Part 2 - Local Educational Agency (LEA)



Appeal Form Completion (appeal form) (Revision Date May 29, 2020) | (792KB)
California Children's Services (CCS) Program (cal child) (Revision Date May 29, 2020) | (298KB)
CCS Program Billing Guidelines (cal child bil guide) (Revision Date May 29, 2020) | (68KB)
CIF Completion (cif co) (Revision Date May 29, 2020) | (813KB)
CIF Submission and Timeliness Instructions (cif sub) (Revision Date May 29, 2020) | (138KB)
Dental Benefits (dental) (Revision Date May 29, 2020) | (50KB)
Forms: Legibility and Completion Standards (forms leg) (Revision Date May 29, 2020) | (99KB)
Forms Reorder Request: Guidelines (forms reo) (Revision Date May 29, 2020) | (86KB)
Genetically Handicapped Persons Program (GHPP) (genetic) (Revision Date May 29, 2020) | (225KB)
HCPCS Introduction (hcpcs) (Revision Date May 29, 2020) | (79KB)
Local Educational Agency (LEA) (loc ed) (Revision Date May 29, 2020) | (136KB)
Local Educational Agency (LEA): Telehealth (loc ed tele) (Revision Date May 29, 2020) | (113KB)
Modifiers: Approved List (modif app) (Revision Date Jul 16, 2020) | (295KB)
Other Health Coverage (OHC) (oth hlth) (Revision Date May 29, 2020) | (137KB)
Remittance Advice Details (RAD) (remit adv) (Revision Date May 29, 2020) | (141KB)
Sign Language Interpretation (sign) (Revision Date May 29, 2020) | (200KB)
UB-04 Completion: Outpatient Services (ub comp op) (Revision Date May 29, 2020) | (330KB)
UB-04 Submission and Timeliness Instructions (ub sub) (Revision Date May 29, 2020) | (160KB)
UB-04 Tips for Billing: Outpatient Services (ub tips op) (Revision Date May 29, 2020) | (130KB)


Note:
If you cannot view the MS Word or PDF (Portable Document Format) documents correctly, please visit the Web Tool Box to link to a download site for the appropriate reader.