child’scurrent ABA services and clinical needs
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  Writing supporting letters describing the level of care required
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  Connecting families with diagnostic providers if updated evaluations are needed
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  Coordinating with other therapy providers togather comprehensive documentation
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  Being a steady source of guidance as you workthrough the process

If you are starting the Katie Beckett processand need clinical documentation from an ABA provider, or if you are looking foran ABA provider who accepts Georgia Medicaid once you are approved, our team ishere to help.

The Bottom Line

If you are considering applying for Katie Beckett and need guidance on the ABA component of your application, or if you are looking for an ABA provider in Atlanta that accepts Georgia Medicaid, reach out to our team. We are here to help.

About the Author
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Keyann Griffin, BCBA, LBA Director of Clinical Growth and Expansion, MyTeam ABA
Keyann Griffin, BCBA, LBA, is the Director ofClinical Growth and Expansion at My Team ABA, where she works to expand accessto compassionate, evidence-based ABA therapy for families across Georgia andbeyond. A Board Certified Behavior Analyst and Licensed Behavior Analyst, sheis passionate about supporting parents and children at every step of theirautism journey. Verify her credentials through the Behavior Analyst Certification Board.

Sources and Further Reading

1. Georgia Department of Community Health. “TEFRA/Katie Beckett.”https://medicaid.georgia.gov/programs/all-programs/tefrakatie-beckett
2. Georgia Department of Community Health. KatieBeckett Portal. https://katiebeckettportal.dch.georgia.gov
3. Georgia Department of Human Services.“TEFRA/Katie Beckett Policy Manual (Section 2133).” https://pamms.dhs.ga.gov/dfcs/medicaid/2133/
4. Parent to Parent of Georgia. “Katie Beckett Deeming Waiver Application Process Webinar.”https://www.p2pga.org/webinars/healthcare/katie-beckett-medicaid-deeming-waiver-a-step-by-step-guide-on-the-application-process/
5. Centers for Medicare & Medicaid Services.“Children with Special Health Care Needs.”https://www.medicaid.gov/medicaid/benefits/early-and-periodic-screening-diagnostic-and-treatment/index.html
6. Social Security Administration. “SupplementalSecurity Income (SSI) for Children.”https://www.ssa.gov/ssi/text-child-ussi.htm
7. Autism Speaks. “Georgia State-RegulatedInsurance Coverage.”https://www.autismspeaks.org/georgia-state-regulated-insurance-coverage
8. Kids’ Waivers. “Georgia Medicaid WaiverPrograms.” https://www.kidswaivers.org/ga/Georgia Gateway (online application portal).https://gateway.ga.gov
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