What CenCal Health covers:
CenCal Health covers all mild to moderate outpatient mental health services. Outpatient services are things that do not require an overnight stay.
CenCal Health also covers behavioral health treatment (BHT), also known as applied behavior analysis (ABA).
What County Behavioral Health covers:
County Behavioral Health covers all severe conditions (also known as “Specialty Mental Health Services”) as well as “Substance Use Disorder” benefits.
If you are experiencing thoughts of hurting yourself or someone else:
- Call the Access Line – SB County (888) 868-1649 or SLO County (800) 838-1381
- Call 911
- Call the National Suicide Prevention Lifeline at 988
Click on the accordions below to learn more about covered services at CenCal Health and County Behavioral Health.
Outpatient mental health services (Provided by CenCal Health)
- Individual, family or group therapy provided by a Licensed Clinical Social Worker, Licensed Marriage and Family Therapist, Licensed Professional Clinical Counselor or Licensed Psychologist. Treatment sessions will usually be 1x/week or bi-weekly or monthly, depending on the recommendation of the treatment provider. Services are available either in-office or via telehealth. For these services you do not need a referral from your PCP.
- Psychiatric medication management services provided by a Psychiatrist or Psychiatric Nurse Practitioner or Physician’s Assistant. Treatment services initially may be weekly or bi-weekly but usually are every 3 -6 months and are available either in-office or via telehealth. For these services you do not need a referral from your PCP.
- Psychological testing with a Clinical Psychologist to diagnose certain conditions and make treatment recommendations. An example will be if you are concerned that your child may have Autism Spectrum Disorder. These services require a referral from your PCP or existing mental health provider.
- Neurological Testing with a Neuropsychologist to assess for certain medical or cognitive conditions i.e. Alzheimer’s, Traumatic Brain Injury. These services require a referral from your PCP or mental health provider.
The mental health services covered by CenCal Health is available for treatment purposes only. Medi-Cal does not cover evaluation services focused on educational needs or custody disputes.
To access psychotherapy or medication management services, please call our Member Services at 1-877-814-1861 or review our mental health provider list to find a provider and contact them to set-up an initial appointment.
Specialty Mental Health Services (Provided by County Behavioral Health)
Specialty mental health services
Some mental health services are provided by county mental health plans instead of CenCal Health. These include specialty mental health services (SMHS) for Medi-Cal members who meet medical necessity rules. SMHS may include these outpatient, residential, and inpatient services:
- Mental health services (assessments, plan development, therapy, rehabilitation and collateral)
- Medication support services
- Day treatment intensive services
- Day rehabilitation services
- Crisis intervention services
- Crisis stabilization services
- Targeted case management services
- Therapeutic behavioral services (covered for members under 21 years old)
- Intensive care coordination (ICC) (covered for members under 21 years old)
- Intensive home-based services (IHBS) (covered for members under 21 years old)
- Therapeutic foster care (TFC) (covered for members under 21 years old
- Adult residential treatment services
- Crisis residential treatment services
- Acute psychiatric inpatient hospital services
- Psychiatric inpatient hospital professional services
- Psychiatric health facility services
To contact County Mental Health services:
Santa Barbara County: 1-888-868-1649
San Luis Obispo County: 1-800-838-1381
How To Get Behavioral Health Treatment/ABA Services?
Members may be eligible if the following criteria is met:
- Under 21 years of age
- Have a recommendation from a licensed physician, surgeon or psychologist
- Are medically stable
- Do not need for 24-hour medical/nursing monitoring or procedures provided in a hospital or intermediate care facility
- Increase language
- Improve attention, focus, social skills and cooperative behaviors
- Decrease problem behaviors
Behavioral Health Treatment services teach skills using behavioral observation and reinforcement, or through prompting to teach each step of targeted behavior. BHT services are based on reliable evidence. Treatment may or may not include Applied Behavioral Analysis (ABA).
ABA treatment can help:
ABA services must be recommended by a Physician, Psychologist or Surgeon.
Please contact your child’s pediatrician or other treatment providers to request a referral for ABA services.
To learn more about ABA services, please call Member Services at (877) 814-1861.
Substance Use Disorder Services (Provided by County Alcohol and Drug Services)
CenCal Health members who are concerned about alcohol and substance use problems can talk with their primary care provider (PCP). Their PCP can provide education and referrals, and may help manage withdrawal symptoms for certain substances. County Alcohol and Drug Services provides an many alcohol and substance use services to CenCal Health members, including:
- Outpatient and Intensive Outpatient Treatment Services
- Residential Treatment Services
- Medication Assisted Treatment (MAT) for management of Opioid Dependence
For Alcohol and Drug services in Santa Barbara call, 1-888-868-1649. For drug and alcohol services in San Luis Obispo County call 1-800-838-1381. For more information for alcohol and drug services provided by County Behavioral Health, click on the links below.