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Cost and Reimbursement Comparison Schedule (CRCS) for Fiscal Year 2011-12

Page Updated: September 16, 2013 


NOVEMBER 30, 2013


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 Quarterly Reimbursement Report will assist LEAs to complete CRCS Worksheets A-4 and B-4 for each FMAP period.  LEAs should verify the reasonableness between your internal accounting system and the LEA Quarterly 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 Quarterly 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.




FY 2011-12 CRCS FORM: 


FY 2011-12 CRCS RESOURCES:    



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, 2013, 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: FY1011.1234567890.SampleSchoolDistrict.10.15.2013.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 2011-2012 CRCS due November 30, 2013, 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: 7/28/2016 10:32 AM