23-1403 Medi-Cal for Kids & Teens Training Due February 15, 2024
Date: 12/06/23
New DHCS training requirement for EPSDT starts 2024 and continues annually
The Department of Health Care Services (DHCS) updated Requirements for Coverage of Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services for Medi-Cal Members Under the Age of 21 in APL 23-005, dated March 16, 20231. As part of the new requirements, DHCS developed a standardized EPSDT-specific training program titled Medi-Cal for Kids & Teens.
The goal is to help plan-enrolled providers and other physicians strengthen their understanding of EPSDT and increase access to health services for all children enrolled in Medi-Cal under age 21.
The training is required and must be completed by February 15 of each year.
Register online
DHCS’ Medi-Cal for Kids & Teens training is a pre-recorded webinar. You can access it on-demand when it best fits your schedule and it lasts about 1.05 hours.
To register for the webinar:
1. Go to the Registration link and enter your email address.
2. Click on ‘Check Registration.’
3. An expanded screen appears. Enter your name, job title, Taxpayer Identification Number(s) (TIN) and answer other related questions.
4. After completing all required fields, click on ‘Register and View Presentation’.
Attestation
You need to complete and submit a brief attestation confirming that you viewed the training and understood the content.
Course outline
There are two modules. The course outline is highlighted below.
- Module 1: What is Medi-Cal for Kids & Teens and How Does it Work?
What is Medi-Cal for Kids & Teens? Medically necessary services are available at no cost for most children and youth under age 21.
What screening, diagnostic services and treatment services are covered under Medi-Cal for Kids & Teens? Review reimbursable screening services and a subset of required screenings and services, including screening tools and billing codes.
What the definition of “medical necessity” means for children enrolled in Medi-Cal. Medical necessity is broader for children and youth in Medi-Cal compared to adults – it includes services that correct or improve conditions, defects, and physical and mental illnesses.
What limitations can be placed on Medi-Cal for Kids & Teens services. Review examples of additional screenings that may be done any time when necessary to assess diagnoses between regularly scheduled screenings. These are called ‘interperiodic screenings.’
How you can help support access to required services for your patients. Providers must offer and assist with arranging non-emergency and non-medical transportation, language assistance and appointment scheduling assistance.
Your role in informing children and families about Medi-Cal for Kids & Teens covered services.
- Module 2: Deep Dive into Behavioral Health Services, California Children's Services Program and Skilled Nursing Services.
What are Medi-Cal for Kids & Teens covered mental health services and substance use disorder (SUD) services.
How non-specialty mental health and specialty mental health differ from each other in Medi-Cal. Review the two different systems leveraged by the state to deliver mental health services – Non-Specialty Mental Health Services (NSMHS) which are carved in to Medi-Cal managed care and Specialty Mental Health Services (SMHS) which is carved out of Medical Managed care.
Which children are eligible for California Children’s Services (CCS) or CCS Whole Child Model (WCM) and why. Describes criteria that must be met for SMHS services to be provided to children and youth.
How children can qualify for Medi-Cal for Kids & Teens covered skilled nursing services. Children and youth with serious physical conditions may be eligible for private duty nursing or pediatric day health care.
Additional information
If you have questions regarding the information contained in this update, contact the California Health & Wellness Plan at 877-658-0305.
1 Access the complete APL 23-005 at www.dhcs.ca.gov/formsandpubs/Documents/ MMCDAPLsandPolicyLetters/APL2023/APL23-005.pdf.
This information applies to Physicians and Independent Practice Associations (IPAs).