California Mental Health Medical Necessity

State of California Health and Human …

https://www.dhcs.ca.gov/Documents/BHIN-21-073-Criteria-for-Beneficiary-to-Specialty-MHS-Medical-Necessity-and-Other-Coverage-Req.pdf

Medi-Cal Specialty Mental Health Services - California

https://www.dhcs.ca.gov/services/Pages/Medi-cal_SMHS.aspx

The Medi-Cal Specialty Mental Health Services (SMHS) program operates under the authority of a Section 1915 (b) waiver approved by the Centers for Medicare & Medicaid …

Medical Necessity Defined in California Insurance Law for the …

https://www.lawcommentary.com/articles/medical-necessity-defined-in-california-insurance-law-for-the-first-time

That state of affairs changed on September 25, 2020, when California Governor Gavin Newsom signed a bill into law regarding insurance coverage for mental …

New California Law Makes It Easier to Get Care for …

https://californiahealthline.org/news/article/new-california-law-makes-it-easier-to-get-care-for-mental-health-and-substance-abuse/

Proponents say the medical necessity guidelines spelled out by the specialists’ associations allow providers wide discretion to decide the best treatment for each patient. ... Mental Health Mental Health in …

California Code Of Regulations

https://www.dhcs.ca.gov/formsandpubs/MHArchiveLtrs/MH-Ltr01-01_enclosure1.pdf

(a) For beneficiaries under 21 years of age who do not meet the medical necessity requirements of Section 1830.205(b)(2) and (3), medical necessity criteria for specialty …

California Medical Necessity for Mental Care

https://www.uhone.com/about-us/legal/california-medical-necessity-review-mental-health

California Medical Necessity Review Process – Mental Health. Licensed nurses perform the initial clinical review for pre-service, concurrent and/or post service/retrospective …

CalAIM Behavioral Health Proposals - California Health …

https://www.chcf.org/publication/cal-aim-behavioral-health-proposals/

Under California’s Specialty Mental Health 1915(b) waiver, counties are reimbursed a percentage of their actual expenditures (certified public expenditures, or CPE) based on the Federal Medical Assistance …

California’s Medicaid Family Therapy Benefit Reimagines …

https://www.clasp.org/blog/californias-medicaid-family-therapy-benefit-reimagines-medical-necessity/

The definition of medical necessity in California for non-specialty mental health services for those under 21 aligns closely with the types of life events and …

California Code Of Regulations

https://www.dhcs.ca.gov/formsandpubs/MHArchives/InfoNotice01-attachment.pdf

Chapter 11. Medi-Cal Specialty Mental Health Services 1820.205. Medical Necessity Criteria for Reimbursement of Psychiatric Inpatient Hospital Services. (a) For Medi-Cal …

State Definitions of Medical Necessity under the Medicaid EPSDT …

https://nashp.org/state-definitions-of-medical-necessity-under-the-medicaid-epsdt-benefit/

California Welfare and Institutions Code, ... “medically necessary” and “medical necessity” mean those health services required to prevent, identify, diagnose, ... disease, physical …