Medi-Cal Qualified Autism Service (QAS) Provider Enrollment Checklist
This enrollment checklist is only for Board Certified Behavioral Analysts and Educational Psychologists to assist them with Medi-Cal enrollment as a QAS provider. Please note that QAS professionals and QAS paraprofessionals (technicians) do not need to apply for Medi-Cal enrollment.
Prior to enrolling as a QAS provider (individual or organization) in the Medi-Cal provider enrollment system, please have the documents, certificates and licenses in the checklist below available. The checklist includes local or state business requirements in addition to qualifications established by the Department of Health Care Services (DHCS) to enroll as a QAS provider.
The checklist will help you determine what documents you will need to upload as part of your Medi-Cal provider application, depending on how you are enrolling and in which counties you will provide services to Medi-Cal members.
QAS providers who currently have an enrollment pathway, including physicians, psychologists, physical therapists, occupational therapists, licensed marriage and family therapists, licensed clinical social workers, licensed professional clinical counselors, speech-language pathologists, and audiologists, do not need to enroll again as a QAS provider to bill for BHT services. These providers will not need to report BCBAs, QAS professionals, or QAS paraprofessionals.
Note: Medi-Cal currently requires that QAS providers have an established place of business (EPOB), in compliance with section 51000.60 of Title 22 of the Code of Federal Regulations. DHCS intends to publish a regulatory bulletin later in 2025 to waive this requirement for individual BCBAs who work out of their home and do have an EPOB where they see clients. Individual BCBAs who are contracted with a Medi-Cal managed care plan and do not have an EPOB do not currently need to enroll. DHCS is working to publish a new regulatory bulletin to waive the EPOB requirement for individual BCBAs. Once published, individual BCBAs would then need to enroll.
Section A – Mandatory Documentation
This section includes all documents that you are required to submit as part of your Medi-Cal provider enrollment application as a QAS provider in Medi-Cal.
- Copy of current Driver’s License or state-issued identification for all persons with 5 percent or more ownership for individual signing the application on behalf of the entity.
- Document identifying how you operate your business, which includes a sole-proprietorship, corporation, Limited Liability Company (LLC) or partnership (See definitions in Appendix A: Definitions)
- National Provider Identification Number (NPI)
- To apply and receive an NPI online, visit the National Plan & Provider Enumeration System website.
- If you have formed an LLC or corporation, you must obtain and use a Type 2 NPI for the LLC or corporation, even if you are the sole owner.
Section B – Potential Additional Documentation
This section includes all documentation that may be required based upon additional city, county and/or state requirements to operate a business in California. Note that all of these additional documents may not apply to your application, so review each item carefully to determine if you need to submit additional documentation.
- Workers’ Compensation Insurance (Source: State law)
- Workers’ Compensation Insurance is required for some businesses. If California state law requires your business to have Workers’ Compensation Insurance, then you must attach proof of coverage with your application.
- If you are not otherwise required to have Workers’ Compensation insurance, you do not have to obtain insurance to enroll as a Medi-Cal provider.
- For more information on Workers’ Compensation Insurance, visit the Workers’ Compensation Insurance website.
- Business License/Permit (Source: City/county regulations)
- Most cities require all businesses to obtain a business license. This is true even if the business is operated by one person.
- In some cities, the business license may be called a business tax certificate or business registration certificate.
- If you do not already have a business license, review the website for your city and obtain a business license before submitting your application.
- If your city does not require a business license, you may note this on your application, but note that most cities require these for all business types.
- If you do not live within the limits of an incorporated city, your county may require a business license. Check the website for your county to verify requirements.
Note: The name and address on the business license must match the name and service address reported on the application.
- Fictitious Business Name Statement (FBNS) (Source: State law)
- The requirement to obtain an FBNS is in state law. However, the process to obtain an FBNS is through the county. If a person lives within a city and needs both a business license and an FBNS, they need to obtain the business license from the city and the FBNS from the county.
- You must obtain an FBNS when:
- You are operating as a sole proprietor and using a name for your business that does not include your last name.
- You are operating as an LLC or corporation and using a business name that does not exactly match the name stated in the Articles of Incorporation or Articles of Organization filed with the California Secretary of State.
- You are operating as a partnership and using a business name that does not include the last name of each partner.
- Visit the website for your county for more information and instructions on obtaining an FBNS.
