Medi-Cal managed care coverage of inpatient psychiatric facilities

DHCS issued this letter to clarify managed care plan requirements to cover inpatient psychiatric services.  Plans are supposed to cover medically necessary covered services when contacted by specialty mental health providers post-admission to psychiatric inpatient hospitals.  The letter lists the requirements.

Plans do not need to cover room and board charges.  However, they do need to cover medically necessary covered nursing facility services when the services are provided to those who are less than age 22 or greater than age 64.

DHCS APL 15-015 (6/12/15).