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Cost and Reimbursement Comparison Schedule for FY 2012-13

Updated: October 14, 2014


The submission deadline for the Cost and Reimbursement Comparison Schedule (CRCS) for Fiscal Year 2012-13 is November 30, 2014.


Participants in the LEA Medi-Cal Billing Option (LBO) Program are required to annually certify, through the CRCS process, that the public funds expended to provide LBO Program services are eligible for federal financial participation. Therefore, continued enrollment in the LBO Program is contingent upon timely submission of the CRCS each fiscal year. Failure to meet this requirement may result in removal from the LBO Program.




NOTE: The LEA Annual Reimbursement Report will assist LEAs to complete CRCS Worksheets A-4 and B-4. LEAs should verify the reasonableness between your internal accounting system and the LEA Annual Reimbursement Report and accurately input encounters, units and reimbursement information for each procedure code/modifier combination on your CRCS form. Potential discrepancies between the LEA Annual Reimbursement Report and your internal system numbers should be documented to support the numbers you input on the CRCS forms and to provide an accounting documentation trail for review and audit. (Please note quarterly reimbursement reports are no longer available.


FY 2012-13 CRCS FORM:



A&I will conduct a field audit and/or desk review of the CRCS to audit submitted information and complete the final settlement amount. To facilitate this process, the reports and supporting documents must be maintained by each LEA for a minimum of three years from the date of final submission of the CRCS. These documents must be verifiable by DHCS Audits and Investigations staff. LEA providers may appeal the determinations made by DHCS pursuant to Welfare and Institutions Code, Section 14171.


LEAs must submit the following electronic files no later than November 30, 2014, to

  • Excel version of the completed CRCS form (all worksheets)
  • Scanned version of the original signed CRCS form (i.e., PDF, JPEG, etc.)


CRCS electronic files and the subject line of the email must follow this naming convention: Fiscal Year, NPI Number, Business LEA Name, Submission Date

    • CRCS Fiscal Year Example: FY1213.1234567890.SampleSchoolDistrict.10.15.2014.CRCS.XLS (or .PDF)


LEAs are required to maintain the original hard copy CRCS with all worksheets and the Certification page signed in blue ink on site for DHCS A&I audit purposes, if necessary.


Per the Audit Review and Analysis Section (ARAS) of A&I, effective immediately, ARAS will be implementing a 100% withhold on providers who are more than 30 days past the due date of the CRCS. The 100% withhold will be lifted once the delinquent CRCS has been submitted and has passed the acceptance review. This will apply to the Fiscal Year 2012-2013 CRCS due November 30, 2014, and forward.


CRCS Questions: LEA.CRCS.Questions@DHCS.CA.GOV

CRCS Submissions: LEA.CRCS.Submission@DHCS.CA.GOV

IRUS Report Requests: LEA@DHCS.CA.GOV

Last modified on: 8/28/2017 8:39 AM