​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​CCS Numbered Letters

Numbered Letter Web Page Updates​

As part of the Department of Health Care Services (DHCS) project to make all DHCS webpages compliant with the Americans with Disabilities Act (ADA), The Integrated Systems of Care Division (ISCD) is reorganizing this California Children's Services (CCS) Numbered Letter (N.L.) webpage. This includes ISCD removing all references to inactive and outdated N.L.s and only listing active N.L.s.

If you need to access a N.L. that is no longer being displayed on this website, or the N.L. hyperlink displayed is not working, please send a request to CCSProgram@dhcs.ca.gov, including the CCS N.L. number and/or title you were trying to access, and we will forward to you a copy of the inactive N.L.

Download the latest version of Adobe Acrobat Reader to view or print these documents.  Sign up for e-mail notices (LISTSERV) when CMS Branch letters are posted.

2014 | 201320122011 | 2010 | 2009 | 2008 | 2007 | 2006 | 2005 | 2004 | 2003 | 2002 | 2001 | 2000 | 1999 | 1997 | 1994 

2021

​Number​Release Date

​Index Category​Title (Subject) of Letter

03-0421​
​04-15-21 
​Case Management
​California Children's Services Program Whole Child Model (Revised)

Note: Supersedes: N.L. 04-0618


02-032105-25-21 
​Authorization/Benefits

​Antisense Oligonucleotide Treatment of Duchene Muscular Dystrophy

Note: Supersedes N.L. 05-0618, 11-1120

01-0121


​01-11-21

​Authorization/Benefits
Cystic Fibrosis Transmembrane Conductance Regulator Modulator Drug Therapies

 

Note: Supersedes N.L.: 13-1120

2020

​Number​Release Date​Index Category​Title (Subject) of Letter

​15-1120


​11-19-20

​Authorization/Benefits
​Treatment for Spinal Muscular Atrophy

Note: Supersedes N.L.: 01-0218

14-1120

​11-19-20
​Medical Therapy Program

​Documentation Standards for the California Children's Services Medical Therapy Program

12-1120

​11-19-20
​Authorization/Benefits
​Bone Conduction Hearing Devices

Note: Supersedes N.L.: 09-0817

10-1120​11-17-20Authorization/Benefits

​Authorization of Sapropterin Dihydrochloride (Kuvan) - Revised

Note: Supersedes N.L.: 02-0315, 01-0109

09-1120​11-17-20Authorization/Benefits

​Policy on Palyniq (pegvaliase-pqpz) for Patients with Phenylketonuria- Revised

Note: Supersedes N.L.: 08-1119

08-1120​11-17-20​Authorization/Benefits

​California Children's Services Program coverage of treatment for Central Precocious Puberty - Revised

Note: Supersedes N.L. 04-1019

07-1120​11-17-20Authorization/Benefits

​Authorization of Restricted Treatment Drugs for Bleeding Disorders - Revised

Note: Supersedes N.L.: 01-0819

06-1120​11-17-20​Benefits

​Authorization of Insulin Infusion Pumps - Revised

Note: Superseded N.L. 11-1017, 08-0799

05-1020​10-12-20​Authorization/Benefits

​Cover​age of Experimental and Investigational Services

Note: Supersedes CCS NL 37-1292

04-0520​5-15-20​BenefitsEarly and Periodic Screening, Diagnostic, and Treatment – Private Duty Nursing Case Management Services
​03-0120​1-23-20​Benefits​Authorization Criteria for Selective Dorsal Rhizotomy
​02-0120​1-9-20​Authorization/Benefits

​Deflazacort (Emflaza) - Authorization Criteria (Revised)

Note: Supersedes CCS N.L. 15-1217

01-0120​1-7-20​Authorization/Benefits

Authorization of Enteral Formula, Nutrition Additives/Modulars, and Related Supplies (Revised)
Note: Supersedes N.L.: 18-0918, 04-0317

2019

​Number​Release Date​Index Category​Title (Subject) of Letter 
12-1119​11-18-19​Benefits

​Palliative Care Options for CCS Eligible Children

Note: Supersedes CCS N.L. 16-1218

11-1119​11-21-19​Benefits​Cerliponase​ Alfa (Brineura) - Authorization Criteria (Revised)
10-1119​11-21-19​Benefits​Voretigene Neparvovec-rzyl (Luxturna) - authorization Criteria
09-1119​11-18-19​Benefits​Authorization of Out of State Service Requests
07-1019​10-31-19​Benefits

​Tisagenlecleucel (Kymriah) - REVISED

Note: Supersedes CCS N.L. 07-1018

​05-1019​10-18-19​Program Administration​Program Requirements for Physician Assistants Providing Patient Care in Neonatal Intensive Care Units
​03-1019​10-18-19Medical Eligibility​Kawasaki Disease
​02-0919​09-30-19​Benefits​California Children's Services Program and Genetically Handicapped Persons Program Policy on Epidiolex (Cannabidiol) -REVISED

2018 

​Number
​Release DateIndex Category​
Title (Subject) of Letter​
​14-08180​9-18-18​Benefits​Continuous Glucose Monitoring (CGM)
​12-08180​8-24-18
​BenefitsCochlear Implant Updated Candidacy Criteria and Authorization Procedure
​11-08180​8-01-18​Benefits​Chapter 3.37 - CCS Provider Core, Special Care Centers (SCCs)
​10-0718​9-18-18​Benefits​Tisagenlecleuce​l (Kymriah)
​09-0718​7-17-18​BenefitsTele-Speech, Auditory Habilitation and Rehabilitation Services with the Home as the Originating Site
​06-0718​7-10-18​BenefitsAuthorization Of Diagnostic And Treatment Service For Infants Referred By The California Newborn Screening (NBS) Program For X-Linked Adrenoleukodystrophy (ALD)
03-0518​05-07-18​Benefits

​Authorization of Genetic Testing - REVISED

NOTE: Supersedes CCS N.L. 10-0291

  

​​​2017

NumberRelease DateIndex Category

Title (Subject) of Letter

16-1217​01-08-18
​Benefits​Telehealth Services Code Update for CCS Program and GHPP
12-1017​10-30-17​BenefitsIVACAFTOR (KALYDECO™) -EXPANDED INDICATION FOR USE – UPDATED NOTE: Supersedes CCS N.L. 05-0317
07-0317​​03-20-17​Medical Therapy Program​Establishment of HIP Surveillance Programs in the California Chil​dren's Services (CCS) Program, Medical Therapy Program (MTP)
01-0117​03-03-17​BenefitsLUMACAFTOR/IVACAFTOR(ORKAMBI™) - REVISED

2016

NumberRelease DateIndex CategoryTitle (Subject) of Letter
06-1116​12-05-16​Program Administration​Program Requirements for Providing Neonatal Therapeutic Hypothermia
05-1016​10-21-16​Benefits​High Risk Infant Follow-Up (HRIF) Program Services
04-0816​09-09-16
​Benefits​Authorization of Diagnostic Services for Infants referred through the California Newborn Hearing Screening Program (NHSP)
01-0616
06-30-16
Benefits
Cochlear Implant Batteries and Parts

2015  

NumberRelease DateIndex CategoryTitle (Subject) of Letter
09-1215​12-30-15​Inter-County Transfer Policy
08-1215​12-30-15
​Benefits

​Cochlear Implant Batteries and Parts (Request Form) (Supplements CCS N.L. 13-1106)

Note: Supersedes CCS N.L. 02-0411

04-0715​07-15-15​Service Authorization​Implementation of Medi-Cal Managed Care All Plan Letter (APL) 15-011, Designated Public Hospitals: Billing for Beneficiaries with California Children's Services Eligible Conditions and/or Medi-Cal Managed Care

  

2014                                                                                       

NumberRelease Date Index CategoryTitle (Subject) of Letter
16-1114​01-09-15
​SupplementsThe CCS Program Administrative Case Management Manual
15-1014​10-24-14​Benefits​Authorization of the Services and Products for the Ketogenic Diet as a Treatment for Epilepsy
13-0914​10-03-14​Benefits
​PALIVIZUMAB (SYNAGIS™)
12-0914​10-13-14​Fund Codes​MR-O-940 REPORTS - Procedures for Requesting Shift of Claim Line Costs From One Funding Category to Another Funding Category
09-051406-05-14Medical Therapy ProgramPowered Mobility Devices (PMD)
05-031404-09-14Standards for Pediatric Intensive Care UnitsThe CCS Program Pediatric Intensive Care Unit Standards Update: Annual PICU Report

04-0314

04-24-14

Program Administration

Guidelines for Critical Congenital Heart Disease Screening Services

03-031404-08-14Standards for NeonatalStandards for Neonatal Intensive Care Unit (NICU)
02-021403-12-14MTP
Implementation of Updated Tools for Classification of Function and Measurement of Functional Outcomes in the Medical Therapy Program

01-0114

​01-15-14​EPSDT​Early and Periodic Screening, Diagnosis, and Treatment - Private Duty Nursing and Pediatric Day Health Care, Treatment Authorization Requests and Services Authorization Requests

 

2013

 

 NumberRelease Date Index CategoryTitle (Subject) of Letter
14-121301-06-14Benefits
Telehealth Services for CCS and GHPP Programs

12-1113

 

 

11-12-13

Benefits

Optional Targeted Low Income Children's Program Aid Codes T1, T2, T3, T4, and T5 and Separate Children's Health Insurance Program Section 2101 (f) Aid Codes E2 and E5; Assignment of CCS Unique Aid Codes

04-061309-30-13BenefitsDental Implant Requests

02-0413

 

04-12-13

Authorizations

Neonatal Intensive Care Unit (NICU) Authorizations

NOTE: This letter supersedes N.L. 04-0511

 

2012

 

NumberRelease DateIndex CategoryTitle (Subject) of Letter

07-0612

07-12-12

Medical Therapy Program

Implementation of the Episodic Treatment Method (ETM) as an Alternative Therapy Provision Method (ATPM) in the Medical Therapy Program (MTP)

05-0612

06-27-12

Medical Benefits

Intrathecal Baclofen (ITB) Pumps for the Management of Spasticity and Dystonia

02-0612

06-20-12

Program Administration

Providing Contact Information to the Newborn Hearing Screening Program

2011

​ Number
Release DateIndex CategoryTitle (Subject) of Letter

11-1211

 

12-14-11

 Benefits

Authorization of Diagnostic Audiology and Treatment Services for Children With Hearing Loss

NOTE: This letter Supersedes CCS N.L. 21-1299

09-1011

10-25-11

 

Cochlear Implant Post Surgical Services
(Supplements CCS N.L. 09-1208)

08-1011

10-25-11

 Benefits

Genetics Evaluation For Children With Hearing Loss

07-1011

10-25-11

 

Hearing Aids (Supplements CCS N.L 12-0605)

06-1011

10-07-11

 

Authorization of Medically Necessary Concurrent Treatment Services for CCS Clients Who Elect Hospice Care

05-0811

08-23-11

 

Participation in the CCS Medical Therapy Program (MTP) Medical Therapy Conference (MTC) By CCS Program Medical Directors and Medical Consultants

 

​ 

2010

 

 NumberRelease DateIndex CategoryTitle (Subject) of Letter

03-0810

08-19-10

Benefits

Maintenance and Transportation for CCS Clients to Support Access to CCS Authorized Medical Services

NOTE: This letter supersedes CCS N.L 01-0104

02-0510

05-20-10

Benefits

Service Code Grouping (SCG) 51 Implementation

01-0510

05-20-10

Benefits

Botulinum Toxin

NOTE: This letter supersedes CCS N.L. 07-0407

 

 

 

2009

 

 Number Release Date Index Category Title (Subject) of Letter

03-0409

05-07-09

Program Administration

Interim Appeal and Fair Hearing Process for Dental and Orthodontic Denials Made by Medi-Cal Dental for CCS

02-0209

03-26-09

Benefits

Update of Table 1 (Family Size and Annual Income Level Chart) - Medi-Cal Year 2009 Federal Poverty Level Chart; Effective Beginning April 1, 2009

 

 

2008

 

NumberRelease DateIndex CategoryTitle (Subject) of Letter

10-1208

01-21-09

Benefits

Update and Clarification of Policy Related to the Authorization of Frequency Modulation (FM) Systems or Assistive Listening Devices
(Supplements 13-0605)

05-0608

05-27-08

Right to Appeal Decisions of the California Children's Services (CCS) Program

01-0108

 

01-10-08

 Benefits

CCS Outpatient Special Care Center (SCC) Services
NOTE: This letter supersedes CCS N.L. 08-0900.

​ 

2007

 

NumberRelease DateIndex CategoryTitle (Subject) of Letter

13-1007

10-12-2007

 

Implementation of Assembly Bill (AB) 1642

11-0807

08-30-07

Benefits

Hearing Aid Supplies and Maintenance (Supersedes 30-1205)

10-0707

11-09-07

Benefits

Revised Guidelines for Authorization of Oxygen, Oxygen Delivery Equipment, and Related Supplies
Note: This letter supersedes CCS N.L. 01-0107.

09-0607

06-18-07

Benefits

Authorization of Diagnostic and Treatment Services for Infants Referred by the California Newborn Screening (NBS) Program for Cystic Fibrosis (CF) and Biotinidase Deficiency (BD)

08-0507

04-26-07

Benefits

Vagal Nerve Stimulator (VNS) Implantation

05-0207

02-16-07

Benefits

Authorization of Short-Term Shift Nursing Services and HCPCS Codes for Short-Term Shift Nursing Services

04-0207

02-14-07

Benefits

Palliative Care Options for CCS Eligible Children and Codes Available for Authorization of Pediatric Palliative Care Services

02-0107

01-08-07

Benefits

Authorization of Rental of Portable Home Ventilators

01-0107

01-03-07

Benefits

Revised Guidelines for Authorization of Oxygen, Oxygen Delivery Equipment and Related Supplies and Oxygen Delivery Systems

 

 

2006

 

NumberRelease DateIndex CategoryTitle (Subject) of Letter
13-110611-27-06BenefitsCochlear Implant Speech Processor Upgrades
10-080608/30/06BenefitsAuthorization of Emergency Services Related to Trauma
07-050605/16/06BenefitsIntermittent Home Health Services Provided by a Home Health Agency (HHA) and Service Allowances (Time) Per Visit List
06-050605/01/06Growth HormoneGrowth Hormone
05-040605/05/06Medical Therapy ProgramDirections for Completion of the Quarterly Time Study (QTS) for Medical Therapy Program (MTP) for 100 Percent State-Funding to Comply with Interagency Agreements (Assembly Bill 3632), Quarterly Time Study for MTP, AND Summary Sheet
03-020605/01/06Authorizations

Neonatal Intensive Care Unit (NICU) Authorizations

NOTE: Superseded by N.L. 04-0511

02-010601/12/06 BenefitsUpdate to Medi-Cal Approved Centers of Excellence for Cochlear Implants Providing Services for CCS Eligible Beneficiaries
Note: See also 14-1003 (Superseded by 03-0411)
01-010601/09/06 BudgetsCalifornia Children’s Services (CCS) Expenditure Reporting to the California Department of Finance (DOF) for the purpose of Calculation of Realignment Caseload Growth

 

2005

 

NumberRelease DateIndex CategoryTitle (Subject) of Letter
29-110511-10-05HIPAAChanges to the CCS Notice of Privacy Practices, Spanish Version and English Version
28-110510-31-05BenefitsInstructions for Certification of Funding Under Health and Safety Code Section 123945

26-0905

09-27-05

Eligibility

Newborn Referral to the Medi-Cal Program and Newborn Referral form
23-090509-16-05DrugsEpoetin Alfa and Carnitine Removed from "Table of Drugs Requiring Separate Authorization"
NOTE: This letter supersedes Supersedes N.L.:27-0989, 01-0192, 12-0393, 20-0895, and 15-0892.

20-0605

07-08-05

Benefits

Non-Benefit Status of Regular Infant Formulas

18-060506-28-05BenefitsNationwide Recall of VAIL Enclosed Bed Systems and FDA Notifies Public That Vail Products, Inc. Issues Nationwide Recall of Enclosed Bed Systems
17-060506-13-05BenefitsAuthorization of Radiology Services as Early Periodic Screening Diagnosis and Treatment Supplemental Services (EPSDT SS)
16-060506-13-05BenefitsDelegation of Authority to Authorize Medical Nutrition Services to County CCS Programs and CMS Regional Offices
15-060506-13-05BenefitsSpeech Pathology Services and Medi-Cal Certified Outpatient Rehabilitation Centers
14-060506-13-05BenefitsAuthorization of Occupational Therapy (OT) Services and Medi-Cal Certified Outpatient Rehabilitation Centers
13-060506-13-05BenefitsDelegation of Authority for Authorization of Assistive Listening Devices to County CCS Programs and CMS Regional Offices and Request for Hearing Aids and Assistive Listening Devices
(Supplemented by 10-1208)
12-060506-13-05BenefitsDelegation of Authority for Authorization of Hearing Aids Previously Reviewed as "Non-Conventional Hearing Aids" to County CCS Programs and CMS Regional Offices and Request for Hearing Aids and Assistive Listening Devices (Supplemented by 07-10-11)
11-060506-13-05BenefitsDelegation of Authority for Authorization of Aural Rehabilitation Services to County CCS Programs and CMS Regional Offices and Medi-Cal Certified Outpatient Rehabilitation Centers
10-060506-03-05TherapyMedical Therapy Unit (MTU) Medi-Cal Reimbursement State County Cost Sharing and Reconciliation
06-0505 (PDF, 8.30MB)05-06-05BenefitsIntermediate Care Facility/Developmentally Disabled - Nursing (ICF/DD-N) Statewide Facility Listing
05-040504-01-05BenefitsAuthorization of Diagnostic Services for Infants Referred by the California Newborn Screening Program and Overview of the Genetic Disease Branch Newborn Screening Program
03-020506-13-05BenefitsDelegation of Authority to Authorize Early and Periodic Screening, Diagnosis and Treatment Supplemental Services (EPSDT SS) to County CCS Programs and CMS Regional Offices, EPSDT Supplemental Services Worksheet, EPSDT Supplemental Services Worksheet Instructions, and Notice of Action (NOA) and First Level Appeal Decision Letter
01-010501-19-05HIPAADependent and Independent County CCS Medical Therapy Program Guidelines for Development of Policies and Procedures for Implementation of the Health Insurance Portability and Accountability Act (HIPAA)
02-020501-20-05Medical Therapy ProgramFunctional Outcome Measurement for the Medical Therapy Program

  

2004

 

NumberRelease DateIndex CategoryTitle (Subject) of Letter
07-100410-28-04BenefitsHealth Care Financing Administration Common Procedural Coding System (HCPCS) Code Changes Effective November 1, 2004 for Durable Medical Equipment (DME) and Diabetic Supplies.
06-100404-08-05Program AdministrationChanges in California Children's Services (CCS) Dental and Orthodontic Service Authorizations and Claims Processing
NOTE: This letter supersedes CCS N.L. 07-0395.
NOTE: This letter is the corrected version.

04-0604

06-29-04

Enhancement 47

CCS E47 System Temporary Dual Procedure

02-010401-21-04BenefitsPurchase and Utilization of Loss and Damage (L & D) Insurance for Hearing Aids, Cochlear Implant Processors, or Alternative Listening Devices for CCS Case-Managed Beneficiaries
01-010401-09-04Transportation

Maintenance and Transportation to Assist Clients in Accessing CCS Authorized Medical Services

NOTE: This letter, which has been corrected, 
supersedes CCS N.L. 16-0801.

NOTE: This letter is superseded by CCS N.L. 03-0810.

  

2003

 

NumberRelease DateIndex CategoryTitle (Subject) of Letter
15-110312-12-03Medical Therapy ProgramRequest for Pilot Project Application: Medical Therapy Program

13-0903

09-12-03Medical EligibilityMedical Eligibility Nephrotic Syndrome
12-080308-21-03EligibilityImplementation of Assembly Bill (AB) 495; Expansion of Children’s Health Insurance Coverage
11-070307-24-03HIPAANotice of Privacy Practices for CCS Clients; Compliance with Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule
NOTE: This letter supersedes CCS N.L. 05-0403.

10-0703

08-15-03GatewayChild Health and Disability Prevention (CHDP) Program Gateway
09-070308-08-03Durable Medical EquipmentRevised California Children's Services (CCS) Guidelines for Recommendation and Authorization of Rental or Purchase of Durable Medical Equipment-Rehabilitation (DME-R)
NOTE: This letter supersedes CCS N.L. 08-0291 and
CCS N.L. 23-0793.

 

 

2002

 

NumberRelease DateIndex CategoryTitle (Subject) of Letter

11-1002

10-31-02BenefitsOutpatient Mental Health Services as CCS Benefits
08-0802 08-30-02BenefitsTwo Additional CCS Approved Metabolic Centers Providing Diagnostic Services for Infants Referred from the Newborn Screening Program Tandem Mass Spectrometry (MS/MS) Research Project
NOTE: This letter supplements CCS N.L. 01-0102.
05-050205-15-02Medical EligibilityMedical Eligibility for Care in a CCS-Approved Neonatal Intensive Care Unit (NICU)
NOTE: This letter is the corrected version. This letter supersedes
CCS N.L. 11-0999.
02-010201-31-02Benefits

Pulse Oximeters
NOTE: This letter supersedes CCS N.L. 01-0191.

01-010201-18-02Benefits

Authorization of Diagnostic Services for Infants Referred by the Newborn Screening Program (Genetic Disease Branch) for Unusual Test Results from the Supplemental Screening for Multiple Metabolic Disorders Tandem Mass Spectrometry (MS/MS) Research Project
NOTE: CCS N.L. 08-0802 supplements this letter.

  

2001

 

NumberRelease DateIndex CategoryTitle (Subject) of Letter
18-090110-17-01Medical Therapy ProgramReimbursement of Local Education Agencies (LEA) or Special Education Local Planning Areas (SELPA) for Provision of Medically Necessary Therapy Services to Children Medically Eligible for CCS/Medical Therapy Program (MTP)
11-060106-12-01-CCS Policy Regarding the Requirement that all CCS Applicants Shall Make Application to the Medi-Cal Program; Health and Safety Code Section 123995
NOTE: This letter supersedes CCS N.L. 03-0300.

​ 

2000

 

NumberRelease DateIndex CategoryTitle (Subject) of Letter
11-1600             12-07-00 Medical Therapy Program Duplication of Physician or Therapy Services Being Provided Through the California Children's Services (CCS)/Medical Therapy Program (MTP)

  

1999

 

NumberRelease DateIndex CategoryTitle (Subject) of Letter
17-119901-14-00BenefitsAutomobile Orthopedic Positioning Devices (AOPDS)
​​ 02-029903-10-99BenefitsMedical Nutrition Assessment and Medical Nutrition Therapy for Children with CCS Medical Eligible Conditions

 

1997

 

NumberRelease DateIndex CategoryTitle (Subject) of Letter

16-0597

05-30-97

Medical Therapy Program

Medical Therapy Program (MTP) Clerical Support Staffing

06-0397

03-10-97

Medical Therapy Program

The Medical Therapy Program (MTP): Dispute Resolution Through "Expert" Physician

02-0197

01-16-97

Durable Medical Equipment

Authorization of Flutter Valves and ThAIRapy Vests

 

1994

 

NumberRelease DateIndex CategoryTitle (Subject) of Letter

43-1194

11-14-94

Medical Therapy Unit

Utilization Review for Outpatient Rehabilitation Center Certification

06-039403-10-94InsuranceRequired Use of Health Insurance

 

1992

 

NumberRelease DateIndex CategoryTitle (Subject) of Letter

29-1092

 

10-07-1992

RehabilitationRehabilitation Facilities Admission Criteria

 


 

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Last modified date: 6/1/2021 10:36 AM