California Children's Services
CCS is a State program for children with certain diseases or health problems. Through this program, children up to 21 years old can get the health care and services they need.
To qualify for the CCS program, a child must have a CCS-eligible condition, reside in California and meet financial eligibility. CCS financial eligibility is not limited to families earning $40,000 or less. Families with an adjusted gross income (AGI) of $40,000 or less may qualify but those with higher incomes may still be eligible if their child's medical expenses are very high. Children enrolled in Medi-Cal may qualify for CCS. The Medical Therapy Program does not have an income limit and is available to all children who qualify. Please contact your local CCS county office to find out more about the CCS program.
Application to Become a CCS Approved Facility
The Department of Health Care Services (DHCS) has received a large volume of facility applications from facilities interested in becoming an approved CCS program hospital or Special Care Center (SCC). DHCS is experiencing a longer than normal timeline in processing facility applications and is prioritizing applications based on geographic coverage and CCS beneficiary access needs.
If you are interested in becoming an approved CCS program facility, please submit an email with your interest to CCSFacilityReview@dhcs.ca.gov for consideration. The email shall include but not limited to the following information:
- Name of Facility
- Type of Facility (hospital or special care center type)
- Location of Facility (city and county)
- Contact Person
Once the inquiry is reviewed and it is identified that there is a need for the facility type in a particular geographic area, the CCS Facility Review team will provide an application package along with instructions.
DHCS apologizes for any inconvenience delays in processing your interest may cause and look forward in working with your organization in the future. New updates will be provided on this page as changes occur in the application review process.
If you have any questions regarding the facility application process or timelines, please contact DHCS at CCSFacilityReview@dhcs.ca.gov.
Electronic Visit Verification
Federal law mandates states implement EVV for all Medicaid-funded personal care services (PCS) and home health care services (HHCS) that require an in-home visit by a provider.
Providers that are impacted by EVV
HHCS was implemented on January 1, 2023 and all
impacted providers must
register with EVV. California Children's Services (CCS) Private Duty Nursing (PDN) providers, including Individual Nurse Providers (INP) and Home Health Agencies (HHA) are impacted by EVV.
For more information on EVV, please visit
DHCS EVV webpage.
For information on impacted INPs, please visit
EVV INP webpage.
CCS SAR Updates
The Integrated Systems of Care Division (ISCD) has updated our process for the Service Authorization Request (SAR) adjudication process. The new process aims to streamline communications with counties and improve internal routing. To support improved SAR adjudication, ISCD has:
- Updated the SAR Cover Sheet to improve internal routing of SARs
- Created three new email inboxes to reduce confusion related to submission of inquiries from the counties to ISCD
Please note that the purpose of the new mailboxes is to:
- Notify ISCD that additional documentation for a pending SAR has been entered to the CMS Net system
- Follow-up on an expedited request
- Bring to ISCD's attention any issue or concern regarding a SAR that shows a pending status after certain period of time (usually, more than 45 days)
- Request review of a SAR
- Request other services from ISCD
New SARs should be directed to the local County CCS office and not sent to the mailboxes listed below.
Email inboxes and the SAR Fax Sheet are as follows:
SAR Fax Cover Sheet
New Email Inboxes and Right Faxes
CCSPhysicianReview@dhcs.ca.gov; RightFax (916) 440-5308
This inbox will process ONLY the following SAR requests:
- Cochlear Implant Surgery Requests
- Out-of-State Requests
- Transplant Requests (including CAR-T: Yescarta, Kymriah)
CCSExpeditedReview@dhcs.ca.gov; RightFax (916) 440-5306
This inbox will process SARs* that require expedited clinician review, but are not limited to:
- Bleeding Disorders: Blood Factor
- Cystic Fibrosis
- Duchenne Muscular Dystrophy
- Growth Disorders
- High-Risk Infants
- Hospital Discharge Needs
- Metabolic Diseases: medical foods
- Retinal Disease: Luxturna
- Seizure management
- Spasticity management
- Spinal Muscular Atrophy: Zolgensma
- Upcoming Surgery including Selective Dorsal Rhizotomy
*Note: All outpatient pharmacy service requests that are payable with NDC including selected physician administered drugs, medical supplies, and durable medical equipment should be submitted to Medi-Cal Rx. Please refer to Medi-Cal Providers | Forms and Information.
CCSDirectedReview@dhcs.ca.gov; RightFax (916) 440-5768
This inbox will process all other requests that require ISCD action, including, but not limited to:
- Annual Medical Reviews (AMRs)
- Diabetic Supplies, Pumps, Monitoring Devices
- Durable Medical Equipment
- Genetic Testing
- Inter-County Transfers
- Medical Eligibility Determination
- Whole Child Model Counties
- CMIPS III Counties
- Medical Therapy Program
- Neonatal Intensive Care Unit
- Off-label or investigational services
- Previous Decision Reconsiderations
- Request for ISCD Second Opinion
- SARs submitted more than 45 days ago
Any requests that are not routed as outlined above, or are submitted without the SAR Cover sheet, will be returned to the requesting county for correction.
Please send any referrals or applications to the
LOCAL COUNTY CCS OFFICE for processing.
Providers are encouraged to continue to work with the local county CCS office for SAR processing.
These mailboxes are primarily for communication between the county CCS offices and ISCD.
SAR inquiries received directly from providers may be returned and deferred to the county.
