Statutes, codes, and regulations
California Code Of Regulations
Title 22 - Social SecurityDivision 3 - Health Care ServicesSubdivision 1 - California Medical Assistance ProgramChapter 3 - Health Care Services
Article 2 - Definitions
Section 51051 - Provider

Cal. Code Regs. tit. 22 § 51051

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Current through Register 2024 Notice Reg. No. 16, April 19, 2024
Section 51051 - Provider
(a) "Provider" means any individual, partnership, group, association, corporation, institution, or entity, and the officers, directors, owners, managing employees, or agents of any partnership, group association, corporation, institution, or entity, that provides services, goods, supplies, or merchandise, directly or indirectly, to a Medi-Cal beneficiary, and that has been enrolled in the Medi-Cal program.
(b) Providers include, but are not limited to:

Acupuncturists

Audiologists

Blood Banks

Child Health and Disability Prevention Providers

Chiropractors

Clinical Laboratories or Laboratories

Comprehensive Perinatal Providers

Dental School Clinics

Dentists

Dispensing Opticians

Durable Medical Equipment and Medical Supply Providers

Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Providers

EPSDT Supplemental Services Providers

Fabricating Optical Laboratory

Hearing Aid Dispensers

Home Health Agencies Hospices

Hospital Outpatient Departments

Hospitals

Intermediate Care Facilities

Intermediate Care Facilities for the Developmentally Disabled

Licensed Midwife

Licensed Substance Use Disorder Treatment Professionals

Local Educational Agency Providers

Nurse Anesthetists

Nurse Midwives

Nurse Practitioners

Nursing Facilities

Occupational Therapists

Ocularists Optometrists

Orthotists

Organized Outpatient Clinics

Outpatient Heroin Detoxification Providers

Personal Care Service Providers

Pharmacies/Pharmacists

Physical Therapists

Physicians

Podiatrists

Portable Imaging Services Providers

Prosthetists

Providers of Medical Transportation

Psychologists Rehabilitation

Religious Nonmedical Health Care Institutions

Renal Dialysis Centers and Community Hemodialysis Units

Respiratory Care Practitioners

Rural Health Clinics

Short-Doyle Medi-Cal Providers

Skilled Nursing Facilities

Speech Therapists

Substance Use Disorder Clinics

Substance Use Disorder Medical Directors

Substance Use Disorder Nonphysician Medical Practitioners

Targeted Case Management Providers

Cal. Code Regs. Tit. 22, § 51051

1. Amendment of subsection (b) filed 10-27-87 as an emergency; operative 10-27-87 (Register 87, No. 44). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 2-24-88. For prior history, see Register 87, No. 38.
2. Certificate of Compliance transmitted to OAL 2-24-88 and filed 3-22-88 (Register 88, No. 15).
3. Amendment filed 11-28-88 as an emergency; operative 11-28-88 (Register 89, No. 11). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 3-28-89.
4. Certificate of Compliance as to 11-28-88 order transmitted to OAL 3-27-89 and filed 4-26-89 (Register 89, No. 18).
5. Amendment of subsection (b) filed 10-1-90 as an emergency; operative 10-1-90 (Register 90, No. 45). A Certificate of Compliance must be transmitted to OAL by 1-29-91 or emergency language will be repealed by operation of law on the following day.
6. Certificate of Compliance as to 10-1-90 order transmitted to OAL 1-29-91 and filed 2-28-91 (Register 91, No. 13).
7. Amendment of subsection (b) filed 5-24-91 as an emergency; operative 5-24-91 (Register 91, No. 26). A Certificate of Compliance must be transmitted to OAL by 9-23-91 or emergency language will be repealed by operation of law on the following day.
8. Amendment of subsection (b) filed 4-14-93 as an emergency; operative 4-14-93. Submitted to OAL for printing only pursuant to section 8, AB 1773 (Chapter 939, Statutes of 1992) (Register 93, No. 16).
9. Amendment of subsection (b) adding Local Educational Agency Providers filed 12-22-93 as an emergency; operative 12-22-93 (Register 93, No. 52). A Certificate of Compliance must be transmitted to OAL by 4-22-94 or emergency language will be repealed by operation of law on the following day.
10. Amendment of subsection (b) and NOTE filed 1-20-94 as an emergency; operative 1-20-94 (Register 94, No. 3). A Certificate of Compliance must be transmitted to OAL by 5-20-94 or emergency language will be repealed by operation of law on the following day.
11. Amendment of subsection (b) adding Early and Periodic Screening, Diagnosis and Treatment, and Supplemental EPSDT Providers filed 4-4-94 as an emergency; operative 4-4-94 (Register 94, No. 14). A Certificate of Compliance must be transmitted to OAL by 8-2-94 or emergency language will be repealed by operation of law on the following day.
12. Certificate of Compliance as to 12-22-93 order transmitted to OAL 4-20-94 and filed 6-2-94 (Register 94, No. 22).
13. Certificate of Compliance as to 1-20-94 order transmitted to OAL 5-19-94 and filed 7-1-94 (Register 94, No. 26).
14. Amendment of subsection (b) adding Early and Periodic Screening, Diagnosis and Treatment and Supplemental EPSDT Providers refiled 8-1-94 as an emergency; operative 8-1-94 (Register 94, No. 31). A Certificate of Compliance must be transmitted to OAL by 11-29-94 or emergency language will be repealed by operation of law on the following day.
15. Amendment of subsection (b) adding Early and Periodic Screening, Diagnosis and Treatment and Supplemental EPSDT Providers refiled 10-24-94 as an emergency; operative 10-24-94 (Register 94, No. 43). A Certificate of Compliance must be transmitted to OAL by 2-21-95 or emergency language will be repealed by operation of law on the following day.
16. Amendment of subsection (b) adding Early and Periodic Screening, Diagnosis and Treatment and Supplemental EPSDT Providers refiled 2-22-95; operative 2-22-95 (Register 95, No. 8). A Certificate of Compliance must be transmitted to OAL by 6-22-95 or emergency language will be repealed by operation of law on the following day.
17. Certificate of Compliance as to 2-22-95 order including amendment of section transmitted to OAL 3-16-95 and filed 4-27-95 (Register 95, No. 17).
18. Amendment of subsection (b) and NOTE filed 7-1-96; operative 7-1-96. Submitted to OAL for printing only pursuant to Section 6, Chapter 305, Statutes of 1995 (Register 96, No. 27).
19. Amendment of subsection (b) and NOTE refiled 10-29-96 as an emergency; operative 10-29-96 (Register 96, No. 44). Submitted to OAL for printing only pursuant to Section 6, Chapter 305, Statutes of 1995. A Certificate of Compliance must be transmitted to OAL by 2-26-97 or emergency language will be repealed by operation of law on the following day.
20. Editorial correction of HISTORY 19 (Register 97, No. 15).
21. Reinstatement of subsection (b) and NOTE as they existed prior to emergency amendment filed 7-1-96 by operation of Government Code section 11346.1(f) (Register 97, No. 15).
22. Amendment of subsection (b) and NOTE filed 4-10-97; operative 4-10-97 pursuant to Government Code section 11343.4(d) (Register 97, No. 15).
23. Amendment of subsection (b) filed 6-23-97; operative 7-23-97 (Register 97, No. 26).
24. Amendment of subsection (b) filed 8-10-99 as an emergency; operative 8-10-99 (Register 99, No. 33). A Certificate of Compliance must be transmitted to OAL by 12-8-99 or emergency language will be repealed by operation of law on the following day.
25. Amendment of section heading, section and NOTE filed 9-28-99 as an emergency; operative 9-28-99 (Register 99, No. 40). A Certificate of Compliance must be transmitted to OAL by 3-27-2000 or emergency language will be repealed by operation of law on the following day. Submitted to OAL for printing only pursuant to section 78, AB 1107 (Chapter 146, Statutes of 1999).
26. Amendment of section heading, section and NOTE refiled 11-24-99 as an emergency; operative 11-24-99 (Register 99, No. 48). A Certificate of Compliance must be transmitted to OAL by 5-22-2000 or emergency language will be repealed by operation of law on the following day. Submitted to OAL for printing only pursuant to section 78, AB 1107 (Chapter 146, Statutes of 1999).
27. Certificate of Compliance as to 8-10-99 order transmitted to OAL 12-7-99 and filed 1-14-2000 (Register 2000, No. 2).
28. Amendment of section heading, section and NOTE refiled 5-5-2000 as an emergency; operative 5-22-2000 (Register 2000, No. 18). A Certificate of Compliance must be transmitted to OAL by 9-19-2000 or emergency language will be repealed by operation of law on the following day.
29. Amendment of section heading, section and NOTE refiled 8-28-2000 as an emergency; operative 9-6-2000 (Register 2000, No. 35). A Certificate of Compliance must be transmitted to OAL by 1-4-2001 or emergency language will be repealed by operation of law on the following day.
30. Amendment of subsection (b) and amendment of NOTE filed 10-24-2000 as an emergency and submitted to OAL for printing only pursuant to Section 78, Chapter 146, Statutes of 1999; operative 10-24-2000 (Register 2000, No. 43). A Certificate of Compliance must be transmitted to OAL by 4-23-2001 or emergency language will be repealed by operation of law on the following day.
31. Certificate of Compliance as to 8-28-2000 order transmitted to OAL 12-26-2000 and filed 2-8-2001 (Register 2001, No. 6).
32. Editorial correction of HISTORY 30 (Register 2001, No. 14).
33. Amendment of subsection (b) and amendment of NOTE refiled 4-4-2001 as an emergency and submitted to OAL for printing only pursuant to Section 78, Chapter 146, Statutes of 1999; operative 4-4-2001 (Register 2001, No. 14). A Certificate of Compliance must be transmitted to OAL by 8-2-2001 or emergency language will be repealed by operation of law on the following day.
34. Certificate of Compliance as to 4-4-2001 order transmitted to OAL 7-31-2001 and filed 9-5-2001 (Register 2001, No. 36).
35. Amendment of subsection (b) and amendment of NOTE filed 9-3-2004; operative 10-3-2004 (Register 2004, No. 36).
36. Amendment of subsection (a) and NOTE filed 9-29-2004 as an emergency; operative 10-7-2004 (Register 2004, No. 41). A Certificate of Compliance must be transmitted to OAL by 2-4-2005 or emergency language will be repealed by operation of law on the following day. Deemed emergency exempt from OAL pursuant to Welfare and Institutions Code section 14043.75.
37. Amendment of subsection (a) and NOTE refiled 1-27-2005 as an emergency; operative 2-5-2005 (Register 2005, No. 4). A Certificate of Compliance must be transmitted to OAL by 6-6-2005 or emergency language will be repealed by operation of law on the following day. Deemed emergency exempt from OAL review pursuant to Welfare and Institutions Code section 14043.75.
38. Amendment of subsection (a) and NOTE refiled 6-2-2005 as an emergency; operative 6-7-2005 (Register 2005, No. 22). A Certificate of Compliance must be transmitted to OAL by 10-5-2005 or emergency language will be repealed by operation of law on the following day. Deemed emergency exempt from OAL review pursuant to Welfare and Institutions Code section 14043.75.
39. Certificate of Compliance as to 6-2-2005 order, including further amendment of subsection (a), transmitted to OAL 9-29-2005 and filed 11-10-2005 (Register 2005, No. 45).
40. Change without regulatory effect amending subsection (b) filed 10-8-2014 pursuant to section 100, title 1, California Code of Regulations (Register 2014, No. 41).
41. Amendment of subsection (b) and amendment of NOTE filed 5-12-2015; operative 7-1-2015 (Register 2015, No. 20).
42. Amendment of section and NOTE filed 8-17-2015 as a deemed emergency exempt from OAL review pursuant to Welfare and Institutions Code section 14043.75; operative 8-17-2015 (Register 2015, No. 34). A Certificate of Compliance must be transmitted to OAL by 2-16-2016 or emergency language will be repealed by operation of law on the following day.
43. Certificate of Compliance as to 8-17-2015 order transmitted to OAL 12-30-2015 and filed 2-11-2016 (Register 2016, No. 7).

Note: Authority cited: Section 20, Health and Safety Code; Sections 10725, 14043.75, 14100.1, 14105 and 14124.5, Welfare and Institutions Code. Reference: Sections 14043, 14043.1, 14043.15, 14043.26, 14043.27, 14043.36, 14100.1, 14105, 14105.3, 14115.6, 14124.5, 14132, 14132.39, 14132.4, 14132.44 and 14134.5, Welfare and Institutions Code; Section 33, Chapter 456, Statutes of 1990; Section 1250(k), Health and Safety Code; Section 1206, Business and Professions Code; and Title 42 United States Code, Section 263a.

1. Amendment of subsection (b) filed 10-27-87 as an emergency; operative 10-27-87 (Register 87, No. 44). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 2-24-88. For prior history, see Register 87, No. 38.
2. Certificate of Compliance transmitted to OAL 2-24-88 and filed 3-22-88 (Register 88, No. 15).
3. Amendment filed 11-28-88 as an emergency; operative 11-28-88 (Register 89, No. 11). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 3-28-89.
4. Certificate of Compliance as to 11-28-88 order transmitted to OAL 3-27-89 and filed 4-26-89 (Register 89, No. 18).
5. Amendment of subsection (b) filed 10-1-90 as an emergency; operative 10-1-90 (Register 90, No. 45). A Certificate of Compliance must be transmitted to OAL by 1-29-91 or emergency language will be repealed by operation of law on the following day.
6. Certificate of Compliance as to 10-1-90 order transmitted to OAL 1-29-91 and filed 2-28-91 (Register 91, No. 13).
7. Amendment of subsection (b) filed 5-24-91 as an emergency; operative 5-24-91 (Register 91, No. 26). A Certificate of Compliance must be transmitted to OAL by 9-23-91 or emergency language will be repealed by operation of law on the following day.
8. Amendment of subsection (b) filed 4-14-93 as an emergency; operative 4-14-93. Submitted to OAL for printing only pursuant to section 8, AB 1773 (Chapter 939, Statutes of 1992) (Register 93, No. 16).
9. Amendment of subsection (b) adding Local Educational Agency Providers filed 12-22-93 as an emergency; operative 12-22-93 (Register 93, No. 52). A Certificate of Compliance must be transmitted to OAL by 4-22-94 or emergency language will be repealed by operation of law on the following day.
10. Amendment of subsection (b) and Note filed 1-20-94 as an emergency; operative 1-20-94 (Register 94, No. 3). A Certificate of Compliance must be transmitted to OAL by 5-20-94 or emergency language will be repealed by operation of law on the following day.
11. Amendment of subsection (b) adding Early and Periodic Screening, Diagnosis and Treatment, and Supplemental EPSDT Providers filed 4-4-94 as an emergency; operative 4-4-94 (Register 94, No. 14). A Certificate of Compliance must be transmitted to OAL by 8-2-94 or emergency language will be repealed by operation of law on the following day.
12. Certificate of Compliance as to 12-22-93 order transmitted to OAL 4-20-94 and filed 6-2-94 (Register 94, No. 22).
13. Certificate of Compliance as to 1-20-94 order transmitted to OAL 5-19-94 and filed 7-1-94 (Register 94, No. 26).
14. Amendment of subsection (b) adding Early and Periodic Screening, Diagnosis and Treatment and Supplemental EPSDT Providers refiled 8-1-94 as an emergency; operative 8-1-94 (Register 94, No. 31). A Certificate of Compliance must be transmitted to OAL by 11-29-94 or emergency language will be repealed by operation of law on the following day.
15. Amendment of subsection (b) adding Early and Periodic Screening, Diagnosis and Treatment and Supplemental EPSDT Providers refiled 10-24-94 as an emergency; operative 10-24-94 (Register 94, No. 43). A Certificate of Compliance must be transmitted to OAL by 2-21-95 or emergency language will be repealed by operation of law on the following day.
16. Amendment of subsection (b) adding Early and Periodic Screening, Diagnosis and Treatment and Supplemental EPSDT Providers refiled 2-22-95; operative 2-22-95 (Register 95, No. 8). A Certificate of Compliance must be transmitted to OAL by 6-22-95 or emergency language will be repealed by operation of law on the following day.
17. Certificate of Compliance as to 2-22-95 order including amendment of section transmitted to OAL 3-16-95 and filed 4-27-95 (Register 95, No. 17).
18. Amendment of subsection (b) and Note filed 7-1-96; operative 7-1-96. Submitted to OAL for printing only pursuant to Section 6, Chapter 305, Statutes of 1995 (Register 96, No. 27).
19. Amendment of subsection (b) and Note refiled 10-29-96 as an emergency; operative 10-29-96 (Register 96, No. 44). Submitted to OAL for printing only pursuant to Section 6, Chapter 305, Statutes of 1995. A Certificate of Compliance must be transmitted to OAL by 2-26-97 or emergency language will be repealed by operation of law on the following day.
20. Editorial correction of History 19 (Register 97, No. 15).
21. Reinstatement of subsection (b) and Note as they existed prior to emergency amendment filed 7-1-96 by operation of Government Code section 11346.1(f) (Register 97, No. 15).
22. Amendment of subsection (b) and Note filed 4-10-97; operative 4-10-97 pursuant to Government Code section 11343.4(d) (Register 97, No. 15).
23. Amendment of subsection (b) filed 6-23-97; operative 7-23-97 (Register 97, No. 26).
24. Amendment of subsection (b) filed 8-10-99 as an emergency; operative 8-10-99 (Register 99, No. 33). A Certificate of Compliance must be transmitted to OAL by 12-8-99 or emergency language will be repealed by operation of law on the following day.
25. Amendment of section heading, section and Note filed 9-28-99 as an emergency; operative 9-28-99 (Register 99, No. 40). A Certificate of Compliance must be transmitted to OAL by 3-27-2000 or emergency language will be repealed by operation of law on the following day. Submitted to OAL for printing only pursuant to section 78, AB 1107 (Chapter 146, Statutes of 1999).
26. Amendment of section heading, section and Note refiled 11-24-99 as an emergency; operative 11-24-99 (Register 99, No. 48). A Certificate of Compliance must be transmitted to OAL by 5-22-2000 or emergency language will be repealed by operation of law on the following day. Submitted to OAL for printing only pursuant to section 78, AB 1107 (Chapter 146, Statutes of 1999).
27. Certificate of Compliance as to 8-10-99 order transmitted to OAL 12-7-99 and filed 1-14-2000 (Register 2000, No. 2).
28. Amendment of section heading, section and Note refiled 5-5-2000 as an emergency; operative 5-22-2000 (Register 2000, No. 18). A Certificate of Compliance must be transmitted to OAL by 9-19-2000 or emergency language will be repealed by operation of law on the following day.
29. Amendment of section heading, section and Note refiled 8-28-2000 as an emergency; operative 9-6-2000 (Register 2000, No. 35). A Certificate of Compliance must be transmitted to OAL by 1-4-2001 or emergency language will be repealed by operation of law on the following day.
30. Amendment of subsection (b) and amendment of Note filed 10-24-2000 as an emergency and submitted to OAL for printing only pursuant to Section 78, Chapter 146, Statutes of 1999; operative 10-24-2000 (Register 2000, No. 43). A Certificate of Compliance must be transmitted to OAL by 4-23-2001 or emergency language will be repealed by operation of law on the following day.
31. Certificate of Compliance as to 8-28-2000 order transmitted to OAL 12-26-2000 and filed 2-8-2001 (Register 2001, No. 6).
32. Editorial correction of History 30 (Register 2001, No. 14).
33. Amendment of subsection (b) and amendment of Note refiled 4-4-2001 as an emergency and submitted to OAL for printing only pursuant to Section 78, Chapter 146, Statutes of 1999; operative 4-4-2001 (Register 2001, No. 14). A Certificate of Compliance must be transmitted to OAL by 8-2-2001 or emergency language will be repealed by operation of law on the following day.
34. Certificate of Compliance as to 4-4-2001 order transmitted to OAL 7-31-2001 and filed 9-5-2001 (Register 2001, No. 36).
35. Amendment of subsection (b) and amendment of Note filed 9-3-2004; operative 10-3-2004 (Register 2004, No. 36).
36. Amendment of subsection (a) and Note filed 9-29-2004 as an emergency; operative 10-7-2004 (Register 2004, No. 41). A Certificate of Compliance must be transmitted to OAL by 2-4-2005 or emergency language will be repealed by operation of law on the following day. Deemed emergency exempt from OAL pursuant to Welfare and Institutions Code section 14043.75.
37. Amendment of subsection (a) and Note refiled 1-27-2005 as an emergency; operative 2-5-2005 (Register 2005, No. 4). A Certificate of Compliance must be transmitted to OAL by 6-6-2005 or emergency language will be repealed by operation of law on the following day. Deemed emergency exempt from OAL review pursuant to Welfare and Institutions Code section 14043.75.
38. Amendment of subsection (a) and Note refiled 6-2-2005 as an emergency; operative 6-7-2005 (Register 2005, No. 22). A Certificate of Compliance must be transmitted to OAL by 10-5-2005 or emergency language will be repealed by operation of law on the following day. Deemed emergency exempt from OAL review pursuant to Welfare and Institutions Code section 14043.75.
39. Certificate of Compliance as to 6-2-2005 order, including further amendment of subsection (a), transmitted to OAL 9-29-2005 and filed 11-10-2005 (Register 2005, No. 45).
40. Change without regulatory effect amending subsection (b) filed 10-8-2014 pursuant to section 100, title 1, California Code of Regulations (Register 2014, No. 41).
41. Amendment of subsection (b) and amendment of Note filed 5-12-2015; operative 7/1/2015 (Register 2015, No. 20).
42. Amendment of section and Note filed 8-17-2015 as a deemed emergency exempt from OAL review pursuant to Welfare and Institutions Code section 14043.75; operative 8-17-2015 (Register 2015, No. 34). A Certificate of Compliance must be transmitted to OAL by 2-16-2016 or emergency language will be repealed by operation of law on the following day.
43. Certificate of Compliance as to 8-17-2015 order transmitted to OAL 12-30-2015 and filed 2-11-2016 (Register 2016, No. 7).