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

Announcements

Certified Wellness Coach (CWC) Services Now Available​ 

On June 24, 2025, the Centers for Medicare and Medicaid Services (CMS) approved State Plan Amendment (SPA) 25-0014​ to add Certified Wellness Coach (CWC) services as a new Medi-Cal benefit. This benefit is reimbursable under the Children & Youth Behavioral Health Initiative (CYBHI) statewide multi-payer school-linked Fee Schedule (Fee Schedule) program, with an effective date of January 1, 2025.

CYBHI Fee Schedule program providers may now submit claims for CWC services with a date of service of January 1, 2025, or later, in accordance with the services listed in the CYBHI Fee Schedule program Scope of Services, Codes, and Reimbursement Rates​ document.  Each CWC session, regardless of the service activity, can be billed under the codes listed and are dependent on whether the service is an individual initial or follow-up session or group session. ​​​

​CYBHI Fee Schedule Program Manual Webinar

DHCS is hosting a public webinar to discuss the updated CYBHI Fee Schedule Program Manual for LEAs and IHEs on:

Each webinar will offer the same information - feel free to choose the time that works best for you. Both webinars will be recorded and the recordings will be made available to the public.​

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

Questions​ and 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: 8/1/2025 8:02 AM