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MedCCC Library 

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Aid Code Master Chart (SDMC)

CSI & DCR Home Page  

Certification Forms

MC 1982 A: SDMC Monthly Claim for Reimbursement - Treatment Cost.pdf 

MC 1982 B: SDMC Quarterly Claim for Reimbursement - Administrative Cost.pdf 

MC 1982 B: SDMC Quarterly Claim for Reimbursement - Administrative Cost.xls

MC 1982 C: SDMC Monthly Claim for Reimbursement - Quality Assurance/Utilization Review (QA/UR) Cost.pdf 

MC 1982 D: SDMC Quarterly Claim for Reimbursement - Medi-Cal Administrative Activities (MAA).pdf

MC 1982 D: SDMC Quarterly Claim for Reimbursement - Medi-Cal Administrative Activities (MAA).xls  

 

Claim Payment Timeliness Report 

County Interim Rate Table

FY 2015-16 County Interim Rate Table.pdf 

FY 2014-15 County Interim Rate Table.pdf

FY 2013-14 County Interim Rate Table.pdf

FY 2012-13 County Interim Rate Table.pdf

Direct Services: County Payment Status

 

Please send any comments or questions about the link above to: MedCCC@dhcs.ca.gov

EPSDT State General Fund (SGF) Payment Tables     

FY 2010-11 EPSDT SGF County Ratios.pdf

FY 2009-10 EPSDT SGF County Ratios.pdf

FY 2008-09 EPSDT SGF County Ratios.pdf

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Katie A Implementation Home Page

 

Managed Care Allocations

          FY10-11 Managed Care Allocation Distribution

FY10-11 Managed Care Allocation Final          

FY09-10 Managed Care Allocation Distribution

FY09-10 Managed Care Allocation Final

 Mental Health Provider Statement Information 

Field Definitions.pdf

Differences between MHP Statement and Weekly Report.pdf 

Where to Download an MHP Statement.pdf 

MHP Statement: A Sample.pdf                                                                                                                                           Back to Top

References and Manuals

837 Claim File Submission Validation (SR, TA1, 999).pdf

ACA Information 

Mental Health Medi-Cal Billing Manual (Rev. 10/13)

Procedure Code Crosswalk.pdf

Links to Other MedCCC Pages

Back to MedCCC Home Page

Last modified on: 8/27/2015 5:01 PM