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 This includes ISCD removing all references to inactive and outdated N.L.s and only listing active N.L.s.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.

Sign up for e-mail notices (LISTSERV) when CMS Branch letters are posted.

2022 | 2021 | 2020 | 2019 | 2018 | 2017 | 2016 | 2015 | 2014 | 2013 | 2012 | 2011 | 2010 | 2009 | 2008 | 2007 | 2006 | 2005 | 2004 | 2003 | 2002 | 2001 | 2000 | 1999 | 1997 | 1994 | 1992

2026

Number	Release Date	Index Category	Title (Subject) of Letter
01-0126	01-16-2026	Program Administration	CCS Program Reporting and Survey Attachment A: Compliance Activities Attachment B: High Risk Assessment Tool Exhibit 1: CCS County Monitoring Template – Quarterly Reports Exhibit 2: CCS County Monitoring Template – Annual Reports Note: Supersedes N.L. 09-1123

2025

Number	Release Date	Index Category	Title (Subject) of Letter
06-1225	12-22-2025	Program Administration	California Children’s Services Members with Unsatisfactory Immigration Status –  Revised
05-1125	11-24-2025	Administrator	California Children’s Services Program Medical Documentation
03-0825	08-15-2025	Benefits	Low-Protein Therapeutic Foods as a Benefit for California Children’s Services Program and Genetically Handicapped Persons Program Beneficiaries with Inborn Errors of Metabolism
02-0525	05-30-2025	Medical Therapy Program	Assessment Tools to Enable Family-Centered Services in the Medical Therapy Program
01-0325	03-19-2025	Medical Therapy Program	Vendored Occupational Therapy and/or Physical Therapy Program Note: Supersedes N.L. 21-0594, 26-0793, 30-1092, 68-0981

2024

Number	Release Date	Index Category	Title (Subject) of Letter
10-1224	12-02-2024	Case Management	California Children’s Services Whole Child Model Program (Revised December 2024) Attachment A: CCS Case Management Core Activities Note: Supersedes N.L. 12-1223
09-1024	10-31-25	Medical Eligibility	Fractures and Soft-Tissue Joint Injuries – Revised Note: Supersedes N.L. 07-0503, 08-0501
08-1024	10-17-24	Medical Therapy Program	Determination of Medical Eligibility for the Medical Therapy Program
07-0924	09-11-24	Medical Eligibility	Medical Eligibility for Care in a California Children’s Services Approved Neonatal Intensive Care Unit
06-0824	08-19-24	Medical Eligibility	CCS Program Coverage of Kawasaki Disease
05-0624	06-28-24	Medical Therapy Program	Medical Therapy Program Utilization Review Process Attachment 1: UR – 1 MTP UR Checklist Attachment 2: UR – 2 Monthly Meeting Log Attachment 3: MTP UR Process UR Timeframe Flow Chart
04-0424	06-03-24	Program Administration	CCS Program Appeals and State Hearing Process
02-0324	03-19-24	Medical Therapy Program	Duplication of and/or Conflict with the Provision of Medically Necessary Therapy Services Provided in the CCS Medical Therapy Program
01-0324	03-08-24	Benefits	CCS Blood, Tissue, and Organ Transplants Attachment 1: Adjudication Responsibilities by SAR and County Type Attachment 2: List of Commonly-Used Transplant Current Procedural Terminology

2023

Number	Release Date	Index Category	Title (Subject) of Letter
11-1223	12-19-23	Medical Supplies	Authorization for Purchase of Incontinence Medical Supplies
10-1123	11-01-23	Case Management	CCS Intercounty Transfer Policy         Attachment 1: Intercounty Transfer Process Flowchart         Attachment 2: Intercounty Transfer Frequently Asked Questions         Attachment 3: CCS Intercounty Transfer Check List         Attachment 4: CCS Whole Child Model Intercounty Transfer Check List
08-1023	11-03-23	Program Administration	Requirements for Certified Physician Assistants in California Children’s Services Special Care Centers
07-1023	11-03-23	Program Administration	Requirements for Nurse Practitioners in California Children’s Services Special Care Centers
06-1023	06-13-25	Program Administration	CCS Program Grievances Process (Revised) Attachment A: Grievance Flowchart (Revised) Attachment B: Grievance Form
05-0823	08-17-23	Medical Therapy Program	Serial Casting in the Medical Therapy Units
04-0723	07-12-23	Program Administration	CCS Training Requirements – REVISED
03-0723	07-07-23	Benefits	Telehealth Services
02-0623	06-26-23	Program Administration	California Electronic Visit Verification Implementation
01-0123	01-25-23	Benefits	CCS Program Medical Necessity Determination

2022

Number	Release Date	Index Category	Title (Subject) of Letter
03-1222	12-21-22	Program Administration	Alternative Format Selection for California Children’s Services Beneficiaries with Visual Impairments
02-0822	08-30-22	Benefits	Assistive Communication Technology Devices and Related Services

2021

No Numbered Letters available.

2020

Number	Release Date	Index Category	Title (Subject) of Letter
14-1120	11-19-20	Medical Therapy Program	Documentation Standards for the California Children’s Services Medical Therapy Program
12-1120	07-31-24	Authorization/Benefits	Bone Conduction Hearing Devices Attachment 1: Examples of Bone Conduction Hearing Devices that are Surface-Worn  Attachment 2: Examples of Bone Conduction Hearing Devices that include Surgically-Inserted Component(s)  Attachment 3: Prior Authorization Request Form for Bone Conduction Hearing Device(s)  Attachment 4:  Coding and Coverage for Bone Conduction Hearing Devices(s), Related Equipment, and Accessories  Note: Supersedes N.L.: 09-0817
07-1120	11-17-20	Authorization/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	Coverage of Experimental and Investigational Services Note: Supersedes CCS NL 37-1292
04-0520	5-15-20	Benefits	Early and Periodic Screening, Diagnostic, and Treatment – Private Duty Nursing Case Management Services
03-0120	1-23-20	Benefits	Authorization Criteria for Selective Dorsal Rhizotomy
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
09-1119	11-18-19	Benefits	Authorization of Out of State Service Requests
05-1019	10-18-19	Program Administration	Program Requirements for Physician Assistants Providing Patient Care in Neonatal Intensive Care Units

2018 

Number	Release Date	Index Category	Title (Subject) of Letter
12-0818	08-24-18	Benefits	Cochlear Implant Updated Candidacy Criteria and Authorization Procedure
11-0818	08-01-18	Benefits	Chapter 3.37 – CCS Provider Core, Special Care Centers (SCCs) Note: The policy is available upon request; please contact the CCS Program inbox at CCSProgram@dhcs.ca.gov
09-0718	7-17-18	Benefits	Tele-Speech, Auditory Habilitation and Rehabilitation Services with the Home as the Originating Site
06-0718	7-10-18	Benefits	Authorization 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

Number	Release Date	Index Category	Title (Subject) of Letter
07-0317	03-20-17	Medical Therapy Program	Establishment of HIP Surveillance Programs in the California Children’s Services (CCS) Program, Medical Therapy Program (MTP)

2016

Number	Release Date	Index Category	Title (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  

Number	Release Date	Index Category	Title (Subject) of Letter
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                                                                                       

Number	Release Date	Index Category	Title (Subject) of Letter
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™)
09-0514	06-05-14	Medical Therapy Program	Powered Mobility Devices (PMD)
05-0314	04-09-14	Standards for Pediatric Intensive Care Units	The 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
03-0314	04-08-14	Standards for Neonatal	Standards for Neonatal Intensive Care Unit (NICU)
02-0214	03-12-14	MTP	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

Number	Release Date	Index Category	Title (Subject) of Letter
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
02-0413	04-12-13	Authorizations	Neonatal Intensive Care Unit (NICU) Authorizations Note: This letter supersedes N.L. 04-0511

2012

Number	Release Date	Index Category	Title (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 Date	Index Category	Title (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
03-0411	04-28-11	Benefits	Cochlear Implants (Supplements N.L.: 09-1208)

 2010

Number	Release Date	Index Category	Title (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

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

Number	Release Date	Index Category	Title (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)
09-1208	12-26-08	Benefits	Cochlear Implants
01-0108	01-10-08	Benefits	CCS Outpatient Special Care Center (SCC) Services Note: This letter supersedes CCS N.L. 08-0900. The policy is available upon request; please contact the CCS Program inbox at CCSProgram@dhcs.ca.gov

2007

Number	Release Date	Index Category	Title (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

2006

Number	Release Date	Index Category	Title (Subject) of Letter
13-1106	11-27-06	Benefits	Cochlear Implant Speech Processor Upgrades
10-0806	08/30/06	Benefits	Authorization of Emergency Services Related to Trauma
07-0506	05/16/06	Benefits	Intermittent Home Health Services Provided by a Home Health Agency (HHA) and Service Allowances (Time) Per Visit List
05-0406	05/05/06	Medical Therapy Program	Directions 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
02-0106	01/12/06	Benefits	Update 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)
01-0106	01/09/06	Budgets	California Children’s Services (CCS) Expenditure Reporting to the California Department of Finance (DOF) for the purpose of Calculation of Realignment Caseload Growth

2005

Number	Release Date	Index Category	Title (Subject) of Letter
29-1105	11-10-05	HIPAA	Changes to the CCS Notice of Privacy Practices, Spanish Version and English Version
28-1105	10-31-05	Benefits	Instructions 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
18-0605	06-28-05	Benefits	Nationwide Recall of VAIL Enclosed Bed Systems and FDA Notifies Public That Vail Products, Inc. Issues Nationwide Recall of Enclosed Bed Systems
16-0605	06-13-05	Benefits	Delegation of Authority to Authorize Medical Nutrition Services to County CCS Programs and CMS Regional Offices
15-0605	06-13-05	Benefits	Speech Pathology Services and Medi-Cal Certified Outpatient Rehabilitation Centers
14-0605	06-13-05	Benefits	Authorization of Occupational Therapy (OT) Services and Medi-Cal Certified Outpatient Rehabilitation Centers
13-0605	06-13-05	Benefits	Delegation 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)
12-0605	06-13-05	Benefits	Delegation 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)
11-0605	06-13-05	Benefits	Delegation of Authority for Authorization of Aural Rehabilitation Services to County CCS Programs and CMS Regional Offices and Medi-Cal Certified Outpatient Rehabilitation Centers
10-0605	06-03-05	Therapy	Medical Therapy Unit (MTU) Medi-Cal Reimbursement State County Cost Sharing and Reconciliation
06-0505	05-06-05	Benefits	Intermediate Care Facility/Developmentally Disabled – Nursing (ICF/DD-N) Statewide Facility Listing
05-0405	04-01-05	Benefits	Authorization of Diagnostic Services for Infants Referred by the California Newborn Screening Program and Overview of the Genetic Disease Branch Newborn Screening Program
03-0205	06-13-05	Benefits	Delegation 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
01-0105	01-19-05	HIPAA	Dependent 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)
02-0205	01-20-05	Medical Therapy Program	Functional Outcome Measurement for the Medical Therapy Program

2004

Number	Release Date	Index Category	Title (Subject) of Letter
07-1004	10-28-04	Benefits	Health Care Financing Administration Common Procedural Coding System (HCPCS) Code Changes Effective November 1, 2004 for Durable Medical Equipment (DME) and Diabetic Supplies.
06-1004	04-08-05	Program Administration	Changes 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
02-0104	01-21-04	Benefits	Purchase and Utilization of Loss and Damage (L & D) Insurance for Hearing Aids, Cochlear Implant Processors, or Alternative Listening Devices for CCS Case-Managed Beneficiaries
01-0104	01-09-04	Transportation	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

Number	Release Date	Index Category	Title (Subject) of Letter
13-0903	09-12-03	Medical Eligibility	Medical Eligibility Nephrotic Syndrome
12-0803	08-21-03	Eligibility	Implementation of Assembly Bill (AB) 495; Expansion of Children’s Health Insurance Coverage
11-0703	07-24-03	HIPAA	Notice 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.
09-0703	08-08-03	Durable Medical Equipment	Revised 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.
07-0503	05-13-03	Medical Eligibility	Injuries to Joints and Tendons-Policy Clarification

2002

Number	Release Date	Index Category	Title (Subject) of Letter
08-0802	08-30-02	Benefits	Two 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.
05-0502	05-15-02	Medical Eligibility	Medical 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.
02-0102	01-31-02	Benefits	Pulse Oximeters Note: This letter supersedes CCS N.L. 01-0191.
01-0102	01-18-02	Benefits	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

Number	Release Date	Index Category	Title (Subject) of Letter
18-0901	10-17-01	Medical Therapy Program	Reimbursement 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)
11-0601	06-12-01	–	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.
02-0301	03-09-01	Case Management	Implementation of Section 14133.05 of the Welfare and Institutions Code Regarding Treatment Authorization

2000

Number	Release Date	Index Category	Title (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)
11-1500	11-27-00	Medical Eligibility	Verifying Residential Eligibility for Children Who Are Medi-Cal Full Scope or Healthy Families (HF) Eligible
04-0400	07-11-00	Benefits	Case Management of Medi-Cal Eligible Beneficiaries With a CCS-Eligible Condition Enrolled in a Medi-Cal Managed Care Plan

1999

Number	Release Date	Index Category	Title (Subject) of Letter
17-1199	01-14-00	Benefits	Automobile Orthopedic Positioning Devices (AOPDS)
02-0299	03-10-99	Benefits	Medical Nutrition Assessment and Medical Nutrition Therapy for Children with CCS Medical Eligible Conditions

1997

Number	Release Date	Index Category	Title (Subject) of Letter
20-0997	09-10-97	Case Management	Case Management Timelines
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

Number	Release Date	Index Category	Title (Subject) of Letter
43-1194	11-14-94	Medical Therapy Unit	Utilization Review for Outpatient Rehabilitation Center Certification
06-0394	03-10-94	Insurance	Required Use of Health Insurance

1992

Number	Release Date	Index Category	Title (Subject) of Letter
29-1092	10-07-1992	Rehabilitation	Rehabilitation Facilities Admission Criteria