Tsev Cov Kev Pabcuam Cov Kev Pabcuam Medi-Cal Medi-Cal rau Cov Menyuam Yaus thiab Cov Hluas Cov Ntaub Ntawv Txog Tus Muab Kev Pabcuam

Cov ntaub ntawv qhia

By law, the Department of Health Care Services (DHCS) is responsible to provide full-scope early and periodic screening, diagnostic, and treatment services to Medi-Cal members under the age of 21. These services are covered without cost.

California hais txog Kev Tshawb Fawb Txog Thaum Ntxov thiab Lub Sij Hawm, Kev Ntsuas, thiab Kev Kho Mob (EPSDT) cov txiaj ntsig raws li Medi-Cal rau Cov Menyuam & Cov Hluas.

Qhia rau cov tswv cuab

Medi-Cal providers (medical, dental, and mental health plans, and enrolled) should inform Medi-Cal members (under age 21), or their parents, about the following: 

  • Vim li cas cov kev pabcuam tiv thaiv thiab kev tshuaj ntsuam xyuas tseem ceeb
  • Cov kev pab twg muaj nyob rau hauv Medi-Cal rau Cov Menyuam & Cov Hluas
  • Qhov twg thiab yuav ua li cas thiaj tau txais kev pabcuam
  • Cov kev pabcuam pub dawb
  • Muaj kev thauj mus los dawb thiab pab teem sijhawm

Cov kws kho mob yuav tsum nthuav tawm tsib yam no ua lus meej:

  • Hauv neeg
  • Hauv xov tooj (siv kev sib tham thiab sau ntawv)
  • Los ntawm cov ntaub ntawv sau 
    • Cov ntaub ntawv pov thawj ntawm cov ntaub ntawv pov thawj
    • Phau ntawv qhia tswv cuab
    • Cov ntaub ntawv ntsig txog

Yog xav paub ntxiv txog kev sib txuas lus nrog cov tswv cuab, saib nplooj ntawv Resources .

Kev xav tau kev kho mob

Medi-Cal for Kids & Teens (the EPSDT benefit) allows enrolled members (under age 21) to receive any medically necessary treatment or procedure, regardless of whether or not Medi-Cal covers it.

Txhais

Rau cov hnub nyoog qis dua 21, lub ntsiab lus ntawm kev kho mob tsim nyog yog los kho lossis kho kom zoo: 

  • kev noj qab haus huv tsis zoo
  • mob lub cev thiab puas siab puas ntsws 
  • thiab tej yam kev mob uas nrhiav tau los ntawm cov kev pabcuam tshuaj ntsuam xyuas

Kev txiav txim siab

Kev txiav txim siab seb qhov kev pabcuam puas tsim nyog rau kev kho mob:

  • yuav tsum coj mus rau hauv tus account qhov kev xav tau ntawm tus me nyuam
  • yuav ua tau nyob rau hauv cov ntaub ntawv los ntawm cov ntaub ntawv

Los ntawm txoj kev Thov Kev Tso Cai Kho Mob (TAR), cov kev pabcuam ntxiv yuav raug pom zoo yog tias txiav txim siab tias yuav tsum muaj kev kho mob rau ib tus menyuam.

Cov kev pab tu

Cov kev pabcuam kho mob txhais tau tias yog cov kev pabcuam uas txhawb nqa lossis txhawb nqa ntau dua li cov uas kho lossis txhim kho teebmeem kev noj qab haus huv.

Ib qho kev pabcuam yuav tsum tsis kho tus mob kom tau txais kev pab. 

Cov kev pabcuam raug them thaum lawv 

  • tiv thaiv kom tsis txhob mob hnyav
  • tiv thaiv kev txhim kho cov teeb meem kev noj qab haus huv ntxiv.

Cov kev pabcuam uas tswj lossis txhim kho tus menyuam txoj kev noj qab haus huv tam sim no raug them vim tias lawv "kho" tus mob. 

Cov peev txheej

Kev cob qhia

Please note, DHCS advises all providers to work with and direct all inquiries regarding the Medi-Cal for Kids & Teens provider training requirements to their respective Managed Care Plans (MCPs) for clarification.  See also All Plan Letter 23-005 for additional information related to training requirements.

California Child and Adolescent Mental Health Access Portal (Cal-MAP)

Cal-MAP yog ib qho pub dawb, thoob plaws xeev kev sib tham txog kev noj qab haus huv thiab kev cob qhia. Los ntawm Cal-MAP, cov kws kho mob nkag mus tau dawb, cov cuab yeej tseem ceeb los daws lawv cov neeg mob hluas cov kev xav tau kev noj qab haus huv zoo dua, suav nrog:

  • Kev sab laj nrog kws kho mob hlwb lossis kws kho hlwb
  • Cov txheej txheem ntawm kev saib xyuas navigation txhawb nqa thiab xa mus
  • Cov ncauj lus thiab kev kuaj mob tshwj xeeb rau cov tsev neeg thiab PCPs
  • Kev Kawm Kho Mob Ntxiv (CME) kev cob qhia credit rau PCPs

Cov ntawv qhia

Phau ntawv

Txhua Daim Ntawv Npaj

  • 23-005 Nws
    Qhia meej txog lub luag haujlwm los muab cov kev pabcuam EPSDT
  • 19-014 ib
    Kev taw qhia thiab cov kev cai rau kev kho mob uas tsim nyog rau Kev Kho Tus Cwj Pwm Kev Kho Mob (BHT).

Daim ntawv ceeb toom txog kev noj qab haus huv ntawm tus cwj pwm

  • 21-019 Nws
    Medical necessity determination and level of care placement as part of California’s Advancing and Innovating Medi-Cal (CalAIM)
  • 18-048 ib
    Cov ntaub ntawv xa tuaj rau cov kev pabcuam EPSDT
  • 17-052 : kuv
    Cov kev pabcuam tshwjxeeb rau kev puas hlwb kev ua tau zoo yog cov cuab yeej ntsuas kev ua haujlwm rau cov menyuam yaus thiab cov hluas
  • 16-063 : kuv
    Cov Kev Pab Cuam Tsis Zoo (SUD) muaj nyob hauv EPSDT
  • Txhua daim ntawv ceeb toom

Tsoom Fwv Teb Chaws Pom Zoo

  • SPA 15-034
    Hloov kho lus rau EPSDT cov kev pab tiv thaiv thiab kev noj qab haus huv

Cov kev pabcuam cuam tshuam

Hu rau

Xav paub ntxiv 

Yog xav paub ntxiv txog Medi-Cal rau cov nyiaj pab rau menyuam yaus & Cov Hluas:
Email: medi-calkidsteens@dhcs.ca.gov

Txhawm rau sau npe ua tus kws kho mob Medi-Cal: Thov mus saib Lub Chaw Pabcuam Sau Npe lub vev xaib.

Medi-Cal Managed Care Plans: Thov hu rau koj tus thawj saib xyuas daim ntawv cog lus rau txhua qhov kev nug.

For general Medi-Cal Provider support or questions: Please visit the Contact Us webpage for further information or call the Telephone Service Center at 1-800-541-5555.