26-586 Updated Youth Trauma Screening Requirements

Date: 05/12/26

Changes to approved screening tools and Medi‑Cal reimbursement began April 1, 2026

Effective April 1, 2026, changes to youth trauma screening requirements may affect physicians, practitioners and other providers who screen Medi-Cal members under age 21 for:

• Specialty Mental Health Services (SMHS) access, or
• Adverse Childhood Experiences (ACEs).

Only specific, approved screening tools may be used when trauma screening is required for SMHS access, and only certain tools qualify for Medi‑Cal reimbursement when billing for ACEs screening services.

Please review current screening practices, workflows and documentation to ensure compliance.

What changed on April 1, 2026

As of April 1, 2026:

• Only Department of Health Care Services (DHCS)‑approved youth trauma screening tools may be used when trauma screening is required to assess SMHS access.
• Only the ACEs questionnaire or Pediatric ACEs and Related Life-events Screener (PEARLS) qualify for Medi‑Cal reimbursement under the ACEs screening services benefit.
• Use of a non‑approved or non‑reimbursable tool may affect service access decisions or payments.

What you need to do

To align with these changes, take the following steps:

1. Review all trauma screening tools currently used with Medi‑Cal members under age 21. 
2. Ensure staff use only DHCS‑approved tools when trauma screening is required for SMHS access.
3. Use only the ACEs questionnaire or PEARLS when billing for ACEs screening services.
4. Update workflows, training materials and internal guidance to reflect the new requirements.
5. Ensure documentation clearly identifies:

• The screening tool used, and
• The purpose of the screening (SMHS access vs ACEs screening).

Approved screening tools for SMHS access

When trauma screening is required to evaluate eligibility for SMHS, use the following tools:

• ACEs questionnaire 
• PEARLS 
  • Parent/caregiver report and youth self‑report versions 
• Child and Adolescent Needs and Strengths (CANS) – Trauma Module 
• California Integrated Practice – CANS (IP‑CANS / CA IP‑CANS) 
• Child and Adolescent Trauma Screen (CATS) 
• Child PTSD Symptom Scale – 6‑item Screening Version (CPSS‑5‑Screen) 
• Child Trauma Screening (CTS) 
• Life Events Checklist for DSM‑5 (LEC‑5) 
• UCLA Child/Adolescent PTSD Reaction Index for DSM‑5 – Brief Form (UCLA PTSD RI‑5 BF)

Clinical note: Each tool’s standard scoring method must be used to determine whether a youth scores in a high‑risk range. Clinical judgment may guide next steps when trauma is identified. 

Tools eligible for Medi-Cal ACEs screening reimbursement

Although several tools are approved for SMHS access, only the tools listed below qualify for Medi‑Cal reimbursement under the ACEs screening services benefit. 

• ACEs questionnaire 
• PEARLS

All other approved youth trauma screening tools do not qualify for the Medi-Cal ACEs screening reimbursement, even when used appropriately for clinical or access purposes.

Resources

These updates reflect guidance from the DHCS. You may review the full guidance at the following links:

• APL 26-002, Medi-Cal Managed Care Plan Responsibilities for Non-Specialty Mental Health Services (PDF)
• Attachment A (PDF)

Relevant sections of the provider operations manuals have been revised to reflect the information contained in this update as applicable. Provider operations manuals are available electronically in the Provider Library on the provider portal.

If you have questions regarding the information contained in this update, contact Community Health Plan of Imperial Valley at 833-236-4141. Behavioral Health providers can call 844-966-0298.

 

This information applies to BehavioralHealth Providers.

This information applies to Medi-Cal in Imperial County.