Skip Navigation LinksNew-CPSP-Provider-Application-and-Process

Comprehensive Perinatal Services Prograā€‹m (CPSP)ā€‹

New CPSP Provider Application and Processā€‹


ā€‹ā€‹ā€‹Visit the CPSP website for current program information, policies, procedures, forms, and templates.

How to become an approvā€‹ā€‹ed CPSP provider:

  1. Enroll in Medi-Cal as one of these CPSP-eligibleā€‹ Provider Types:

    • Physician (MD/DO) specializing in obstetrics, pediatrics, family practice, or general medicine
    • Physician Group with at least one member who specializes in one of the above specialtiesā€‹
    • Certified Nurse Midwife (CNM)
    • Certified Nurse Midwife Group
    • Community Clinic
    • County Clinic
    • FQHC/RHC/IHS
    • Hospital Outpatient Clinic
    • Licensed Midwives (LMs)
    • Alternative Birth Center

  2. ā€‹Veā€‹ā€‹rifā€‹ā€‹y practitioner trainingā€‹ā€‹, experience, and license information to ensure:

    • ā€‹Prā€‹ā€‹actitionersā€™ professional licenses, certificates, or registrations are valid and unexpired
    • Practitionersā€™ training (school, degree, year of graduation) and years of experience comply with Title 22 Regulationsā€‹

  3. Deā€‹velop templatesā€‹ā€‹ for use in delivering CPSP services in alignment with CPSP protocols.

  4. ā€‹Idā€‹ā€‹enā€‹ā€‹tify local referral resources for these non-CPSP services:

    • Women, Infants & Children (WIC for nutrition and breastfeeding services and supplies
    • Child Health and Disability Prevention (CHDP) for child wellness services
    • Family Planning, Access, Care and Treatment (Family PACT) For family planning services
    • Genetic Disease Screening Program (GDSP) for newborn genetic screening services
    • Medi-Cal Dental Program for dental services

  5. Dā€‹ā€‹evelop site specific CPSP protocols within six months ā€‹ā€‹of CPSP approval.

  6. ā€‹Comā€‹ā€‹plete a CPSP Provider Application (CDPH 4448) and, if applicable, an Additional CPSPPractitioners Form (CDPH 4448A).

    • Download the current version of the forms from the CPSP website
    • ā€‹Complete the forms and digitally sign the 4448
    • Submit the completed, signed CPSP Provider Application to CDPH/MCAH Division via email to CPSPProviderEnrollment@cdph.ca.gov.

Contact Us:

  • For assistance with the CPSP application process email CDPH/MCAH Division at CPSPProviderEnrollment@cdph.ca.gov.
  • For assistance with implementing CPSP and for general program inquiries email CDPH/MCAHDivision at MCAHCPSPGeneralInquiry@cdph.ca.govā€‹.
  • For assistance with Medi-Cal enrollment or to check status contact Provider Enrollment Division (PED) at (916) 323-1945.
  • For assistance with Medi-Cal billing or to leave a message for your Regional Representative contact the ā€‹Telephone Service Center (TSC) at (800) 541-5555.ā€‹
Page Last Updated :