CalAIM for BHS Providers
California Advancing and Innovating Medi-Cal — more commonly known as CalAIM — is a far-reaching, multiyear plan to transform California’s Medi-Cal program and enable it to work more seamlessly with other social services. The goal of CalAIM is to improve outcomes for the millions of Californians covered by Medi-Cal, including those with the most complex needs.
CalAIM includes multifaceted changes to the behavioral health system of care. In San Diego, CalAIM policy and operational changes are being rolled out in stages for the behavioral health network of providers to help ensure clear and consistent communication regarding procedural changes.
To review the State’s FAQ page, visit CalAIM Behavioral Health Initiative Frequently Asked Questions.
All BHS Providers
All BHS Providers
Communication Materials
Topic |
Link |
For Staff |
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For Clients |
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For Clients (Spanish) |
CPT Coding
Topic |
Link |
Required Training |
CPT Coding for Direct Service Providers offered through CalMHSA |
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Optional trainings: CPT Coding 101 and CPT Coding 102 |
State Guidance |
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Questions? |
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Documentation Redesign
Topic |
Link |
Required Training |
Diagnosis & Problem List and Progress Notes, both offered through CalMHSA |
Provider Memo |
State Guidance |
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Questions? |
Payment Reform
Peer Support Services
Topic |
Link |
Provider Memo |
2021-10-05 BHS Peer Support Specialist Certification Program |
Provider Q&A |
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Required Training |
San Diego Certified Peer Support Specialists – TRAINING REQUIREMENTS |
Billing Codes |
San Diego Certified Peer Support Specialists – BILLING CODES |
State Guidance |
23-003 Extended Deadlines for Medi-Cal Peer Support Specialist Grandparenting and Implementation of Medi-Cal Peer Support Specialist Certification Program Curriculum |
22-018 Medi-Cal Peer Support Specialist Supervisors |
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22-062 Complaints and Investigations of Medi-Cal Peer Support Specialist Certification Programs |
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22-061 Medi-Cal Peer Support Specialist Areas of Specialization |
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22-026 DMC, DMC-ODS, and Specialty Mental Health Peer Support Services |
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Resources |
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To view Medi-Cal Peer Certification application status, log on to the application portal. Applicants with the status “In Revision” must complete additional requests for information to proceed. For any inquiries regarding certification application status, contact PeerCertification@calmhsa.org. |
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Questions? |
Required CalAIM Trainings
Programs are responsible for ensuring staff complete required trainings. Except where noted below, all BH clinical staff (including their supervisors and managers, as well as SUD Medical Directors) are required to complete the following training offered through CalMHSA.
Training |
Notes |
CalAIM Overview |
applicable to all BHS Programs including administrative and non-clinical staff |
Access to Services |
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Assessment |
except NTP |
Diagnosis & Problem List |
except NTP |
Progress Notes |
except NTP |
Care Coordination |
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Screening |
applicable to SMHS Programs only |
Administering the Adult & Youth Screening Tools |
applicable to SMHS Programs only (optional) |
Transition of Care Tool |
applicable to SMHS Programs only |
Administering the Transition of Care Tool |
applicable to SMHS Programs only (optional) |
Discharge Planning |
except NTP |
CPT Coding for Direct Service Providers |
except Peer Support Specialists |
Instructions for accessing these trainings:https://www.calmhsa.org/calaim-2/
New staff shall complete required training no later than 90 days from hire date.
Instructions for viewing training completion evidence can be found on the CalMHSA site (https://www.calmhsa.org/calaim-2/); this includes how to view the dashboard or download the data.
Questions about the trainings, login, proof of completion, etc. should be sent to: calaim@calmhsa.org
DHCS Information Notices on CalAIM
BHIN |
Subject |
Criteria for beneficiary access to SMHS, medical necessity, and other coverage requirements |
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This BHIN outlines the criteria for determining medical necessity and access to specialty mental health services for beneficiaries under the California Medicaid program (Medi-Cal). The implementation of these criteria should be effective from January 1, 2022. |
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This BHIN outlines a policy to create a seamless and coordinated system of care, where individuals seeking mental health support can easily navigate and access appropriate services. It highlights the importance of collaboration among various agencies and organizations involved in mental health care, such as healthcare providers, social service agencies, and community-based organizations. The policy emphasizes the need for a person-centered approach, ensuring that individuals receive the right level of care and support tailored to their specific needs. It also promotes the use of technology and data-sharing systems to enhance communication and coordination among service providers. The ultimate goal of the policy is to eliminate barriers and ensure that individuals facing mental health challenges can access timely and effective care through any entry point in the healthcare system, and it is effective from July 1, 2022. |
Updates to Documentation Requirements for all SMHS and DMC-ODS services |
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This BHIN updates and clarifies documentation requirements for all SMH, DMC, and DMC-ODS services. This notice builds on DHCS’ goal of streamlining and standardizing clinical documentation requirements for Specialty Mental Health Services (SMHS), DMC, and DMC-ODS delivery systems. The updated documentation requirements better align with the Centers for Medicare and Medicaid Services’ (CMS) national coding standards and physical health care documentation practices. This BHIN updates member chart documentation requirements for most SMH, DMC, and DMC-ODS services (exceptions are noted within). The updated standards are effective January 1, 2024. This documentation policy was initially developed and published in 2022 and subsequently updated based on feedback from stakeholders, including county behavioral health directors, consumer advocates, labor organizations representing county behavioral health workers, and behavioral health treatment providers. Changes in documentation requirements that directly affect SDCBHS system of care practices will be communicated to providers. |
Adult and Youth Screening and Transition of Care Tools for Medi-Cal Mental Health Services |
This BHIN provides guidance and tools for the screening and transition of care for adults and youth in MHS program. The update aims to assist healthcare providers and organizations in effectively identifying and supporting individuals with mental health needs as they transition between different levels of care. It emphasizes the importance of standardized screening tools and assessment protocols to ensure accurate identification of mental health conditions. The BHIN provides a comprehensive overview of the screening tools available for both adults and youth, including their purpose, administration procedures, and scoring guidelines. It also outlines strategies for effective transition planning and coordination between providers, ensuring continuity of care for individuals moving from one level of care to another. The tools and recommendations provided in the BHIN are intended to support the delivery of high-quality mental health services within the Medi-Cal MHS program, ultimately improving outcomes for individuals with mental health needs. The updates are effective January 1, 2023. |
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Transition of Care Tool for Medi-Cal Mental Health Services (Adult and Youth) |
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Drug Medi-Cal Organized Delivery System (DMC-ODS) Requirements for the Period of 2022 – 2026 |
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This BHIN outlines Drug Medi-Cal Organized Delivery System (DMC-ODS) program requirements pursuant to CalAIM, effective January 2022 through December 2026, including program updates. |
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Specialty Mental Health Services and Drug Medi-Cal Services Rates |
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This BHIN outlines Counties’ SMHS and DMC-ODS fee schedules effective July 1, 2023 and the State’s methodology used to calculate them. |
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Elimination of Cost Reporting Requirements for Counties and Providers |
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This BHIN is a policy statement from DHCS regarding the elimination of cost reporting requirements for counties and providers of Medi-Cal services. Effective July 1, 2022, MHPs, DMC-ODS, and DMC counties will no longer be required to submit an annual Medi-Cal cost report. This policy change eliminates the need for counties to collect and submit cost reports from subcontracted network providers for Medi-Cal reimbursement purposes. However, counties may still need to collect cost information from subcontracted network providers for various reasons, such as compliance with DHCS cost reporting policies for services rendered before BH Payment Reform implementation on July 1, 2023, or when required by state or federal law. Please note that only the Certified Public Expenditures (CPE) submission requirement is being waived by the State. |
DMC-ODS Providers
DMC-ODS Policy Improvements
Topic |
Link |
State Guidance |
24-001 Drug Medi-Cal Organized Delivery System Requirements for the Period of 2022–2026 |
Questions? |
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CPT Coding
Topic |
Link |
Provider Memo |
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SMHS Providers
Providers of Specialty Mental Health Services
Please note to also review the information for BHS All Providers
Criteria for Services
Topic |
Link |
State Guidance |
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Questions? |
No Wrong Door
Topic |
Link |
State Guidance |
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Questions? |
Standardized Screening and Transition of Care Tools
Topic |
Link |
Provider Memo |
2023-02-22 – BHS Provider Memo – Screening and Transition Tool (docx) |
Required Training |
Screening and Transition of Care Tool trainings, both offered through CalMHSA |
Optional trainings through CalMHSA: Administering the Adult & Youth Screening Tools and Administering the Transition of Care Tool |
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State Guidance |
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Transition of Care Tool for Medi-Cal Mental Health Services (Adult and Youth) |
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Questions? |
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CPT Coding
Topic |
Link |
Provider Memo |
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Documentation Redesign
Topic |
Link |
Provider Memo |
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This webpage was last updated on: 08/20/2024