MedicaidCoverageMedium impact
Provider Bulletin 12-23-2025 Medi-Cal Managed Care Health Plan Responsibilities for Non-Specialty Mental Health Services and Provider Education Requirement APL 24-012 IE LA SAC SD
Molina Healthcare·CA · Family Medicine, Internal Medicine, Pediatrics +2 more·Medicaid
Effective date
Jan 1, 2025
We identified it
Jun 19, 2026
Summary
Molina Healthcare of California has clarified their responsibilities for non-specialty mental health services (NSMHS) under Medi-Cal managed care, including required coverage for mental health evaluation, psychotherapy, psychological testing, psychiatric consultation, and substance use disorder screening. This affects billing for mental health services provided to Medi-Cal members in primary care and specialty settings.
Action Required
Immediately: Review current mental health service billing procedures for Molina Medi-Cal members to ensure compliance with NSMHS coverage requirements. Billing team should verify that mental health evaluations, psychotherapy sessions (up to 20 sessions for pregnant/postpartum members), psychological testing, and psychiatric consultations are being billed appropriately. Primary care providers should ensure mental health screenings are documented and billed when performed. Contact Molina Provider Relations at (888) 562-5442 for specific billing questions.