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​​​​​​​​​​​​​​​​​​​​Children and Youth Behavioral Health Initiative Fee Schedule program 

Announcements

Cohort 5 Readiness Application is live!

On May 1, 2025, the Department of Health Care Services (DHCS) released the Cohort 5 Readiness Application for Local Educational Agencies (LEAs) and public Institutions of Higher Education (IHEs) to participate in the Children and Youth Behavioral Health Initiative (CYBHI) statewide multi-payer school-linked fee schedule (Fee Schedule) program and statewide provider network. The fifth cohort of the CYBHI Fee Schedule program is open to all LEAs and IHEs that seek to start billing in January 2026.

The Readiness Application must be completed via SurveyMonkey​ by 5:00 PM on ​July 31, 2025. Please save your responses as you draft them as SurveyMonkey may log you out and delete your progress after 30 minutes of inactivity.​ Applicants may select to apply an Independent LEA/IHE, Consortium Lead, or Consortium Member. Please see the definitions below:

  • Independent: You will submit data and claims directly to the Third Party Administrator (TPA), and receive funds back from the TPA for only your LEA/IHE.
  • Consortium Lead: You will submit data and claims directly to the TPA on behalf of other LEAs/IHEs, and receive the funds back for all members of your consortia.
  • Consortium Member: You will not directly receive funds from the TPA. The Consortia Lead will receive funds on your behalf.

Overview of the CYBHI Fee Schedule program

As part of the Children and Youth Behavioral Health Initiative (CYBHI), the California Department of Health Care Services launched the CYBHI Fee Schedule program, a first-of-its kind effort to make it easier for students and families to get outpatient mental health and substance use disorder support when, where, and how they need it. This program creates a sustainable reimbursement pathway for Local Educational Agencies (LEAs) and public institutions of higher education (IHEs) to receive funding for services rendered at a school or school-linked site. The program sets the reimbursement rate for a certain set of outpatient, school-linked services rendered to children and youth who are:

  • Under the age of 26, 
  • Enrolled in public TK-12 schools or institutions of higher education (e.g., California Community Colleges), and ​

  • ​Covered by Medi-Cal managed care plans, Medi-Cal Fee-for-Service, health care service plans, and disability insurers.​

Children, youth, and families will not pay out-of-pocket expenses and there will not be any impact to their existing insurance plan nor deductibles. ​

Let’s work together to improve the behavioral health of children, youth, and families in California by expanding their access to youth-centered, equitable, and prevention-orientated services.​

Impact by the numbers

  • ⁓500 Local Educational Agencies and public Institutions of Higher Education enrolled in the CYBHI Fee Schedule program
  • ⁓​3.6M students enrolled across participating schoolsites
  • 97% of counties in California represented by current participants

​Current List of Participating LEAs and IHEs

CYBHI Fee Schedule Program Overview video​​

 

Resources​

Parent and Caregiver Flyer and Brochure

​​Relevant Policies and Legislation​

​Provider Participation Agreement

Affiliate Provider Guidance

CYBHI Fee Schedule Program Provider Manual

  • ​The Department of Health Care Services (DHCS) released the first draft of the CYBHI Fee Schedule program guidance document (Program Provider Manual) for public comment in February 2024. DHCS has taken all public comments and feedback from stakeholders in various forums into consideration of revisions to the CYBHI Fee Schedule Program Provider Manual.​

CYBHI Fee Schedule Program Scope of Services, Codes, and Reimbursement Rates

  • Please see the CYBHI Fee Schedule Scope of Services, Codes and Reimbursement Rates PDF​, updated as of April 2025, for information about reimbursable services for the CYBHI Fee Schedule program.
  • The CYBHI Fee Schedule program allows DHCS to establish the minimum rates at which Managed Care Plans and insurers must reimburses LEAs and IHEs for the provision of CYBHI Fee Schedule program covered services to a student under the age of 26 at a school site or school-linked location, including on-campus, off-campus and mobile clinic locations. The Scope of Services, Rates and Codes for the CYBHI Fee Schedule includes the appropriate billing codes, reimbursement rates, eligible practitioner types, service limitations and required modifiers for each type of billable service as part of the CYBHI Fee Schedule program.

State Third-Party Administrator (Carelon Behavioral Health)​​ Resources

  • For additional resources from the state third-party administrator, Carelon Behavioral Health, please click here.​

Questions​ & Email Distribution 

If you have any questions about the Statewide Multi-Payer School-Linked Fee Schedule, or if you would like to be added to the distribution list for newsletters and other related communications, please contact DHCS.SBS@dhcs.ca.gov​.


Last modified date: 5/14/2025 10:02 AM