If you need assistance with Long-Term Care or Intermediate Care Facility – Developmentally Disabled or additional resources, go to our Skilled Nursing Resources web page.
Effective June 01, 2025, L.A. Care will no longer require prior authorization for LTC and ICF/DD service codes: 0101 and 0190.
The following service codes still require prior authorization:
- 0101: LTC and ICF/DD Room and Board for NON-CONTRACTED facilities only
- 0190: LTC Subacute for NON- CONTRACTED facilities only
- 0191-0194: Skilled Level of Care
- 0199: Pediatric Subacute with Rehabilitation Therapy and Ventilator Weaning Services
To request authorization that is needed for LTC or ICF/DD, complete and fax a Prior Authorization form.
- Fax: 213-438-4877
- Required Documents for ICF/DD:
- L.A. Care Authorization Request Form
- Certification for Special Treatment Program Services form (HS 231) signed by Regional Center
- Medical Review/Prolonged Care Assessment (PCA) form (DHCS 6013A)
Please note: Initial ICF/DD placement needs to be coordinated with Regional Center