Katie Beckett, also called TEFRA, is a Georgia Medicaid program for children 18 and under with disabilities who live at home. It ignores family income and looks instead at the level of care the child needs: the kind provided in a hospital, a nursing facility, or a care facility for people with intellectual disabilities. You apply with Form 94 and two medical forms, sent to the Centralized Katie Beckett Medicaid Team in Norcross. Once approved, a level of care decision now lasts at least two years.
For many Georgia families it is the door to everything else. A child who has Medicaid through Katie Beckett can then receive GAPP nursing or personal support at home, Medicaid’s autism services and other covered care. This page explains who qualifies, what to send, and what to do if the answer is no.
What Katie Beckett is
The program was created in 1982 under the federal Tax Equity and Fiscal Responsibility Act, which is why it is also called TEFRA. It lets the state ignore family income for certain children with disabilities who live at home rather than in an institution. Income eligibility is based solely on the child’s own income, and an approved child gets the same Medicaid coverage as any other Georgia Medicaid member.
You will often see it called the “Katie Beckett waiver”. The state’s own manual calls it the TEFRA/Katie Beckett deeming waiver. They are the same program.
Who qualifies
All of these have to be true:
- Your child is 18 or younger and lives at home.
- Your child qualifies as disabled under the Social Security definition of disability.
- Your child needs an institutional level of care. Specifically, the care provided in a hospital, a nursing facility, or an intermediate care facility for people with intellectual disabilities (ICF/ID).
- Care at home costs Medicaid no more than the institution would. This is checked with the Katie Beckett cost-effectiveness form, Form 704.
Qualification is not based on a diagnosis. Two children with the same diagnosis can get different answers, because the review looks at the care each child actually needs.
The levels of care, in plain words
- Nursing facility level of care fits a child who does not need a hospital but, on a regular basis, needs licensed nursing, rehabilitation or other health-related services. The state’s criteria list four conditions, and all four must be met.
- ICF/ID level of care fits a child who needs the kind of active treatment a facility for people with intellectual disabilities or related conditions provides.
- Hospital level of care is the third option in the federal rules, for children whose needs are at that level.
Level of care and disability are reviewed by Alliant Health Solutions for the Department of Community Health.
How to apply
- Get Form 94. It is the Katie Beckett Medicaid application, in English or Spanish, on the Georgia Medicaid website. You can also ask the Centralized Katie Beckett Medicaid Team (678-248-7449) or your county DFCS office for one.
- Ask your child’s doctor for the two medical forms. The Pediatric DMA-6(A) must be completed in full and signed and dated by the physician and by you, and it is valid for 90 days, so send it soon after it is signed. The Medical Necessity/Level of Care Statement must be signed and dated by the physician and the primary caregiver.
- Add the cost-effectiveness form. Form 704 compares the cost of caring for your child at home with the cost of institutional care.
- Add the plans and evaluations you have. If your child has an Individualized Education Plan (IEP) or an Individualized Family Service Plan (IFSP) from Babies Can’t Wait, it must be included. If your child has a condition that affects thinking or learning, such as autism, cerebral palsy, Down syndrome or an intellectual disability, Alliant will ask for a psychological or developmental evaluation by a licensed professional. Evaluations by school psychologists and Babies Can’t Wait are accepted.
- Send it. Mail or deliver it to the Centralized Katie Beckett Medicaid Team, 2211 Beaver Ruin Road, Suite 150, Norcross, GA 30071, fax it to 678-248-7459, take it to any DFCS office, or apply online at gateway.ga.gov. Do not use the old P.O. Box 172 address. It has not been accepted since June 17, 2024.
- Set up the portal. Once your application is entered, you receive an email inviting you to the Katie Beckett online portal, launched April 15, 2026. There you can upload documents, see the status of your application or renewal and its checklist, and message your caseworker.
Our printable Katie Beckett checklist puts every item on one page.
Renewals
Georgia now authorizes level of care approvals that meet the standard for no less than two years, for new and existing members. Eligibility is still redetermined periodically, and each time you will need a current DMA-6(A) and a current Medical Necessity/Level of Care Statement. A psychological evaluation, when your child needs one, is required every three years. The online portal shows your renewal checklist.
If Katie Beckett is denied
- Administrative review within 30 days. If the level of care or disability review is denied, you receive an “Initial Denial of Admission/Continued Stay” notice. You can request an administrative review within 30 days of it. Include every issue you disagree with and any additional medical information. If you do not request a review, the denial becomes final on the 30th day. The state allows two days for the letter to reach you, and if the 30th day falls on a weekend or holiday, the next business day counts.
- Hearing within 30 days of the final denial. If the review is also denied, the Legal Services Section of the Department of Community Health must receive your request for a hearing before an Administrative Law Judge within 30 days of the date of the “Final Denial” letter. Send a copy of the letter with it. You can speak for yourself at the hearing or have a friend or family member speak for you.
How Katie Beckett connects to GAPP
Katie Beckett gives your child Medicaid. It does not provide nursing at home by itself. If your child needs skilled nursing or hands-on personal care at home, GAPP is the program for that, and it is requested separately through a GAPP agency once Medicaid is in place. GAPP cannot be approved while a Medicaid application is still pending. Our GAPP guide explains the next step.
In short
- Katie Beckett is Medicaid for children 18 and under with disabilities, without counting parents’ income.
- It is based on the level of care a child needs, not on a diagnosis.
- Send Form 94, the DMA-6(A) (valid 90 days), the Medical Necessity/Level of Care Statement, Form 704, and any IEP, IFSP or evaluation.
- Approvals now last at least two years. If denied, you have 30 days to ask for a review.
If your child already has Medicaid and needs nursing or personal care at home, tell us about your child. If you are still working on Medicaid, we are glad to help you work out the order of things.
Common questions
Who qualifies for Katie Beckett in Georgia?
Children 18 and under who live at home, qualify as disabled under Social Security rules, and need the level of care provided in a hospital, a nursing facility, or an intermediate care facility for people with intellectual disabilities. Caring for the child at home must not cost Medicaid more than that institution would. Qualification is based on the level of care, not on a diagnosis.
Does Katie Beckett count my income?
No. Georgia's Katie Beckett program ignores family income. Income eligibility is based solely on the child's own income.
How do I apply for Katie Beckett in Georgia?
Complete Form 94 and send it with the medical forms to the Centralized Katie Beckett Medicaid Team, 2211 Beaver Ruin Road, Suite 150, Norcross, GA 30071 (phone 678-248-7449, fax 678-248-7459), or apply through any DFCS office or online at gateway.ga.gov. The old P.O. Box 172 address has not been accepted since June 17, 2024.
How long does Katie Beckett approval last?
Georgia now authorizes level of care approvals that meet the standard for no less than two years. The physician's DMA-6(A) and the Medical Necessity/Level of Care Statement are still needed at each renewal, and a psychological evaluation, when one is required, is needed every three years.
Does Katie Beckett cover autism therapy?
An approved child gets the same Medicaid coverage as other Georgia Medicaid members. Georgia Medicaid covers autism assessment and treatment for members under 21 with a documented diagnosis, based on medical necessity.
What can I do if Katie Beckett is denied?
Request an administrative review within 30 days of the Initial Denial letter, with any additional medical information. If that review is denied, request a hearing within 30 days of the Final Denial letter by sending it, with a copy of the letter, to the Legal Services Section of the Department of Community Health.
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.