School Based Medi-Cal Reimbursement Programs

For most current billing information and workgroup minutes please refer to websites attached.

What is the LEA Medi-Cal Billing Option Program?

The Local Educational Agency (LEA) Medi-Cal Billing Option Program was established in 1993 in conjunction with the California Department of Education (CDE).  The LEA Program is authorized under California’s Welfare and Institutions Code.  Regulations governing the TCM Program are contained in the California Code of Regulations, Title 22, Division 3, Chapter 3, Article 3, Section 51271.  Reimbursement is based upon a “fee-for-service.”

The purpose of the LEA Program is to:

  • Provide comprehensive health services to eligible Medi-Cal students and, when applicable, to their families
  • Allow Local Education Agencies to become Medi-Cal providers and bill the Medi-Cal program for the health services provided by the medical professionals they employ
  • Facilitate reinvestment in health and social services for students and their families