LEA Medi-Cal Billing Option Program Policy and Procedure Letters
Back to Policy and Procedure Letters Archive by Year
| Number and Date | Description | Attachment |
|---|---|---|
| PPL 26-002 May 11, 2026 | Specialized Medical Transportation Requirement Update in the LEA BOP | |
| PPL 26-001 January 26, 2026 | Practitioner Enrollment in Medi-Cal | |
| PPL 21-017R.2 January 8, 2026 | Alternative Format Request Requirements | |
| PPL 23-006 August 2, 2023 | Termination of the Public Health Emergency (PHE) Due to COVID-19 and Unwinding of the PHE Flexibilities | |
| PPL 23-005 May 25, 2023 | Submitting Quarterly Random Moment Time Survey (RMTS) Percentage Results to the Department of Health Care Services (DHCS) | PPL 23-005 Attachment A |
| PPL 23-004R September 11, 2023 | Alternative Format Extension | |
| PPL 22-009R June 21, 2022 | Local Educational Agency Medi-Cal Billing Option Program (LEA BOP) Reimbursement for Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Screening Services | |
| PPL 22-008R May 13, 2022 | Notification of Expansion of Covered Services Provided by Associate Marriage and Family Therapists (AMFTs) and Registered Associate Clinical Social Workers (ACSWs) | |
| PPL 22-006 March 21, 2022 | Notification of Reimbursement for Vaccine Administration and Vaccine Counseling in the Local Educational Agency Medi-Cal Billing Option Program (LEA BOP) | |
| PPL 22-002 January 18, 2022 | New submission requirement related to the State Fiscal Year 2020-21 Cost Reimbursement Comparison Schedule. | |
| PPL 22-001 January 12, 2022 | Calculation of Medicaid Eligibility Rate by State Fiscal Year for LEA Medi-Cal Billing Option Program Cost Reporting | MER Assistance Form |
| PPL 21-042 December 10, 2021 | Notification of State Fiscal Years 2015-16 through 2019-20 Cost Settlement Requirements for the Local Educational Agency Medi-Cal Billing Option Program. | |
| PPL 21-040 December 10, 2021 | Notification of Reimbursement for COVID-19 Vaccinations in the Local Educational Agency Medi-Cal Billing Option Program (LEA BOP) | |
| PPL 21-015R December 1, 2021 | Unsatisfactory Immigration Status Beneficiaries in the Local Educational Agency Medi-Cal Billing Option Program | |
| PPL 21-034R February 9, 2022 | Local Education Agency Medi-Cal Billing Option Program (LEA BOP) notification of opportunities for COVID-19 testing in schools and the impact on local educational agency LEA BOP reimbursement. | |
| PPL 21-030 October 18, 2021 | Local Education Agency Medi-Cal Billing Option Program (LEA BOP) notification of policy related to Time Survey Participants (TSPs) that are identified as being in the incorrect participant pool for the Random Moment Time Survey (RMTS). | |
| PPL 21-029 October 4, 2021 | Local Education Agency Medi-Cal Billing Option Program (LEA BOP) notification of contractor placement on the Time Survey Participant (TSP) lists for the Random Moment Time Survey (RMTS). | |
| PPL 21-028 October 4, 2021 | Local Education Agency Medi-Cal Billing Option Program (LEA BOP) notification of inclusion of Long-Term Direct Service Practitioner Substitutes and Administrative Service Personnel Substitutes in the Random Moment Time Survey (RMTS) Process. | |
| PPL 21-025 October 4, 2021 | Local Education Agency Medi-Cal Billing Option Program (LEA BOP) notification of the compliance process for LEA Providers that do not submit the Cost and Reimbursement Comparison Schedule by the mandated due date. | |
| PPL 21-024 October 4, 2021 | Local Education Agency Medi-Cal Billing Option Program (LEA BOP) notification of proposed regulation update related to the authorization of speech pathology and audiological services, occupational therapy services, and physical therapy services. | |
| PPL 19-025R September 28, 2021 | Random Moment Time Survey (RMTS) Pre-Sample Question (revised) | |
| PPL 21-019 August 17, 2021 | Local Educational Agency Medi-Cal Billing Option Program billing guidance to LEA Providers participating in the LEA BOP regarding covered direct medical services provided to Medi-Cal enrolled students via telehealth. | |
| PPL 21-018 August 16, 2021 | Local Educational Agency Medi-Cal Billing Option Program policy related to annual or triennial individual education plans (IEP) and individual family service plans | |
| PPL 21-017R December 10, 2021 | Alternate Format Request Requirements (revised) | |
| PPL 21-017 August 10, 2021 | Alternate Format Request Requirements | |
| PPL 21-016 July 20, 2021 | Local Educational Agency (LEA) Medi-Cal Billing Option Program Direct Medical Services Provided to Medi-Cal Enrolled Students by LEA-Contracted Health Service Practitioners. | |
| PPL 21-007 March 18, 2021 | Local Educational Agency Medi-Cal Billing Option Program (LEA BOP) Interpretation of “Complete 15-Minute Period” Following an Initial Service Increment. | |
| PPL 20-052 November 10, 2020 | Claiming Targeted Case Management (TCM) Costs for the School-Based Medi-Cal Programs | |
| PPL 20-051 November 5, 2020 | Notification for Stakeholders Participating in the Local Educational Agency Billing Option Program that the Department Encourages the Coordination of Mental Health Services With Their Respective Special Education Local Plan (SELPA), County Office of Education (COE), County Mental Health Plan (MHP), and Managed Care Organization (MCO). | |
| PPL 20-046 November 2 , 2020 | Notification of New Requirements for the Quarter One Time Survey Participant (TSP) List For The Local Educational Agency Medi-Cal Billing Option Program (LEA BOP) Under The Random Moment Time Survey (RMTS) Process | |
| PPL 20-045 October 26, 2020 | Notification of Approved California State Plan Amendment (SPA) 16-001 Regarding Targeted Case Management (TCM) Services for the Local Educational Agency Medi-Cal Billing Option Program (LEA BOP) | |
| PPL 20-043 October 12, 2020 | Notification of Random Moment Time Survey (RMTS) 85% Compliance Policy for School Based Medi-Cal Programs | RMTS Compliance Threshold Attachment |
| PPL 20-040 August 26, 2020 | Notification of Cost Settlement Process for Specialized Medical Transportation (SMT) in the Local Educational Agency Medi-Cal Billing Option Program (LEA BOP) | |
| PPL 20-039R November 30, 2021 | Notification of New Services and New Practitioners in the Local Educational Agency Medi-Cal Billing Option Program (LEA BOP) | |
| PPL 20-039 August 12, 2020 | Notification of New Services and New Practitioners in the Local Educational Agency Medi-Cal Billing Option Program | Attachments A&B |
| PPL 20-038 August 11, 2020 | Notification of Temporary Increase of 6.2 Federal Medicaid Assistance Percentage (FMAP) During The COVID-19 Public Health Emergency | |
| PPL 20-037 August 10, 2020 | This Policy and Procedure Letter (PPL) notifies LEAs interested in participating in the LEA BOP that the new quarterly enrollment process will begin on January 1, 2021. | LEA Enrollment and Timeframe |
| PPL 20-033 August 12, 2020 | Notification of Reinstatement of Targeted Case Management Claiming for the Local Educational Agency Medi-Cal Billing Option Program | TCM Form |
| PPL 20-031 July 24, 2020 | Notification of New Requirements for Time Survey Participation Equivalency Requests for the Local Educational Agency Medi-Cal Billing Option Program (LEA BOP) Under the Random Moment Time Survey (RMTS) Process | Equivalency Request Form |
| PPL 20-029 July 8, 2020 | Notification of Expansion of Covered Services Population Under the Local Educational Agency Medi-Cal Billing Option Program (LEA BOP) | |
| PPL 20-028 July 22, 2020 | Notification of the Termination of LEAs that failed to submit a Provider Participation Agreement (PPA) For State Fiscal Year (SFY) 2020-21 | |
| PPL 20-022R October 30, 2020 | Notification of Random Moment Time Survey Requirement (RMTS) for the Local Educational Agency Medi-Cal Billing Option Program (LEA BOP) | Model 2 Certification |
| PPL 20-014R September 15, 2020 | Local Educational Agency Medi-Cal Billing Option Program (LEA BOP) Telehealth Policy Relative to the 2019 Novel Coronavirus (COVID-19) | |
| PPL 20-012R September 8, 2020 | Notification of Approved California State Plan Amendment (SPA) 15-021 Regarding LEA BOP Services | |
| PPL 20-004R August 4, 2020 | Notification of State Plan Amendment (SPA) 15-021 Requirements in Fiscal Year (FY) 2019-20 for Local Educational Agency Providers | |
| PPL 20-003 January 6, 2020 | Notification of the Compliance Process for Local Educational Agency Providers that Did Not Submit the Cost and Reimbursement Comparison Schedule for Prior Reporting Years | |
| PPL 19-033 December 19, 2019 | LEA Psychology/ Counseling CPT Replaced With New CPT Codes | |
| PPL 19-019 September 18, 2019 | Amendment to the annual submission requirements for the Cost and Reimbursement Comparison Schedule (CRCS). | |
| PPL 19-015 June 28, 2019 | Authorizations for direct medical treatment services may be signed by Physician Assistants (PAs) or Nurse Practitioners (NPs), as appropriate, in place of an authorization signed by a physician. | |
| PPL 18-029 December 10, 2018 | Elimination of CPT Code 96101 and Implementation of New Replacement Code 96130 in the Local Educational Agency Medi-Cal Billing Option Program | |
| PPL 18-027 November 13, 2018 | Specialized Medical Transportation in the Local Educational Agency Medi-Cal Billing Option Program | |
| PPL 18-018R April 25, 2018 | Notification of Ordering, Referring or Prescribing Practitioner Requirements in the Local Educational Agency Medi-Cal Billing Option Program | |
| PPL 18-016 May 16, 2018 | Elimination of Current Procedural Terminology Codes 97001, 97002, 97003 and 97004; and Implementation of Four New Replacement CPT Codes 97163, 97164, 97167 and 97168 | |
| PPL 17-016 November 13, 2017 (Replaces PPL 15-018) | Notification of Compliance Process for LEAs that Do Not Submit the Provider Participation Agreement (PPA) by the Mandated Due Date | |
| PPL 17-002 February 16, 2017 | Rescinding Policy and Procedure Letters (PPL) 13-004, 13-014, and 16-019 Regarding Subrecipient Monitoring for CMAA, TCM, LEA BOP, and SMAA Contracts | |
| PPL 16-012 July 1, 2016 | Notification of Third-Party Liability Recoupment Requirements | |
| PPL 16-010 June 10, 2016 | Implementation of Electronic Signature Policy | |
| PPL 15-024R June 28, 2016 PPL 15-024 December 1, 2015 (superseded by 15-024R) | Implementation of Telehealth for Speech Therapy Services in the Local Educational Agency Medi-Cal Billing Option Program | |
| 15-023 December 1, 2015 | Elimination of CPT Code 92506; and Implementation of Four New Replacement CPT Codes 92521-92524; and Implementation of New Audiology Code 92557 | |
| 15-020 August 24, 2015 | Implementation of the Evergreen Provider Participation Agreement (PPA) in the LEA Medi-Cal Billing Option Program | |
| 15-019 July 24, 2015 | Notification of Compliance Process for LEAs that Do Not Submit the Cost and Reimbursement Comparison Schedule by the Mandated Due Date | |
| 15-018 July 29, 2015 | Notification of Compliance Process for LEAs that Do Not Submit the Provider Participation Agreement and the Annual Report by the Mandated Due Date | |
| 15-017 July 1, 2015 | Notification of new Cost and Reimbursement Comparison Schedule Certification Statement for Participating LEAs Receiving No LEA Medi-Cal Billing Option Reimbursement During a Fiscal Year | |
| 15-016 July 1, 2015 | Notification of Approved California State Plan Amendment Number 12-009 Targeted Case Management Services and the June 30, 2015, Sunset of Current Reimbursement Methodology | |
September 13, 2013 | LEA Medi-Cal Billing Option Program – Freedom of Choice of Qualified Medicaid Providers including TCM Providers | |
July 1, 2013 | LEA Medi-Cal Billing Option Program – Contracted Practitioners | |
June 6, 2013 | Department of Health Care Services Authority to Establish, Provide and Disseminate Policy Related to the LEA Medi-Cal Billing Option Program | |
January 8, 2013 | LEA Medi-Cal Billing Option Program – Revision to Medical Transportation Outlined in Assembly Bill 2608 | |
| June 5, 2012 | Prohibition on Claiming Reimbursement for Contingency Fees | |
March 30, 2012 | LEA Medi-Cal Billing Option Program – Changes to Standardized Account Code Structure Resource Code 5640 | |