Specialty Behavioral Health Services Provider Information
About Us
This page contains information for Providers (and potential providers) of specialty mental health services (SMHS) to Medi-Cal beneficiaries in CA or in a CA Border Community.
“Providers” are:
- County-owned and operated clinics that provide specialty mental health services to Medi-Cal beneficiaries
- Individuals and organizations who are contracted with a CA county to provide specialty mental health services to Medi-Cal beneficiaries
Each County Mental Health Plan (MHP) is responsible for enrolling, certifying, recertifying, and monitoring all its Directly Operated Providers as well as Contract Legal Entity Provider. For a Provider to provide and be reimbursed for services to a Medi-Cal member, the Provider must be certified by the Department of Health Care Services. The MHP must facilitate the completion of specific documents for certification and recertification of each of its providers.
Submit Your Form Here
LEFU
The Legal Entity File Update (LEFU) Form is used by the MHP to update or correct information is related to the legal entity providing behavioral health services. This includes updates such as changes in ownership, tax identification numbers, addresses, or other important legal and organizational details. The LEFU form is critical for maintaining up- to-date records of entities that are participating in Medi-Cal funded programs.
PFU
The Provider File Update (PFU) Form is used by the MHP to update or correct information related to behavioral health service providers in the Medi-Cal system. Like the LEFU form, the PFU form is designed to ensure that DHCS has accurate and up-to-date records for providers that offers services funded by Medi-Cal.
Resources
LEFU Training Video
PFU Training Video
Specialty Mental Health (SMH) Forms FAQs
Inquiries
- For questions related to the PFU and LEFU forms and/or facilitating Provider Information Management System (PIMS) access requests, please contact ProviderFile@dhcs.ca.gov.
- For questions related to the DHCS 1735, DHCS 1736, and DHCS 1737, please contact DMHCertification@dhcs.ca.gov.