CCS Provider Paneling and Application

Why a Health Care Provider should Become a CCS Paneled Provider:

There are several advantages for providers, including referral of patients to the provider, case management by CCS in support of the provider, and reimbursement for services offered to children who otherwise would have no medical coverage.

Who should become a CCS Provider:

Any physician who offers special services to children with CCS medically eligible conditions may become a CCS paneled provider. This would include all pediatricians, other medical & surgical specialists who have special training in pediatric conditions within their specialty, pediatric dentists and orthodontists, allied health professionals who work with children.

How a Provider Applies to become a CCS Provider:

A physician or allied provider must be an active Medi-Cal provider and have a valid National Provider Identifier (NPI) to become a CCS Provider. To apply to become a Medi-Cal provider, please go to the Medi-Cal Provider Enrollment Website .

The application can be completed on-line at the CCS Provider Enrollment Website on the State CCS Website or manually. A signed form must be mailed to the State DHCS office at the address on the form, and it is recommended that an additional copy be mailed to the CCS Office so that we can help resolve processing issues. Once approval is obtained, please notify our CCS office at 805-681-5360.

Requirements for Approval:

Physicians must be licensed in California, limit their practice to their specialty, and be board certified or eligible in their specialty. Orthopedists must demonstrate special training in pediatric orthopedics. Cardiac surgeons must meet special standards and be part of an approved cardiac center. Family practitioners may be paneled in special situations.

Conditions placed on a CCS Paneled Provider:

The Provider does agree to several conditions on the application describing authorization of service, billing, payment and access of patients to the provider. These will be sent to the applicant prior to submitting the application to the State CCS Office.