Overview of CCS Medical Eligibility
This brief summary page has been developed solely for the convenience and use in understanding the general medical eligibility criteria of the California Children's Services (CCS) program. It is not an authoritative statement of, and may not be cited as authority, for any decisions, determinations, or interpretations under the CCS program.
Please refer to the California Code of Regulations, Title 22, Division 2, Subdivision 7, Chapter 3, Article 2, Sections 41515.1-41518.9 for full description. The applicable medical eligibility section is noted with each category below.
CCS applicants diagnosed with at least one of the following shall be medically eligible for participating in the CCS program:
Section 41515.2: Infectious Diseases (ICD-10 A00-B99)
Section 41516: Neoplasms (ICD-10 C00-D49)
Section 41516.1: Endocrine, Nutritional, and Metabolic Diseases, and Immune Disorders (ICD-10 E00-E89)
Section 41516.3: Diseases of Blood and Blood-Forming Organs (ICD-10 D50-D89)
Section 41517: Mental Disorders and Mental Retardation (ICD-10 F01-F99)
Section 41517.3: Diseases of the Nervous System (ICD-10 G00-G99)
Section 41517.5: Medical Therapy Program
Section 41517.7: Diseases of the Eye (ICD-10 H00-H59)
Section 41518: Diseases of the Ear and Mastoid (ICD-10 H60-H95)
Section 41518.2: Diseases of the Circulatory System (ICD-10 I00-I99)
Section 41518.3: Diseases of the Respiratory System (ICD-10 J00-J99)
Section 41518.4: Diseases of the Digestive System (ICD-10 K00-K95)
Section 41518.5: Diseases of the Genitourinary System (ICD-10 N00-N99)
Section 41518.6: Diseases of the Skin and Subcutaneous Tissues (ICD-10 L00-L99)
Section 41518.7: Diseases of the Musculoskeletal System and Connective Tissue (ICD-10 M00-M99)
Section 41518.8: Congenital Anomalies (ICD-10 Q00-Q99)
Section 41518.9: Accidents, Poisonings, Violence, and Immunization Reactions (ICD-10 S00-T88)
CCS Neonatal Intensive Care Unit (NICU) Eligibility Criteria (ICD-10 P00-P96)
- Neonates meet eligibility criteria if they have a
CCS eligible condition and need care in a
CCS-approved NICU due to that condition.
- Infants who require a threshold level of specialized care services meet CCS eligibility for the duration of the NICU stay.
- CCS Numbered Letter 07-0924 provides details of both medical and service eligibility criteria and circumstances under which eligibility ceases.
