Children and Youth Behavioral Health Initiative Fee Schedule program
Announcements
On February 21, 2025, the Department of Health Care Services (DHCS) announced the Local Educational Agencies (LEAs) and public Institutions of Higher Education (IHEs) approved to participate in the fourth cohort of the Children and Youth Behavioral Health Initiative (CYBHI) statewide multi-payer school-linked fee schedule (Fee Schedule) program and statewide provider network. DHCS implemented an operational readiness review process for all interested Cohort 4 entities. In determining readiness for this cohort, DHCS considered a variety of factors, including, but not limited to: Medi-Cal enrollment, service delivery infrastructure and capacity building, data collection and documentation, and billing infrastructure.
See PDF list of selected Cohort 4 Participants.
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
- CYBHI Fee Schedule Program Parent and Caregiver Flyer
- CYBHI Fee Schedule Program Parent and Caregiver Brochure
- CYBHI Fee Schedule Program Parent and Caregiver Flyer (Spanish)
- CYBHI Fee Schedule Program Parent and Caregiver Brochure (Spanish)
- Please contact DHCS.SBS@dhcs.ca.gov to request virtual copies of the Flyer and Brochure in any of the following languages: Arabic, Armenian, Farsi, Hmong, Khmer, Korean, Punjabi, Russian, Simplified Chinese, Tagalog, Traditional Chinese, and Vietnamese.
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 November 2024, 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 Plan Amendment (SPA) 23-0027 was approved by the Center for Medicaid and Medicare Services (CMS) on December 19, 2024, with an effective date of January 1, 2024. This SPA adds Pupil Personnel Services (PPS) Credentialed School Counselors, School Social Workers, and School Psychologists as eligible to render and bill for CYBHI Fee Schedule services.
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 Listserv
If you have questions regarding the Statewide Multi-Payer School-Linked Fee Schedule, please contact
DHCS.SBS@dhcs.ca.gov. You can sign up for the DHCS School Based Services Listserv at
this link.
