行为健康治疗常见问题解答
The following FAQs provide additional guidance and clarification to Medi-Cal members regarding BHT services. As the Department of Health Care Services (DHCS) receives additional questions, this FAQ will be updated.
BHT 服务是什么？
BHT services consist of Applied Behavioral Analysis and other generally accepted 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 member, including those with or without autism spectrum disorder (ASD).
Who is eligible for BHT Services?
Medi-Cal members under 21 years of age with or without ASD for whom a physician or psychologist determines it is medically necessary, regardless of diagnosis.
谁可以开具BHT处方？
A referral for an evaluation for BHT services can be made by any ordering, rendering, or treating provider for evaluation. Only physician or a psychologist, following an evaluation, can determine if BHT services are medically necessary for the child and make the recommendation to a BHT provider for services.
How do children access BHT services?
参加Medi-Cal管理式医疗计划并被分配到Medi-Cal Managed Care计划 (MCP) 的 Medi-Cal 会员可从其Medi-Cal MCP 获得 BHT 服务。
符合Medi-Cal Fee-for-Service ( FFS ) 会员特定 BHT 服务资格标准（除Medi-Cal资格标准外）的会员，可以通过其当地区域中心协调获得 BHT 服务。 从 7 月 1、2025 日起，21 岁以下的 Medi-Cal 按服务付费 (FFS) 会员可以选择直接从已注册的 Medi-Cal 合格自闭症服务 (QAS) 提供商处获得 BHT 服务，而不是通过其当地的区域中心。
儿童如何才能符合接受 BHT 的医疗必要性标准？
医生或心理学家会根据 BHT 服务是否能纠正或改善儿童可能存在的任何身体和/或行为状况，来确定 BHT 是否对儿童具有医疗必要性。
Who can provide BHT services?
As defined in Health & Safety Code section 1374.73, treatment services must be provided by a QAS provider, QAS professional, or QAS paraprofessional. QAS provides may be a board-certified behavior analyst or a licensed provider with training in treating BHT. QAS professionals must be supervised by a QAS professional or QAS provider, while QAS paraprofessionals must be supervised by either a QAS provider or QAS professional.
Medi-Cal是否要求家长/监护人参与行为健康技师（BHT）服务？
A Medi-Cal member cannot be denied BHT services for lack of parent participation. However, BHT services may include optional parent/guardian training when it is part of the treatment plan.
Who is responsible for providing BHT services if the child has private insurance and Medi- Cal?
Children with dual coverage would receive BHT services from their private insurance and Medi-Cal will wrap around those services that are not covered by the private insurance.
Medi-Cal儿童接受行为健康技师（BHT）服务评估的时间表是什么？
Medi-Cal MCPs must provide BHT services in the same manner as timely access standards for other services. There are no specified timelines in Medi-Cal FFS for when a local Regional Center or enrolled QAS provider must conduct an assessment for BHT services.
被安置在寄养家庭的儿童是否有资格获得行为健康治疗师（BHT）服务？
Yes, foster children/youth and former foster youth under the age 21 years with Medi-Cal may receive BHT services when determined medically necessary by a physician or psychologist.
如果我不同意拒绝或更改我的 BHT 服务，我的权利是什么？
- 如果您的孩子接受了管理式医疗，您必须首先向您的 Medi-Cal MCP 对该决定提出上诉。您可以在完成 MCP 的内部上诉程序并收到告知您健康计划不会提供服务的信函后，或者您没有收到告知您决定的信函并且已经超过 30 天后，申请州听证会。
- 如果您的孩子有 Medi-Cal FFS，并且您不同意拒绝或更改服务，您可以申请州听证会。
州听证会
To ask for a State Hearing, you can fill out the “State Hearing Request” form at www.dhcs.ca.gov/services/medi-cal/Pages/Medi-CalFairHearing.aspx and send it to:
California社会服务部州听证处
P.O. Box 944243, MS 19-37
萨克拉门托，加利福尼亚州 94244-2430
You may also call to ask for a State Hearing. The number can be very busy so you may get a message to call back later.
免费电话：(800) 952-5253
电话：（800）952-8349
申请州级听证会的时限是什么？
- 您只有 90 天的时间来要求举行听证会。
- 90 天从拒绝信函发出之日起开始计算。
我还能继续获得行为健康技师服务并要求举行州级听证会吗？
To still get your BHT services that the denial notice is stopping or changing, you must:
要求在以下日期起十天内举行州听证会
通知书邮戳日期，或
通知书寄给您的日期，或
通知称您的 BHT 服务将停止或变更之日之前。
请说明您希望在听证过程中继续获得 BHT 的服务。
您的案件可能需要长达 90 天的时间才能得到裁决并收到答复。
Can I Ask for a Quick Hearing?
Yes. This is called an “expedited” hearing. If you think waiting up to 90 days may be risky for you or your child’s health, ask your doctor for a letter. The letter must explain how waiting for up to 90 days could be risky for you or your child’s life or health. Then you can ask for an expedited hearing. You need to send the letter with your hearing request.
You do not have to attend the State Hearing alone. You may bring someone with you. You can bring a friend, a relative, a lawyer, or anyone you choose. You can speak for yourself or have someone else speak for you.
查看州听证程序页面了解更多信息。