Requesting a CCS SAR#

When requesting a CCS SAR number you will first want to identify if the patient is eligible.

-Under 21 years old

-Congenital diagnosis

-Currently established with a Medi-Cal health plan

-If they have an existing SAR verify that the case is still active before continuing

(If the patient has "Partnership" as their health plan and is associated to one of the following counties, they may be covered in full by Partnership without requiring a CCS SAR: Del Norte, Humboldt, Lake, Lassen, Marin, Mendocino, Modoc, Napa, Shasta, Siskiyou, Solano, Sonoma, Trinity, and Yolo.)

For the most up to date CCS SAR Forms please select the following the link:

https://dhs.saccounty.gov/PUB/Pages/California-Childrens-Services/RL-Provider-Relations-SARs.aspx

-Scroll down to "C. SAR Forms"

-Select either the NEW or Existing CCS Client forms and fill out the form accordingly, there are instructions on the second page if help is needed.

The following link has all the Fax and Phone numbers to reach every CCS county office for sending the request, and calling for updates.

https://www.dhcs.ca.gov/services/ccs/Pages/CountyOffices.aspx

(use the "Ctrl +F" keys to locate county names faster)

Use the link below to verify if the CPT code is covered by an 01 SAR or an 02 SAR.

https://www.dhcs.ca.gov/services/ccs/cmsnet/Documents/SCG-Codes.pdf