Medi-Cal 合格自闭症服务 (QAS) 提供商注册清单
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. Please see the Behavioral Health TreatmentFrequently Asked Questions for Providers, Question No. 3, for information about attesting to the qualifications of rendering QAS providers, QAS professionals, and QAS paraprofessionals as part of the application, starting in mid-November, 2025.
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.
- 对于代表实体签署申请且拥有 5% 或以上所有权的所有人员，需提供当前驾驶执照或州政府颁发的身份证件的复印件。
- Document identifying how you operate your business, which includes asole-proprietorship, corporation, Limited Liability Company (LLC) or partnership (See definitions in Appendix A: Definitions)
- 国家医疗服务提供者识别号 (NPI)
- To apply and receive an NPI online, visit the National Plan & Provider Enumeration System website.
- 如果您已经成立了有限责任公司或公司，则必须为该公司或公司获取并使用第 2 类 NPI，即使您是唯一所有者。
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.
- 工伤赔偿保险（来源：州法律）
- 一些企业需要工伤赔偿保险。如果加利福尼亚州法律要求您的企业购买工伤赔偿保险，那么您必须在申请中附上保险证明。
- 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.
- 营业执照/许可证（来源：市/县法规）
- 大多数城市要求所有企业都必须获得营业执照。即使企业由一个人经营，情况也是如此。
- 在某些城市，营业执照可能被称为营业税证明或营业登记证明。
- 如果您还没有营业执照，请在提交申请之前查看您所在城市的网站并获取营业执照。
- 如果您所在的城市不需要营业执照，您可以在申请中注明，但请注意，大多数城市都要求所有类型的企业都持有营业执照。
- 如果您不居住在建制城市的范围内，您所在的县可能会要求您提供营业执照。请查看您所在县的网站来核实要求。
Note: The name and address on the business license must match the name and service address reported on the application.
- 虚构商业名称声明（FBNS）（来源：州法律）
- 获得 FBNS 的要求符合州法律。但是，获得 FBNS 的过程需要通过县政府。如果某人居住在城市内并且同时需要营业执照和 FBNS，则他们需要从城市获得营业执照，从县获得 FBNS。
- 在下列情况下您必须取得 FBNS：
- 您以独资经营者的身份开展业务，并且使用的企业名称不包含您的姓氏。
- 您以有限责任公司或股份有限公司的名义开展业务，但使用的企业名称与向加利福尼亚州务卿提交的公司章程或组织章程中规定的名称不完全一致。
- 您以合伙企业的形式经营，并且使用的企业名称不包含每个合伙人的姓氏。
- 请访问您所在县的网站以获取有关获取 FBNS 的更多信息和说明。