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Medi-Cal Manual Claim Forms- 1982B and 1982C

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MH1982B SDMC Quarterly Claim for Reimbursement: Administrative Costs

Submit Claim Forms

MHP Director-signed 1982B Claim Forms should be submitted by email to:  

MHP Director-signed 1982C Claim Forms should be submitted by email to:


Note: Please do not include the MH1982B or 1982C with the MH1982A in the claim submission .zip file. 

Contact Us

If you have any questions regarding these forms, please contact MedCCC at (916) 650-6525 or

Last modified on: 5/10/2017 8:32 AM