Introduction

The Department of Health Care Services (DHCS) has created an enrollment pathway for Statewide Affiliated Providers (e.g., health clinics, telehealth providers, regional community organizations) to participate in the Children & Youth Behavioral Health Initiative (CYBHI) statewide, multi-payer school-linked fee schedule (Fee Schedule) program. Community-based school-linked providers who meet all of the following criteria below are eligible to apply as a Statewide Affiliated Provider:
  1. The provider must serve multiple local educational agencies or public institutes of higher education (LEAs/IHEs) across two (2) or more counties.
  2. The provider must not be located at a single fixed location but serving students at multiple sites (or via telehealth) across the state. Note: DHCS would not consider a provider that has only one clinic or facility-based site to be a “statewide” provider that meets this criterion even if that provider served multiple LEAs across 2 or more counties.
  3. The provider must submit to DHCS a letter from each LEA and/or IHE that “designates” the provider as an affiliated provider of the LEA and/or IHE that serves students who attend that LEA/IHE prior to any claims submissions.
  4. As a condition of participation in the CYBHI Fee Schedule program, all participating designated affiliated providers MUST be enrolled as a Fee-for-Service (FFS) provider in the Medi-Cal program through DHCS’ Provider Enrollment Division. Any affiliated provider that applies to participate in the CYBHI Fee Schedule program must be actively enrolled and in good status as a Medi-Cal provider. DHCS will verify enrollment of affiliated providers by validating the provider’s National Provider Identifier (NPI) number and checking the DHCS’ Provider Master File, which lists all enrolled providers approved to participate in the Medi-Cal FFS program.
A Statewide Affiliated Provider may be eligible to participate regardless of the status of LEA or IHE participation in the CYBHI Fee Schedule program, meaning the Statewide Affiliated Provider could be designated by an LEA or IHE that is not yet a part of an active cohort and/or has not yet started submitting claims as part of the CYBHI Fee Schedule program.

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