A Georgia Katie Beckett packet is Form 94 plus two medical forms signed by your child’s doctor, the cost-effectiveness Form 704, and any IEP, IFSP or evaluation your child has. The physician’s DMA-6(A) is valid for only 90 days, so time the doctor’s appointment close to when you send everything.
Print this page and tick each line before you send your packet. Keep a copy of everything you send, and note the date.
Before you start
- My child is 18 or younger and lives at home.
- I have read who qualifies in our Katie Beckett guide: an institutional level of care, not a diagnosis, decides it.
- I have booked an appointment with my child’s doctor to complete the medical forms.
The application
- Form 94, the Katie Beckett Medicaid application, completed and signed (English or Spanish versions are on the Georgia Medicaid website).
The medical forms
| Form | Who signs | Watch for |
|---|---|---|
| Pediatric DMA-6(A) | The physician and the parent | Completed in full. Valid for 90 days. Needed again at every renewal. |
| Medical Necessity/Level of Care Statement | The physician and the primary caregiver, at a minimum | Other members of your child’s care team can help complete it. Needed again at every renewal. |
| Form 704, cost-effectiveness | Completed with your child’s physician | Compares the cost of care at home with the cost of institutional care. |
Supporting documents
- Your child’s IEP (Individualized Education Plan), if they have one.
- Your child’s IFSP (Individualized Family Service Plan) from Babies Can’t Wait, if they have one.
- A psychological or developmental evaluation by a licensed professional, if your child has a condition that affects thinking or learning, such as autism, cerebral palsy, Down syndrome or an intellectual disability. School psychologist and Babies Can’t Wait evaluations are accepted. It is needed every three years.
- Any recent medical records that show the care your child needs day to day.
Sending it
- Mail or deliver to: Centralized Katie Beckett Medicaid Team, 2211 Beaver Ruin Road, Suite 150, Norcross, GA 30071. Not the old P.O. Box 172, which has not been accepted since June 17, 2024.
- Or fax to 678-248-7459, take it to any DFCS office, or apply online at gateway.ga.gov.
- Questions: the Centralized Katie Beckett Medicaid Team, 678-248-7449.
- I have kept a copy of everything and written down the date I sent it.
After you send it
- Watch your email for the invitation to the Katie Beckett online portal. You can upload documents, check status and message your caseworker there.
- Open every letter from the state the day it arrives. If anything is denied, you have 30 days to ask for a review.
At renewal
- A new DMA-6(A), signed and dated within 90 days.
- A new Medical Necessity/Level of Care Statement.
- A psychological evaluation, if the last one is more than three years old and your child needs one.
- The renewal checklist in the online portal, completed.
Once your child has Medicaid and needs nursing or personal care at home, the next step is GAPP. Our GAPP guide explains it, or tell us about your child.
Common questions
What do I need for a Katie Beckett application in Georgia?
Form 94, the Pediatric DMA-6(A) signed by the physician and parent, the Medical Necessity/Level of Care Statement signed by the physician and primary caregiver, the cost-effectiveness Form 704, and your child's IEP or IFSP if they have one. A psychological or developmental evaluation is needed for conditions that affect thinking or learning.
How long is the DMA-6(A) valid?
90 days. It must be completed in full, signed and dated by the physician and the parent, and completed again at each renewal.
Where do I send a Katie Beckett application?
To the Centralized Katie Beckett Medicaid Team, 2211 Beaver Ruin Road, Suite 150, Norcross, GA 30071, by fax to 678-248-7459, through any DFCS office, or online at gateway.ga.gov. Do not use the old P.O. Box 172 address.
Sources
- Georgia Department of Community Health, Part II Policies and Procedures for Georgia Pediatric Program (GAPP) In-Home Nursing, July 1, 2025 edition, published on GAMMIS under Provider Manuals.
- Georgia Department of Community Health, Georgia Pediatric Program (GAPP) provider presentation, June 2023, published on the Georgia Medicaid Management Information System portal.
- Georgia Medicaid, Waiver Programs.
- Georgia Department of Community Health, Community Based Services.
- Georgia Medicaid, TEFRA/Katie Beckett.
- Georgia Department of Community Health, Policies and Procedures for TEFRA/Katie Beckett Deeming Waiver, revised April 1, 2022.
Please read. This article is general information about a public program, not medical, legal or financial advice, and it is not a decision about your child. Program rules change. Confirm anything that matters with the Georgia Department of Community Health or with a GAPP participating agency before you rely on it.