Dyadic Services
Provider Type
- Physicians
- Participating Physician Groups (PPG)
- Hospitals
- Ancillary
Dyadic Services denote a family and caregiver-focused Model of Care intended to address developmental and Behavioral Health conditions of Children as soon as they are identified. Dyadic services include dyadic behavioral health (DBH) well-child visits, dyadic comprehensive community support services, dyadic psychoeducational services, and dyadic family training and counseling for child development. The DBH well-child visit is provided for both child (members under age 21) and parent(s)/caregiver(s) together, preferably within the pediatric primary care setting the same day as the medical well-child visit. Dyadic services screen for behavioral health problems, interpersonal safety, tobacco and substance misuse and social drivers of health (SDOH), such as food insecurity and housing instability, and include referrals for appropriate follow-up care.
Facilities or clinics that offer integrated physical health and behavioral health services, such as Community Health Centers and Federally Qualified Health Centers (FQHCs), are able to conduct the medical well-child visit, the DBH well-child visit and some or all of the ongoing dyadic services. Physicians who do not offer integrated behavioral health services are able to initiate dyadic services by conducting the medical well-child visit and making referrals to behavioral health providers for the DBH well-child visit and ongoing dyadic services.
ELIGIBILITY REQUIREMENTS
Members under age 21 and their parent(s)/caregiver(s) are eligible for DBH well-child visits when:
- Delivered according to the Bright Futures/American Academy of Pediatrics periodicity schedule for behavioral/social/emotional screening assessment.
- Medically necessary, in accordance with Medi-Cal's Early and Periodic Screening, Diagnostic and Treatment (EPSDT) standards.
- The child must be enrolled in Medi-Cal. The parent(s) or caregiver(s) does/do not need to be enrolled in Medi-Cal or have other coverage so long as the care is for the direct benefit of the child.
REFERRAL TO BEHAVIORAL HEALTH SERVICES
Primary care physicians (PCPs) or sites that do not offer behavioral health services can initiate dyadic services by conducting the medical well-child visit and referring members to Health Net to connect with a dyadic services provider who will conduct the DBH well-child visit and determine needs for ongoing dyadic services.
CLAIMS SUBMISSION
Provider sites with integrated physical health and behavioral health services, such as Community Health Centers, FQHCs, and some primary care sites, will be able to administer the medical well-child visit, the DBH well-child visit and some or all of the additional dyadic services (depending on scope of practice). In such cases, integrated provider sites will bill the Plan for the medical well-child visit and dyadic service(s).