Healthy Kids - Mental Health Benefits

​Mental Health Services

Mental health services are provided by the U.S. Behavioral Health Plan, California (USBHPC). Members who access mental health services must follow the USBHPC authorization requirements. To access mental health services and find out about mental health providers, please call USBHPC at (800) 718-8430. In a psychiatric emergency, please call 911 or go to the nearest emergency room for help.
Some conditions requiring mental health treatment may be California Children’s Services (CCS) eligible conditions. Children eligible for CCS would receive these services through the CCS Program. Please see Part 13 for more information on the CCS Program.


Mental Health Services (Inpatient)

No copayment
Inpatient mental health services are authorized, arranged and provided by U.S. Behavioral Health Plan, California (USBHPC).

    • Mental health care during a certified confinement in a participating hospital when ordered and performed by a plan mental health provider for the treatment of a mental health condition.
    • Includes care provided by non-licensed qualified autism service providers (“QAS”), professionals, or paraprofessionals with whom the Plan may contract to provide behavioral health treatment (“BHT”) for pervasive developmental disorder (“PDD”) or autism
    • Unlimited benefit, including the treatment of Serious Emotional Disturbances (SED) and Severe Mental Illness (SMI). SMI conditions include:
        • Schizophrenia
        • Schizoaffective disorder
        • Panic disorder
        • Anorexia nervosa
        • Bulimia nervosa
        • Bipolar disorder (manic-depressive illness)
        • Pervasive developmental disorder or autism
        • Major depressive disorders
        • Obsessive-compulsive disorder

Mental Health Services (Outpatient)

$5 copayment per visit
Outpatient mental health services are authorized, arranged and provided by the U.S. Behavioral Health Plan, California (USBHPC).

    • Mental health care when ordered and performed by a plan mental health professional
    • This includes the treatment of children who have experienced family dysfunction or trauma, including child abuse or neglect, domestic violence, substance abuse in the family, or divorce and bereavement
    • Family members may be involved in the treatment to the extent PHC determines it is appropriate for the health and recovery of the child
    • Includes care provided by non-licensed qualified autism service providers (“QAS”), professionals, or paraprofessionals with whom the Plan may contract to provide behavioral health treatment (“BHT”) for pervasive developmental disorder (“PDD”) or autism.

Unlimited benefit, including the treatment of SMI and SED. SMI conditions include:

      • Schizophrenia
      • Schizoaffective disorder
      • Panic disorder
      • Anorexia nervosa
      • Bulimia nervosa
      • Bipolar disorder (manic-depressive illness)
      • Pervasive developmental disorder or autism
      • Major depressive disorders
      • Obsessive-compulsive disorder