Behavioral Health Treatment
The Department of Health Care Services (DHCS) submitted State Plan Amendment (SPA) 14–026 to the Centers for Medicare & Medicaid Services (CMS) on September 30, 2014 to seek the necessary approval to include Behavioral Health Treatment (BHT) as a covered Medi–Cal service for individuals under 21 years of age, pursuant to Section 14132.56
of the Welfare and Institutions (W&I) Code.
On January 21, 2016, CMS approved SPA 14-026 for DHCS to provide BHT services for children under 21 years of age. BHT services are effective retroactively to July 7, 2014.
BHT services are covered Medi–Cal benefits for individuals under 21 years of age with autism spectrum disorder. DHCS will provide BHT as it is defined by Section 1374.73
of the Health and Safety Code.
In consultation with stakeholders as required by section 14132.56 of the W&I Code, the Department developed and defined eligibility criteria, provider participation criteria, utilization controls, and the delivery system for BHT services, subject to the limitations allowed under federal law.
Beginning February 1, 2016, the authorization and payment of BHT services to Medi-Cal beneficiaries will transition from Regional Centers to Medi-Cal over an estimated six-month period. Please see below for more information about the transition plan
DHCS's responses to Frequently Asked Questions (pdf) -- New
Department of Health Care Services February 5, 2016 response to stakeholder comments regarding SPA 14-016 (pdf)
Revised All Plan Letter for BHT Released December 3, 2015
On December 3, 2015 DHCS released the revised All Plan Letter (APL)
15-025 concerning "Responsibilities for Behavioral Health Treatment Coverage for Children Diagnosed with Autism Spectrum Disorder" to managed care plans. This letter provides final policy guidance to the plans for the provision of BHT services and replaces the interim policy issued September 15, 2014 in APL 14-011.
BHT Services Report
BHT Transition Update
DHCS and the Department of Developmental Services (DDS) jointly issued the final transition plan
November 20, 2015 that describes the transition of Behavioral Health Treatment (BHT) services from the regional centers to the Medi-Cal managed care and fee-for-service delivery systems. The transition will begin no sooner than February 2016 over a period of six months. The transition plan outlines the operational steps taken by DHCS and DDS to ensure a successful transition of approximately 13,000 Medi-Cal beneficiaries.
DHCS and DDS allowed for a public comment period in June 2015 on the transition plan to provide an opportunity for stakeholders to provide input and feedback on the various components of the transition.
DHCS and DDS allowed for a public comment period in June 2015 on the transition plan to provide an opportunity for stakeholders to provide input and feedback on the various components of the transition. On the week of November 16, the broader transition plan that describes the operational steps taken by DHCS and DDS to ensure a successful transition of approximately 13,000 Medi-Cal beneficiaries will be issued and posted on both departments’ websites.
The Department of Health Care Services (DHCS) has delayed the transition of responsibility for the provision of Behavioral Health Treatment (BHT) services from Regional Centers to DHCS Medi-Cal managed care health plans (MCP) from November 1, 2015, to February 1, 2016, and the transition of financial responsibility for BHT services for fee-for-service Medi-Cal beneficiaries from Regional Centers to DHCS from October 1, 2015 to February 1, 2016. This delay will provide additional time for DHCS and the Department of Developmental Services (DDS) to prepare for the transition. DHCS has worked closely with DDS, MCPs, Regional Centers, and stakeholders to operationalize the transition since the Centers for Medicare and Medicaid Services (CMS) released its guidance requiring states to cover BHT for children with autism spectrum disorder under the Early and Periodic Screening, Diagnostic and Treatment benefit. State capitation rates to be paid to MCPs are being updated to reflect changes in transition assumptions and will be posted to the DHCS website as soon as they become available.
Statewide Median Rates
Department of Developmental Services letter regarding new provider rates effective July 1, 2016 (pdf)
Regional Center 2011 Statewide Median Rates (pdf)
BHT Supplemental Rates for 2014-2015
Posted 8/14/15: Behavioral Health Treatment (BHT) Supplemental Payment Rates (September 15, 2014 - June 30, 2015)
Posted 8/14/15: State Fiscal Year 2014-15 Behavioral Health Treatment (BHT) Supplemental Payment Methodology
Public Notice: August 15, 2014 -- Adding Behavioral Health Treatment
Tribal Notice: August 19, 2014 -- SPA 14-026, Adding Behavioral Health Treatment as a covered Medi-Cal Service
All Plan Letter 14-011: INTERIM POLICY FOR THE PROVISION OF BEHAVIORAL HEALTH TREATMENT COVERAGE FOR CHILDREN DIAGNOSED WITH AUTISM SPECTRUM DISORDER
Past Meeting Archive
March 24, 2016
December 22, 2015
October 2015 update (no meeting)
August 2015 update (no meeting)
July 17, 2015
July 7, 2015 BHT providers stakeholder briefing
June 18, 2015
May 22, 2015
Items for public comment shared May 22, 2015. Comments were due to ABAinfo@dhcs.ca.gov by June 5, 2015.
- Draft Behavioral Health Treatment Transition plan (pdf)
- Draft transition notice for beneficiary with Fee-for-Service Medi-Cal (pdf) (Word)
- Draft 60-day transition notice for beneficiary with Managed Care (pdf) (Word)
- Draft 30-day transition notice for beneficiary with Managed Care (pdf) (Word)
- Draft All Plan Letter 14-021 (pdf)
April 23, 2015
March 19, 2015
January 22, 2015
December 19, 2014
November 18, 2014
October 16, 2014
September 4, 2014
Please direct your comments, questions, or suggestions regarding the DHCS Stakeholder Advisory Committee to the following email address: ABAinfo@dhcs.ca.gov.