Resource Corner

HRIF Medical Eligibility Criteria

HRIF Manual and Reporting Forms

Released 01.2018

Data Finalization Process (DFP) - 2018

Reporting System Tools

  1. System Updates & Presentations



  1. CCS NICU HRIF Eligible Infants Referral Guidelines

  2. Family Information Form 

The purpose of this tool is to collect social-demographic information about High Risk Infant Follow-up (HRIF) patients and their families to determine the specific needs of this patient population and develop better standards of care for California HRIF Programs. This tool is available in the following languages:

  1. CCS HRIF Program Billing Codes
  2. Office of Statewide Health Planning and Development (OSHPD) Facility Codes
    1. Sorted by Hospital Name
    2. Other Codes
  3. Gross Motor Function Classification System (GMFCS) - Expanded and Revised 2007 
  4. Autism Screening Tools


Children's Medical Services (CMS)/ California Children Services (CCS) Program

  1. For CMS/CCS Program HRIF Information including updates and latest news go to:
  2. HRIF Program Letter (P.L.): 01-0917 - Clarification of Congenital Heart Disease Eligibility Criteria
  3. High Risk Infant Follow-up Program Letter (P.L.): 01-1016

This Program Letter (P.L.) updates the Medical Eligibility criteria for HRIF under Section III, HRIF Eligibility, and reiterates policy and guidance for the HRIF Program’s diagnostic services, provider responsibilities, reporting requirements, and procedures for billing authorized services provided to HRIF-eligible neonates, infants, and children. This letter supersedes HRIF P.L. 01-1113, dated November 22, 2013.

  1. CCS HRIF-QCI Memo 8-2012
  2. Hearing Assessment Requirements: CCS Number Letter (N.L.): 06-1008
  3. Provider Standards (CCS Manual of Procedures)

Chapter 3.25 - Neonatal Intensive Care Unit (NICU) Standards:

  1. Chapter 3.25.1 (Regional NICU)
  2. Chapter 3.25.2 (Community NICU)
  3. Chapter 3.25.3 (Intermediate NICU)