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LEA Medi-Cal Billing Option Program Policy and Procedure Letters

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Number & Date Description

Attachment

PPL 23-004

February 1, 2023
Alternative Format Extension
PPL 22-009R

June 21, 2022
Local Educational Agency Medi-Cal Billing Option Program (LEA BOP) Reimbursement for Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Screening Services
PPL 22-009

March 22, 2022

Local Educational Agency Medi-Cal Billing Option Program (LEA BOP) Reimbursement for Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Screening Services

PPL 22-008R

May 13, 2022
Notification of Expansion of Covered Services Provided by Associate Marriage and Family Therapists (AMFTs) and Registered Associate Clinical Social Workers (ACSWs)
PPL 22-008

March 22, 2022
Local Educational Agency Medi-Cal Billing Option Program (LEA BOP) notification of the expansion of covered services provided by Associate Marriage and Family Therapists (AMFT) and Registered Associate Clinical Social Workers (ACSW)
PPL 22-006

March 21, 2022
Notification of Reimbursement for Vaccine Administration and Vaccine Counseling in the Local Educational Agency Medi-Cal Billing Option Program (LEA BOP)
PPL 22-002

January 18, 2022
New submission requirement related to the State Fiscal Year 2020-21 Cost Reimbursement Comparison Schedule.
PPL 22-001

January 12, 2022
Calculation of Medicaid Eligibility Rate by State Fiscal Year for LEA Medi-Cal Billing Option Program Cost Reporting
MER Assistance Form
PPL 21-042

December 10, 2021
Notification of State Fiscal Years 2015-16 through 2019-20 Cost Settlement Requirements for the Local Educational Agency Medi-Cal Billing Option Program.
PPL 21-040

December 10, 2021
Notification of Reimbursement for COVID-19 Vaccinations in the Local Educational Agency Medi-Cal Billing Option Program (LEA BOP)
PPL 21-015R

December 1, 2021
Unsatisfactory Immigration Status Beneficiaries in the Local Educational Agency Medi-Cal Billing Option Program
PPL 21-034R

February 9, 2022
Local Education Agency Medi-Cal Billing Option Program (LEA BOP) notification of opportunities for COVID-19 testing in schools and the impact on local educational agency LEA BOP reimbursement.  
PPL 21-030

October 18, 2021
Local Education Agency Medi-Cal Billing Option Program (LEA BOP) notification of policy related to Time Survey Participants (TSPs) that are identified as being in the incorrect participant pool for the Random Moment Time Survey (RMTS).
PPL 21-029

October 4, 2021
Local Education Agency Medi-Cal Billing Option Program (LEA BOP) notification of contractor placement on the Time Survey Participant (TSP) lists for the Random Moment Time Survey (RMTS).
PPL 21-028

October 4, 2021
Local Education Agency Medi-Cal Billing Option Program (LEA BOP) notification of inclusion of Long-Term Direct Service Practitioner Substitutes and Administrative Service Personnel Substitutes in the Random Moment Time Survey (RMTS) Process.
PPL 21-025

October 4, 2021
Local Education Agency Medi-Cal Billing Option Program (LEA BOP) notification of the compliance process for LEA Providers that do not submit the Cost and Reimbursement Comparison Schedule by the mandated due date. 
PPL 21-024

October 4, 2021
Local Education Agency Medi-Cal Billing Option Program (LEA BOP) notification of proposed regulation update related to the authorization of speech pathology and audiological services, occupational therapy services, and physical therapy services.
PPL 19-025R

September 28, 2021
Random Moment Time Survey (RMTS) Pre-Sample Question (revised)
PPL 21-019

August 17, 2021
Local Educational Agency Medi-Cal Billing Option Program billing guidance to LEA Providers participating in the LEA BOP regarding covered direct medical services provided to Medi-Cal enrolled students via telehealth.
PPL 21-018

August 16, 2021
Local Educational Agency Medi-Cal Billing Option Program policy related to annual or triennial individual education plans (IEP) and individual family service plans
PPL 21-017R

December 10, 2021
Alternate Format Request Requirements (revised)
PPL 21-017

August 10, 2021
Alternate Format Request Requirements
PPL 21-016

July 20, 2021
Local Educational Agency (LEA) Medi-Cal Billing Option Program Direct Medical Services Provided to Medi-Cal Enrolled Students by LEA-Contracted Health Service Practitioners. 

PPL 21-007

March 18, 2021

Local Educational Agency Medi-Cal Billing Option Program (LEA BOP) Interpretation of "Complete 15-Minute Period" Following an Initial Service Increment.
PPL 20-052

November 10, 2020
Claiming Targeted Case Management (TCM) Costs for the School-Based Medi-Cal Programs

PPL 20-051

November 5, 2020

Notification for Stakeholders Participating in the Local Educational Agency Billing Option Program that the Department Encourages the Coordination of Mental Health Services With Their Respective Special Education Local Plan (SELPA), County Office of Education (COE), County Mental Health Plan (MHP), and Managed Care Organization (MCO).

PPL 20-046

November 2 , 2020

Notification of New Requirements for the Quarter One Time Survey Participant (TSP) List For The Local Educational Agency Medi-Cal Billing Option Program (LEA BOP) Under The Random Moment Time Survey (RMTS) Process

PPL 20-045

October 26, 2020

Notification of Approved California State Plan Amendment (SPA) 16-001 Regarding Targeted Case Management (TCM) Services for the Local Educational Agency Medi-Cal Billing Option Program (LEA BOP)

PPL 20-043

October 12, 2020

Notification of Random Moment Time Survey (RMTS) 85% Compliance Policy for School Based Medi-Cal ProgramsRMTS Compliance Threshold Attachment

PPL 20-040

August 26, 2020

Notification of Cost Settlement Process for Specialized Medical Transportation (SMT) in the Local Educational Agency Medi-Cal Billing Option Program (LEA BOP)
PPL 20-039R

November 30, 2021
Notification of New Services and New Practitioners in the Local Educational Agency Medi-Cal Billing Option Program (LEA BOP) 

PPL 20-039

August 12, 2020 

Notification of New Services and New Practitioners in the Local Educational Agency Medi-Cal Billing Option Program Attachments A&B      

PPL 20-038

August 11, 2020

Notification of Temporary Increase of 6.2 Federal Medicaid Assistance Percentage (FMAP) During The COVID-19 Public Health Emergency

PPL 20-037

August 10, 2020

This Policy and Procedure Letter (PPL) notifies LEAs interested in participating in the LEA BOP that the new quarterly enrollment process will begin on January 1, 2021.

LEA Enrollment and Timeframe

PPL 20-033

August 12, 2020

Notification of Reinstatement of Targeted Case Management Claiming for the Local Educational Agency Medi-Cal Billing Option Program TCM Form

PPL 20-031

July 24, 2020

Notification of New Requirements for Time Survey Participation Equivalency Requests for the Local Educational Agency Medi-Cal Billing Option Program (LEA BOP) Under the Random Moment Time Survey (RMTS) Process
Equivalency Request Form

PPL 20-029

July 8, 2020

Notification of Expansion of Covered Services Population Under the Local Educational Agency Medi-Cal Billing Option Program (LEA BOP)

PPL 20-028

July 22, 2020

Notification of the Termination of LEAs that failed to submit a Provider Participation Agreement (PPA) For State Fiscal Year (SFY) 2020-21

PPL 20-022R

October 30, 2020

 

Notification of Random Moment Time Survey Requirement (RMTS) for the Local Educational Agency Medi-Cal Billing Option Program (LEA BOP) Model 2 Certification

PPL 20-014R

September 15, 2020
Local Educational Agency Medi-Cal Billing Option Program (LEA BOP) Telehealth Policy Relative to the 2019 Novel Coronavirus (COVID-19)

PPL 20-012R

September 8, 2020

Notification of Approved California State Plan Amendment (SPA) 15-021 Regarding LEA BOP Services

PPL 20-004R

August 4, 2020

Notification of State Plan Amendment (SPA) 15-021 Requirements in Fiscal Year (FY) 2019-20 for Local Educational Agency Providers

PPL 20-003

January 6, 2020

Notification of the Compliance Process for Local Educational Agency Providers that Did Not Submit the Cost and Reimbursement Comparison Schedule for Prior Reporting Years

PPL 19-033

December 19, 2019

LEA Psychology/ Counseling CPT Replaced With New CPT Codes

PPL 19-019

September 18, 2019

Amendment to the annual submission requirements for the Cost and Reimbursement Comparison Schedule (CRCS).

PPL 19-015

June 28, 2019

Authorizations for direct medical treatment services may be signed by Physician Assistants (PAs) or Nurse Practitioners (NPs), as appropriate, in place of an authorization signed by a physician.

PPL 18-029

December 10, 2018

Elimination of CPT Code 96101 and Implementation of New Replacement Code 96130 in the Local Educational Agency Medi-Cal Billing Option Program

PPL 18-027

November 13, 2018 

Specialized Medical Transportation in the Local Educational Agency Medi-Cal Billing Option Program

PPL 18-018R

April 25, 2018 

Notification of Ordering, Referring or Prescribing Practitioner Requirements in the Local Educational Agency Medi-Cal Billing Option Program

PPL 18-016

May 16, 2018

Elimination of Current Procedural Terminology Codes 97001, 97002, 97003 and 97004; and Implementation of Four New Replacement CPT Codes 97163, 97164, 97167 and 97168

PPL 17-016
November 13, 2017
(Replaces PPL 15-018)

Notification of Compliance Process for LEAs that Do Not Submit the Provider Participation Agreement (PPA) by the Mandated Due Date

PPL 17-002
February 16, 2017

Rescinding Policy and Procedure Letters (PPL) 13-004, 13-014, and 16-019 Regarding Subrecipient Monitoring for CMAA, TCM, LEA BOP, and SMAA Contracts

PPL 16-012
July 1, 2016

Notification of Third-Party Liability Recoupment Requirements

PPL 16-010
June 10, 2016

Implementation of Electronic Signature Policy
PPL 15-024R
June 28, 2016
 
PPL 15-024
December 1, 2015
(superseded by 15-024R)
Implementation of Telehealth for Speech Therapy Services in the Local Educational Agency Medi-Cal Billing Option Program

15-023
December 1, 2015

Elimination of CPT Code 92506; and Implementation of Four New Replacement CPT Codes 92521-92524; and Implementation of New Audiology Code 92557

15-020
August 24, 2015

Implementation of the Evergreen Provider Participation Agreement (PPA) in the LEA Medi-Cal Billing Option Program
15-019
July 24, 2015
Notification of Compliance Process for LEAs that Do Not Submit the Cost and Reimbursement Comparison Schedule by the Mandated Due Date
15-018
July 29, 2015
Notification of Compliance Process for LEAs that Do Not Submit the Provider Participation Agreement and the Annual Report by the Mandated Due Date
July 1, 2015
Notification of new Cost and Reimbursement Comparison Schedule Certification Statement for Participating LEAs Receiving No LEA Medi-Cal Billing Option Reimbursement During a Fiscal Year

15-016
July 1, 2015

Notification of Approved California State Plan Amendment Number 12-009 Targeted Case Management Services and the June 30, 2015, Sunset of Current Reimbursement Methodology 


September 13, 2013

LEA Medi-Cal Billing Option Program - Freedom of Choice of Qualified Medicaid Providers including TCM Providers

July 1, 2013
LEA Medi-Cal Billing Option Program - Contracted Practitioners


June 6, 2013

Department of Health Care Services Authority to Establish, Provide and Disseminate Policy Related to the LEA Medi-Cal Billing Option Program

January 8, 2013

LEA Medi-Cal Billing Option Program - Revision to Medical Transportation Outlined in Assembly Bill 2608


June 5, 2012
Prohibition on Claiming Reimbursement for Contingency Fees
 


March 30, 2012

LEA Medi-Cal Billing Option Program - Changes to Standardized Account Code Structure Resource Code 5640



Last modified date: 2/21/2023 12:46 PM