Designated Intermediate Care Facilities

The Designated Intermediate Care Facility (DICF) Quality Assurance Fee (QAF) program is governed by the California Health and Safety Code, Sections 1324 through 1324.14. These provisions require the California Department of Health Care Services (DHCS) to impose a QAF based on the gross receipts for each DICF, including Developmentally Disabled (DICF-DD), Developmentally Disabled Habilitative (DICF-DD-H), and Developmentally Disabled Nursing (DICF-DD-N). For the purposes of this program, the term “gross receipts" is defined as compensation for services provided to residents of a DICF, not including the following:

  1. Return of any amounts to the payer as a result of overpayments
  2. Bad debts
  3. Vendor rebates received by the facility
  4. Charitable contributions received by the facility

As a condition for a DICF to participate in the Medi-Cal program, payments to DHCS must be made on or before the last day of each calendar quarter, following the calendar quarter for which the fee is imposed. DHCS has the discretion to make retroactive adjustments as necessary to ensure that the fees collected do not exceed 6 percent. Please refer to the following link regarding important changes to DICF QAF requirements: DICF Bulletin 388      

Please note that the Day Treatment Costs Payment section has been removed from the QAF quarterly payment invoices. Separate invoices will be mailed for Day Treatment Costs Payments.

QAF-DICF Payment and Reporting Forms

Online Submission Forms - Use these links to electronically submit gross receipts data:

Printable Forms - Use these links to print the form and mail gross receipts data:

Please make sure to enter your facility name, address, and National Provider Identification (NPI) number, so that your payment will be credited to the correct account.

Provider bulletins and rates information is available on the Long Term Care Reimbursement webpage.  

DHCS now accept Electronic Funds Transfer (EFT) to the DICF programs. For more information, please visit the TPLRD EFT Payments webpage.

Note: If  you misplaced or do not have an invoice number, refer to the following table and use the default invoice number to make a payment.

​QAF Program ​Invoice Number
​Designated Intermediate Care Facility (DICF)​ICF12345678
​Day Treatment - DICF​DAY12345678


When paying by EFT using the default Invoice Number above, please send an email to  and include the details listed below to ensure the EFT payment is posted and applied correctly:

  • Provider Name
  • National Provider Identifier (NPI) Number
    • If you share an NPI with another facility, please provide your Vendor Number.
  • Amount of the EFT payment
  • Date of EFT payment
  • Payment invoices and/or census data identifying what the EFT payment is for (i.e., quarter and rate year).


Any questions about the QAF payments should be directed to:

Department of Health Care Services
Third Party Liability & Recovery Division
Quality Assurance Fee Program - MS 4720
P.O. Box 997425
Sacramento, CA  95899-7425

Phone: (916) 650-0583
Fax: (916) 440-5671 

Back to QAF Home Page 

Last modified date: 11/1/2019 2:51 PM