LEA Direct Medical Billing

What is the Medi-Cal LEA Billing Option Program?

In California, the LEA Billing Option Program provides the federal share of reimbursement for health assessment and treatment. This reimbursement is for eligible children and family members within the school environment. The program was established in 1993 and is administered by the California Department of Health Care Services.

The main function of the LEA Billing Option Program is:

  • To provide comprehensive health services to eligible Medi-Cal students and, when applicable, to their families.
  • To allow Local Education Agencies (schools) to become Medi-Cal providers, and to bill the Medi-Cal program for health services provided by the medical professionals they employ.
  • To facilitate reinvestment in health and social services for students and their families.

Who Should Participate in the Medi-Cal LEA Billing Option Program?

Participants of the Medi-Cal LEA Billing Option Program are Licensed and/or Credentialed Psychologists, Speech and Language Pathologists, District Nurses, Occupational Therapists and Student Assistants. Participation includes completion of a monthly log or entering services to our on-line billing program indicating services provided to students during the month. Services to report include Initial, Annual, Triennial and Amended Assessments, therapy services that are included in a student’s IEP and nursing services provided to students.

All revenue received for services claimed is restricted and can only be utilized to supplement programs and services to the students and families of our district. A collaborative committee has been formed for this purpose.

LEA Direct Medical Billing Forms

Assessment Form