SPA 23-0027 Approved: Updates to the CYBHI Fee Schedule Program
We are pleased to share that California's State Plan Amendment (SPA) 23-0027 has been approved by the Centers for Medicare & Medicaid Services (CMS) as of December 19, 2024, with an effective date of January 1, 2024.
This approval marks a significant update to the Child and Youth Behavioral Health Initiative (CYBHI) Fee Schedule, expanding coverage for behavioral health services and providing further flexibility to providers under this initiative. Below are the key changes included in the SPA:
Key Updates in SPA 23-0027
1 - Expanded Eligibility for Behavioral Health Providers: SPA 23-0027 expands the pool of eligible professionals who can provide services under the CYBHI Fee Schedule, including:
School Psychologists
School Social Workers
School Counselors
These professionals are now able to provide services in school-linked settings and are eligible for reimbursement through the CYBHI Fee Schedule.
2 - Credentialing and Provider Requirements: The expanded provider types must hold a valid Pupil Personnel Services (PPS) credential issued by the Commission on Teacher Credentialing (CTC). This ensures that only credentialed professionals are reimbursed for their services under the CYBHI Fee Schedule.
Additionally, these providers must be working within the scope of their credentialing to be eligible for reimbursement.
3 - Service Delivery Locations: The new SPA allows services to be provided in school-linked settings, including mobile units, off-campus clinics, and other settings not necessarily part of a district’s main operations but still serving children and youth with mental health needs.
4 - Impact on Documentation Requirements: The SPA explicitly states that documentation requirements for providers, including documentation of student encounters and service authorizations, will remain consistent with existing procedures under the CYBHI Fee Schedule. There is no change in the process for documenting services delivered.
The passage of SPA 23-0027 represents a significant development for the CYBHI Fee Schedule program, ensuring that a broader range of credentialed behavioral health providers can serve children and youth in school-linked settings. The approval of this SPA helps ensure that vital mental health services remain accessible to students and families, particularly those who may have previously faced barriers to care.
We will continue to keep you informed of any additional updates regarding the CYBHI Fee Schedule and other related programs. As always, if you need assistance navigating these changes or optimizing your billing processes, our team is here to support you. Learn more about how we can help streamline your operations and maximize your reimbursement opportunities by visiting our CYBHI Fee Schedule Support Services page.
