Children and Youth Behavioral Health Initiative (CYBHI) - Health Services Reimbursement 


check markEligibility for Services
This program will not change students' eligibility to receive behavioral health services. Rather, the program will expand the availability of services by creating a new, sustainable method for providers to be reimbursed. Services delivered to students covered by Medi-Cal MCPs and Medi-Cal FFS, most commercial health care plans or disability insurers (with certain exceptions), are eligible to be reimbursed at the CYBHI fee schedule rate. 

lockPrivacy and Consent 
Our District may ask for your student's health insurance information. All health information will be securely stored and only shared in alignment with existing federal and state laws. 

billingNo Cost to Families 
There will be cost to families or caregivers for students who receive services at school. Receiving services at school will not reduce or impact students or their families' ability to receive care outside of school.


Background Information


As part of Governor Newsom's Children and Youth Behavioral Health Initiative (CYBHI), the Department of Health Care Service, the Department of Managed Health Care and the Department of Insurance are partnering with schools to expand access to school-based mental, physical and behavioral health services for students. 

Through the CYBHI fee schedule, our schools and affiliated providers may be eligible for the reimbursement of health services, including screening, assessments and ongoing mental and physical health supports for our students. 

The reimbursement will come directly from the insurance companies that cover the students in our District, at no higher cost to the families or caregivers. This program will not affect your insurance coverage (ex. no copays, no higher premiums or deductibles) and students can continue to receive the same mental and physical health services at and outside of school. 


CYBHI Frequently Asked Questions
Will the CYBHI fee schedule change the services my student receives?
This program is not intended to significantly change the way your student currently receives behavioral health services – rather, it is a way for our school to be reimbursed for the provision of behavioral health services. Examples of eligible services include physical health nurse visits, behavioral health screenings, assessments and ongoing mental health supports. The CYBHI fee schedule may not apply to students on certain insurance plans (e.g., self insured plans, high-deductible health plans).

How does this relate to students receiving special education services?
The CYBHI fee schedule program will not impact services provided to a student that are specified in their IEP1/IFSP2. This program may expand access for all students to receive additional behavioral health services (as appropriate) outside their IEPs/IFSPs.

Why do I need to provide health information? How will this information be used?
Our school will need to gather students’ health insurance information so that it can receive funding for eligible services under the CYBHI fee schedule. If shared with our school, this health information will be used to verify insurance coverage and eligibility with DHCS, DMHC, CDI and your existing insurance provider.

Can I choose which behavioral health services my student receives? What type of direction can I give as a family member or caregiver?
Families and caregivers will have the same process for consenting for services or allowing their student’s information to be shared. Note: minors aged 12 years or older in California may be able to independently consent for certain services.

Will families or caregivers have to pay for services provided to their student? How does the CYBHI fee schedule affect a family’s insurance?
Our school will need to gather students’ health insurance information so that it can receive funding for eligible services under the CYBHI fee schedule. If shared with our school, this health information will be used to verify insurance coverage and eligibility with DHCS, DMHC, CDI and your existing insurance provider.

Families or caregivers do not need to pay for behavioral or physical health services provided to students within the context of the CYBHI fee schedule program. The program will not introduce co-payments for services provided. The CYBHI fee schedule program is designed to complement existing insurance coverage and participation in the program will not affect a family’s insurance (ex. premiums or deductibles). Please note that some insurance plans such as high deductible health plans and Medi-Cal share of cost plans may require additional verification for program eligibility.
Resources
Department of Health Care Services - Children and Youth Behavioral Health Initiative Fee Schedule Program 

Video - School Health Services and Data Privacy - Alameda County Office of Education