DHCS APL 26-002: Medi-Cal Managed Care Plan Responsibilities for Non-Specialty Mental Health Services


Date: April 15, 2026
From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”)
To: Health Plan Practitioners and Providers
Type: Regulatory
Subject: DHCS APL 26-002: Medi-Cal Managed Care Plan Responsibilities for Non-Specialty Mental Health Services
Business: Medi-Cal Managed Care

The Department of Health Care Services (DHCS) issued All Plan Letter (APL) 26- 002 on February 2, 2026, regarding Medi-Cal managed care plan (MCP) responsibilities for the provision or arrangement of clinically appropriate and covered Non-Specialty Mental Health Services (NSMHS) and the regulatory requirements for the Medicaid Mental Health Parity Final Rule (CMS-2333-F). This APL outlines MCP responsibilities for referring and coordinating with County Mental Health Plans (MHPs) for the delivery of Specialty Mental Health Services (SMHS), including providing a list of Department of Health Care Services (DHCS)- approved youth trauma screening tools for the purposes of determining access
criteria for the SMHS delivery system. This APL supersedes APL 22-006.

The primary goals include:
• MCPs

  • Provide or arrange clinically appropriate NSMHS under Medicaid
    Mental Health Parity rules
  •  Refer and coordinate members needing SMHS with County MHPs
  •  Administer DHCS-approved trauma screening tools for youth to
  • determine SMHS eligibility
  • Ensure Early and Periodic Screening, Diagnostic and Treatment (EPSDT) compliance for members under 21: services must correct or ameliorate health issues even if services are not covered in the state’s Medicaid State Plan

• Network Providers, Subcontractors, or Downstream Subcontractors

  •  Deliver or arrange NSMHS consistent with MCP guidance and Parity
    requirements
  •  Use the DHCS-approved youth trauma screening tools during
    behavioral health evaluations
  •  Recognize when to refer youth meeting screening criteria to county
    SMHS via MCP

To learn more about Medi-Cal Managed Care Plan Responsibilities for Non-Specialty Mental Health Services, or for the full text of DHCS APL 26-002, please visit https://www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL%202026/APL26-002.pdf.


If you have any further questions, please contact your Provider Services Representative, or call our Customer Service Department at 1-888-936-PLAN (7526). You may also visit https://www.hpsj.com/alerts/ for online access to the documents shared. The most recent information about Health Plan and our services is always available on our website www.hpsj-mvhp.org

Virtual Look and Learn

Posted on April 17th, 2026

top
X