Children and Youth Behavioral Health Initiative (CYBHI)

The San Diego County Office of Education (SDCOE) received approximately $28 million in School-Linked Partnership and Capacity Grant funding, supporting 86 LEAs across San Diego County in building their capacity and operational readiness needed to participate in the CYBHI Fee Schedule Program.

SDCOE’s Student Wellness and School Culture team leads local implementation as the grant administrator, providing hands-on technical assistance, implementation guidance, and ongoing support to participating LEAs.

The goal of the School-Linked Partnership and Capacity Grant is to help school districts and charter schools build sustainable infrastructure, strengthen partnerships, and develop the systems needed to successfully implement the CYBHI Fee Schedule. Ultimately, this work expands access to school-linked behavioral health services for children and youth across California.

See the Essential Program Components for detailed information on the CYBHI Fee Schedule Program and the School-Linked Partnership and Capacity Grants.

For more information, please email our team at cybhigrant@sdcoe.net.

San Diego County LEAs participating in the SDCOE CYBHI Capacity Grant selected one of two participation models:

• Direct Grant Funding Model
• SDCOE Capacity Grant Consortium Model

Participating LEAs and Primary Contacts

This list reflects the LEAs participating in the SDCOE CYBHI School-Linked Partnership and Capacity Grants with their selected participation model (Direct vs. Consortium) and primary contacts:

Please note that the deadline to participate in the SDCOE CYBHI School-Linked Partnership and Capacity Grants has passed. However, LEAs may still apply to join a cohort to participate in the CYBHI Fee Schedule Program.

If your LEA is not listed in the SDCOE CYBHI School-Linked Partnership and Capacity Grants Participation Models above, visit the How New LEAs Can Join the Fee Schedule to learn how SDCOE can support your LEA in accessing this statewide funding source—the CYBHI Fee Schedule Program.

There is no cost to students or families, and participation does not affect insurance benefits or deductibles. State law prohibits health plans and insurers from passing on the costs of these services to families. This means that the health plans and insurers will pay for mental health services provided to students in a school-linked setting, and there will not be any out-of-pocket expenses (e.g., co-payments, deductibles) for the student and family. Families only need to provide insurance information and consent for services. For more information for parents and caregivers, visit the Parent/Caregiver Information.

The program sets reimbursement rates for select behavioral health services provided to students in grades TK through 12 covered by most health insurance plans, including but not limited to Medi-Cal, commercial plans, and managed care plans. See the CYBHI Fee Schedule for service categories, procedure codes, brief service descriptions, eligible practitioners, and reimbursement rates.

How can LEAs join the Fee Schedule? Join a Cohort!

Applications to participate in a cohort are on a rolling basis (every six months). LEAs can join the CYBHI Fee Schedule Program through rolling six-month enrollment cohorts, offering ongoing opportunities to participate.

TK–12 LEAs interested in applying to the CYBHI Fee Schedule Program are encouraged to ensure key infrastructure is in place to maximize readiness for participation. Department of Health Care Services has implemented an operational readiness review process for all cohort applications. To support successful implementation, LEAs should be prepared to demonstrate capacity in the following areas:

• Service delivery infrastructure
• Data collection and documentation
• Billing infrastructure
• Medi-Cal enrollment

SDCOE is here to help you. For SDCOE to best support you through this process, please notify us of your intent to apply to the CYBHI Fee Schedule Program at cybhigrant@sdcoe.net.

How is the CYBHI Fee Schedule Program Different From Traditional Medi-Cal Billing?

The CYBHI Fee Schedule Program is not traditional Medi-Cal billing (such as Local Educational Agency Medi-Cal Billing Option Program (LEA BOP) or School-Based Medi-Cal Administrative Activities (SMAA).

Here is how the CYBHI Fee Schedule differs from traditional Medi-Cal billing:

• Reimbursement from Medi-Cal and commercial insurance plans
• The Fee Schedule is a fee-for-service model, not a cost-reimbursement model
• Different platforms that are easier to use
• Less administrative burden
• LEA receives funds immediately
• Expanded provider and practitioner types
• No time surveys
• Reimbursements are for behavioral health activities provided to all students with eligible coverage

Participating LEAs and Primary Contacts

This list reflects the LEAs participating in the CYBHI Fee Schedule Program and primary contacts:

CYBHI Fee Schedule Program Participants Who Have Received Reimbursement

The Statewide CYBHI Fee Schedule Program Participants Who Have Received Reimbursement page provides information to the public on which of the approximately 700 participating LEAs, public institutions of higher education (IHEs), and affiliated providers statewide have received reimbursement through the CYBHI Fee Schedule Program.

This list reflects the San Diego County LEAs participating in the CYBHI Fee Schedule Program, their Cohort number, EHR vendor, and primary contact:

CYBHI Fee Schedule Program Participants Who Have Received Reimbursement

The Statewide CYBHI Fee Schedule Program Participants Who Have Received Reimbursement page provides information to the public on which of the approximately 700 participating local educational agencies (LEAs), public institutions of higher education (IHEs), and affiliated providers statewide have received reimbursement through the CYBHI Fee Schedule Program.

First, review the Participating LEAs in the CYBHI Fee Schedule Program list. If your LEA is listed, please reach out to your LEA’s primary contact for additional information.

If your LEA is not currently included on the San Diego County list, the information below outlines how to get started in the CYBHI Fee Schedule Program.

Option B: SDCOE/TadHealth Partnership Opportunity

(Designed for San Diego County LEAs seeking implementation support and a turnkey billing solution.)

What is the SDCOE/TadHealth partnership opportunity?

SDCOE has vetted and contracted with TadHealth, an all-in-one electronic health record (EHR) and third-party billing vendor, to support San Diego LEAs that did not opt into the CYBHI School-Linked Partnership and Capacity Grant and are now interested in joining the CYBHI Fee Schedule Program.

TadHealth created a school-based EHR system and billing system designed specifically for K-12 settings to support LEAs in accessing this new reimbursement opportunity.

What support does SDCOE provide?

• Expert Guidance: A dedicated SDCOE team of subject matter experts to guide you through each step of the process.
• Turnkey Billing Solution: Access a vetted, all-in-one EHR and third-party billing vendor. Start-up costs covered by SDCOE!
• Hands-On Support: Receive direct support from the TadHealth team to help reduce administrative burden and support a smooth implementation experience.

Interested in learning more?

If you are interested in exploring this partnership opportunity, please contact the SDCOE CYBHI Team to schedule a consultation and discuss next steps.

What do Certified Wellness Coaches Do?

Certified Wellness Coaches (CWCs) provide non-clinical services that support youth behavioral health and well-being, such as wellness promotion and education, screening, care coordination, individual and group support, and crisis referral. The CWC model strengthens and complements existing behavioral health roles by addressing service gaps and fostering connections with a diverse workforce that youth can engage with.

In school settings, CWCs:

• Lead small groups and one-on-one check-ins
• Teach coping, resilience, and social-emotional skills
• Support students during the school day
• Partner with staff and families
• Help connect students to additional services

CWCs work alongside school staff to help students feel safe, supported, and ready to learn.

Pathways: How to Become a Certified Wellness Coach

Individuals interested in becoming a Certified Wellness Coach can follow one of two structured pathways. Each pathway outlines the required degrees, accepted academic majors, and field experience needed to obtain certification.

Learn More

Explore the following resources to learn more about Certified Wellness Coaches and other  training opportunities:

• Certified Wellness Coach (CWC) Service Manual
• Foundation for California Community Colleges Wellness Coach Designated Education Program
• California Association of Community Health Workers

Community-based organizations (CBOs) play an important role in expanding access to school-linked behavioral health services through the CYBHI Fee Schedule Program. LEAs may partner with CBOs as part of their network of designated providers to support student needs.

If you already have an existing partnership with an LEA, we encourage you to connect with them directly to explore participation in the CYBHI Fee Schedule Program.

Under DHCS guidance, community providers may participate in one of the following Provider Participation Types:

Key Considerations

• Community-based school-linked providers must be designated by an LEA as part of its “network of designated providers and practitioners” serving enrolled students of the district; therefore, in alignment with the statute, services of a designated provider are furnished at a location where the LEA “arranges for the provision” of medically necessary mental health or substance use disorder services (behavioral health services). 
• Without a formal designation by an LEA or IHE, community-based providers are not eligible for reimbursement under the CYBHI Fee Schedule program. 

Learn More

For detailed guidance, please review the DHCS CYBHI Fee Schedule Program Participation of Community Providers resource.

If you have questions, please email our team for support at cybhigrant@sdcoe.net.

What is CYBHI?

The Children and Youth Behavioral Health Initiative (CYBHI) is a statewide effort to expand access to mental health and substance use services for students in California schools.

The San Diego County Office of Education supports San Diego districts and charter schools in implementing this initiative to enhance and keep free, school-based services and supports to students.

These services are available at no cost to families and are reimbursed through your child’s existing health insurance (such as Medi-Cal or private insurance).

California law now requires health plans and insurers to reimburse public schools for covered (or eligible) mental health services provided to students under age 26.

There are no out-of-pocket costs (such as co-pays or deductibles), and this does not impact your insurance plans (or benefits).

How Can You Help?

To obtain this funding from the health plans and insurers, your child’s school district must submit a claim for reimbursement to your health plan or insurer. To support this process, your child’s school may ask you to:

• Provide your child’s health insurance information for verification purposes only
• Sign consent forms allowing the school to bill your health plan

All information you share is strictly confidential. Refer to your district or school for the process for how the information is being collected. Health and personal information are securely stored and only used in accordance with federal and state privacy laws (FERPA and HIPAA).

What If I Choose Not to Share Insurance Information?

That decision is entirely up to you. If you choose not to provide insurance information:

• Your child’s school may have less funding available to support these services
• Your child will still have access to services — their right to receive care will not be affected

If your child receives special education services through an Individualized Education Program (IEP), they will continue to receive all required services regardless of your decision.

Please contact DHCS.SBS@dhcs.ca.gov to request translated materials in any of the following languages: Arabic, Armenian, Farsi, Hmong, Khmer, Korean, Punjabi, Russian, Simplified Chinese, Tagalog, Traditional Chinese, and Vietnamese.

Q: How is the CYBHI Fee Schedule Program different from traditional Medi-Cal billing?

The CYBHI Fee Schedule is not traditional Medi-Cal billing. Key differences include:

• Reimbursement applies to services for students with Medi-Cal and commercial insurance plans
• The Fee Schedule is a fee-for-service model, not a cost-reimbursement model
• Uses more user-friendly platforms for submitting claims
• Less administrative burden
• LEA receives funds more quickly
• Expanded provider and practitioner types are eligible to bill
• No time surveys
• Reimbursements support behavioral health activities provided to all students with eligible coverage

Q: How can the claims reimbursement funds be used?

Reimbursement funds received through the CYBHI Fee Schedule are not restricted to a specific line-item use. LEAs can reinvest these funds to expand and sustain behavioral health services, such as:

• Hiring or contracting with behavioral health staff
• Expanding student mental health supports and interventions, including screenings, assessments, case management, and preventive services
• Strengthening program sustainability by creating flexible, ongoing funding that reduces reliance on one-time grants and supports program growth over time
• Investing in training and professional development for staff
• Enhancing infrastructure needed to deliver and support services

Q: Who is eligible for reimbursement under the CYBHI Fee Schedule?

A broader range of qualified providers and practitioners can be reimbursed under the CYBHI Fee Schedule Program compared to traditional Medi-Cal billing. This may include:

• Pupil personnel services (PPS) credentialed staff (or school-based behavioral health providers): school psychologists, school social workers, and school counselors.
• Licensed behavioral health practitioners (or clinical staff): psychologists, LCSWs, LMFTs, and LPCCs.
• Certified Wellness Coaches (CWCs): Non-licensed professionals who provide preventive and early intervention support.
• Associates and rrainees: clinical associates registered with the Board of Behavioral Sciences (e.g., ASWs, AMFTs) may also provide and bill for services under required clinical supervision.
• Other eligible practitioners as defined by the program

LEAs should confirm that staff meet the program’s credentialing and supervision requirements.

Q: What's the difference between the CYBHI Capacity Grant and the CYBHI Fee Schedule?

The CYBHI Capacity Grant and Fee Schedule serve complementary but distinct purposes:

• CYBHI Capacity Grant:
  Provides upfront, one-time funding to help LEAs build infrastructure, technology, and capacity, such as hiring staff, developing systems, or preparing to bill. Grant funding is now closed.
   
• CYBHI Fee Schedule:
  A statewide reimbursement model that provides ongoing funding to schools and school-linked providers for delivering eligible behavioral health services to students with qualifying coverage. Continuous enrollment for LEAs.

These publications and testimonials highlight partner experiences, program implementation, and the growing impact of the CYBHI Fee Schedule Program and Capacity Grant across San Diego County.

For reference, the following glossary is included in the Children and Youth Behavioral Health Initiative (CYBHI) Fee Schedule Program Guidance for Local Educational Agencies (LEAs) and Institutions of Higher Education (IHEs).

Key Terms

Affiliated Provider

Including but not limited to community-based providers, clinics, or individual licensed behavioral health practitioners that are contracted to provide medically necessary services on behalf of the LEA or IHE.

Authorized Representatives

Individuals legally responsible for a student (e.g., parent, caregiver, legal advocate) or someone formally (i.e., legally) designated by a student, age 18 or older, to act on their behalf.

Covered Services

Outpatient mental health and substance use disorder (SUD) services specified in DHCS’ published CYBHI Fee Schedule, when furnished to students 25 years of age or younger at a school site, in accordance with state law. See Welfare and Institutions Code section 5961.4; Health and Safety Code section 1374.722; and Insurance Code section 10144.53

Clean Claim

A claim or bill for covered services that has no defect, impropriety, or lack of substantiating documentation. The claim includes the information necessary to meet the requirements for encounter data (clinical information and data with content and in a format that comports with the HIPAA 837 requirements), and uses a completed CMS1500 form or respective successor forms or alternative electronic equivalents (which electronic equivalents must comport with all HIPAA Administrative Simplification Act requirements for electronic transactions), that is received timely from an eligible Provider, and complies with standard industry coding guidelines, and/or other government program requirements where applicable. The claim requires no further documentation, information, or alteration in order to be processed and paid timely. Claims or bills from a participating Provider who is under investigation for fraud or abuse are not Clean Claims.

CYBHI Fee Schedule Program

The statewide, multi-payer, school-linked fee schedule program established by DHCS, pursuant to the Welfare and Institutions Code section 5961.4, Health and Safety Code section 1374.722, and Insurance Code section 10144.53.

Embedded Provider

This includes, but is not limited to, community-based providers, clinics, counties, or individually licensed behavioral health practitioners to which the LEA or IHE refers students for services but does not have a formal agreement or financial relationship.

FERPA

The Family Educational Rights and Privacy Act (FERPA) codified at 20 U.S.C. § 1232g, and the FERPA regulations codified at 34 CFR Part 99.

HIPAA

The Health Insurance Portability and Accountability Act of 1996 (Pub. L. 104- 191), including without limitation its privacy, security and administrative simplification provisions, and the rules and regulations promulgated thereunder, each as may be amended from time to time.

Insurer

A commercial disability insurer that covers hospital, medical, or surgical benefits as defined in Insurance Code section 106(b).

Managed Care Plan or MCP

A health care service plan, as defined in Health and Safety Code section 1345(f). MCP includes both Medi-Cal and commercial lines of business. MCPs must be licensed by the Department of Managed Health Care, as applicable.

Member

An individual who is enrolled and receives health insurance coverage from an MCP or Insurer and who meets all of the eligibility requirements for membership in the MCP or Insurer based on the registration file received by CBH from a Provider. For the CYBHI Fee Schedule program, the term “member” may be interchangeable with the term “student” or “pupil” throughout this website.

Non-Covered Services

Those services specified by the MCP or Insurer or DHCS as not covered benefits under the CYBHI fee schedule. A non-covered service may include services that were provided to a student not covered by the MCP or Insurer, were never performed, or were not provided by a health care provider appropriately licensed or authorized to provide the services.

Protected Health Information (“PHI”)

Shall have the meaning as defined in 45 C.F.R §160.103 and/or applicable state law, but shall also include “Patient Identifying Information” (“PII”) as defined in 42 C.F.R. Part 2, Subpart B, §2.11.

Provider or CYBHI Provider

A local educational agency (LEA), county office of education (COE), institution of higher education (IHE), or participating provider or practitioner in the DHCS CYBHI school-linked behavioral health provider network. Only participating providers or practitioners, COEs, LEAs, IHEs and designated providers and practitioners appropriately identified as part of this DHCS network will be eligible for reimbursement under the CYBHI Fee Schedule.

“School site”

Has the meaning described in paragraph (6) of subdivision (b) of Section 1374.722 of the California Health and Safety Code and Section 10144.53(b)(6) of the Insurance Code.

State Regulators

Means the California Department of Managed Health Care (DMHC), California Department of Health Care Services (DHCS), and California Department of Insurance (CDI). 

Common Acronyms

CBO: Community-Based Organization

CYBHI: Children and Youth Behavioral Health Initiative

DHCS: Department of Health Care Services

DUA: Data Use Agreement

EHR: Electronic Health Record

LEA: Local Educational Agency

LEA BOP: Local Educational Agency Medi-Cal Billing Option Program

NPI:  National Provider Identifier

ORP:  Ordering, Rendering, Prescribing Provider

PFA:  Priority Funding Activities included in your LEA Implementation Plan

PPA: Provider Participant Agreement

PFA: Priority Funding Activities included in your LEA Implementation Plan

SCCOE: Santa Clara County Office of Education

SCOE: Sacramento County Office of Education

SBHIP: Student Behavioral Health Initiative Program

SMAA: School-Based Medi-Cal Administrative Activities

TPA: Third Party Administrator

Additional Resources

Visit the CYBHI Fee Schedule Resource Library to access guidance and tools to support implementation, including:

• Provider resources for LEAs and community-based partners
• Onboarding and training modules
• Parent and caregiver engagement materials
• Program policies and guidance documents