Medi-Cal Mental Health Services Referral Processes
Medi-Cal beneficiaries enrolled in Medi-Cal Managed Care Plans (MCPs) may receive mental health services via their MCP, or specialty mental health services (SMHS) through their County Mental Health Plan (MHP) if they meet SMHS medical necessity criteria. MHPs have a memorandum of understanding (MOU) with each MCP that enrolls beneficiaries covered by the MHP. Each MOU contains MCP/MHP referral and coordination of care protocols, among other required elements. While there is not a standard referral process that beneficiaries must follow to access Medi-Cal covered mental health services, the flow charts below graphically illustrate three typical referral scenarios that a beneficiary may follow.
1.) MCP Primary Care Provider (PCP) Refers to MCP Behavioral Health Provider
2.) MCP PCP Refers to MHP
3.) MHP Refers to MCP
4.) Access to Mental Health Services for Medi-Cal Youth Ages 0-21