The Circle Expands: Understanding Medi-Cal Coverage of Mild-to-Moderate Mental Health Conditions

Funders: Prepared with support from the California Health Care Foundation

August 2016 – Until 2014, Medi-Cal beneficiaries with mental health conditions that did not meet the criteria for specialty mental health services only had access to limited outpatient mental health services. With the expansion of Medi-Cal in 2014, medically necessary mental health services, including individual and group psychotherapy, psychological testing, psychiatric consultation, and medication management, are now available to all Medi-Cal beneficiaries, and limitations on the number of visits and the types of providers have been removed. This issue brief provides an overview of California’s public mental health system in light of the changes brought by the Affordable Care Act (ACA) and other reforms, with special attention to the implementation of expanded outpatient mental health benefits to treat mild-to-moderate mental health conditions. The brief also describes contracting relationships between the Medi-Cal managed care plans and network providers/MBHOs, explains managed care plans’ responsibilities for mental health services, and includes a map of all of the Medi-Cal managed care plans and the managed behavioral health care organizations (MBHOs) that they work with.