Behavioral Health Treatment
Medi-Cal covers all medically necessary behavioral health treatment (BHT) services for eligible Medi-Cal members under 21 years of age. This may include children with autism spectrum disorder (ASD) as well as children for whom a physician or psychologist determines it is medically necessary, regardless of diagnosis. A referral to a physician or psychologist for evaluation for BHT services can be made by any health care provider. However, consistent with state and federal requirements, only a physician or a psychologist can determine that BHT services are medically necessary to correct or ameliorate any physical and/or behavioral conditions and recommend the child for services from BHT providers.
BHT services include applied behavioral analysis (ABA) and a variety of other behavioral interventions that have been identified as evidence-based approaches that prevent or minimize the adverse effects of behaviors that interfere with learning and social interaction, and promote, to the maximum extent practicable, the functioning of a beneficiary, including those with or without ASD.
Medi-Cal members in a Medi-Cal managed care plan receive BHT services from their plan (MCP). For more information, please see the Managed Care Health Plan Directory for contact information.
Children with fee-for-service (FFS) Medi-Cal receive BHT services from their local Regional Center. For more information about Regional Centers, including directory and listing by county, please visit the Department of Development Services’ (DDS’) Regional Center directory. Starting July 1, 2025, children with FFS Medi-Cal will have the option to receive BHT services from enrolled Medi-Cal Qualified Autism Service (QAS) providers instead of through their local Regional Center. For more information on Medi-Cal QAS providers, please review this bulletin.
Coverage Policy
- Medi-Cal Provider Manual: Behavioral Health Treatment (BHT)
- BHT Frequently Asked Questions (FAQs) for Medi-Cal Members
- Reimbursement for Behavioral Health Treatment Services Provided to Medi-Cal Members with Fee-For-Service
- Managed Care APL Subject Listing – Behavioral Health Treatment
Qualified Autism Service (QAS) Provider Enrollment
- Presentation on Enrolling in PAVE as a QAS Provider
- QAS Provider Enrollment Checklist
- FAQs for Enrollment as a QAS Provider (Updated September 3, 2025)
- Webinar for QAS Providers on BHT Services for Fee-for-Service Members
Medi-Cal Managed Care
- MCP Directory: Phone number for each MCP by county.
- MCP Contacts: Phone numbers and website addresses for MCPs for BHT.
Department of Developmental Services (DDS) Information
- Autism Spectrum Disorders: Best Practice Guidelines for Screening, Diagnosis and Assessment: Developed for and under the direction and supervision of DDS by the Northern California Autism Collaborative with assistance from the Association of Regional Center Agencies.
- Regional Centers (RC) Listings: List of the RCs and contact information.
Other Information
- CMS Informational Bulletin: Clarification on Medicaid Coverage of Services to Children with Autism.
- Findings and Conclusions: National Standards Project, Phase 2, Addressing the Need for Evidence-Based Practice Guidelines for Autism Spectrum Disorder
- Disability Rights California: Office of Client’s Rights Advocacy.
- Guide to Medi-Cal Behavioral Health: What’s Covered and How to Get Care– This brochure provides a clear and accessible overview of behavioral health services available through Medi-Cal.
Contact Us
For questions regarding BHT, please contact Medi-Cal.Benefits@dhcs.ca.gov.