May 12, 2022
The following are the requirements and procedures to report Intermittent Clinics and Mobile Health Units as required pursuant to the Welfare & Institutions (W&I) Code, Section 14043.15(e). This update only applies to intermittent clinic sites that are operated by a licensed (parent) primary care clinic and does not apply to unlicensed clinics reporting an intermittent clinic site.
Intermittent clinic sites of unlicensed clinics must submit a full application through Provider Application and Validation for Enrollment (PAVE) to enroll.
Pursuant to W&I Code, Section 14043.15(e), new or converted intermittent clinic sites that are operated by a licensed (parent) primary care clinic are to report to the Department of Health Care Services (DHCS) via written notification on letterhead at the address below:
Department of Health Care Services
Provider Enrollment Division
P.O. Box 997412, MS 4704
Sacramento, CA 95899-7412
For more detailed information, providers may refer to the Requirements and Procedures for Reporting of Intermittent Clinics and Mobile Health Units located on the Provider Enrollment page of the Medi-Cal Provider website.