If you’re part of a CYBHI cohort, big changes are underway. You’re making the operational shift from being a school-based mental health team to providing services and billing more like a true behavioral health organization. Your connection to students should stay the same, but to prepare for billing, you’ll need to meet CYBHI Fee Schedule requirements and make a few key decisions.
For those in early cohorts, the first CYBHI reimbursements might already be trickling in. But regardless of what cohort you’re in, there’s still time to plan and get ready for a smooth process! Here’s what you’ll need to know:
Becoming a Medicaid provider
Cohort deadlines to watch
What goes into establishing readiness
Onboarding with Carelon
How the CYBHI Fee Schedule works
How a AxiomEHR for billing management makes the process easier
And Just Like That, You’re a Provider
School counselors, psychologists, and social workers are used to doing relationship-driven work with the students in their care. But very soon, your team will need to start billing for the work you do. That means getting more consistent about how you document your work, tracking each encounter in a way that clearly connects to student services and supports billing down the line.
It might feel like you’re switching between your superhero cape and Clark Kent glasses when you used to be able to just fly. But how much you feel the shift depends on how you manage the effort. You have options.
Once you get into the swing of things, this new way of working should have several upsides:
- The work you do will be fully quantifiable and make it easier to demonstrate the value (and necessity) of your programs
- You’ll be less dependent on one-time grants and local funding sources
- Revenue will flow back into your program, giving you more independence to hire, train, and expand your programs as you see fit
The Deadlines
We’ve included key deadlines for cohorts 3 through 6 below. It’s important to understand the steps necessary to establish readiness for reimbursement, and what happens between claim submission and actually receiving reimbursement payments.
According to DHCS, schools are reimbursed only after completing the following:
- A countersigned Standard Provider Participation Agreement (PPA) and Business Associate Addendum (BAA) from DHCS,
- A countersigned Data Use Agreement (DUA) from the program’s third-party administrator, and
- Meeting all other program requirements.
The third-party administrator (TPA) for CYBHI is Carelon Behavioral Health.
- Cohort 3: Readiness Application due September 27, 2024 / Billing began January 1, 2025
- Cohort 4: Readiness Application due January 31, 2025 / Billing began July 1, 2025
- Cohort 5: Readiness Application due July 31, 2025 / Billing begins July 1, 2026
- Cohort 6: Readiness Application due January 16, 2026 / Billing begins July 2026
Establishing Readiness
In the readiness application for your specific cohort, you’ll indicate whether you’re “Ready,” “In Progress,” or “Not Started” for each standard listed. Although you may be in a less-than-ready state at the time of application, it’s important to keep things moving forward so that you don’t fall behind once billing is open.
Before You Can Bill
Because the CYBHI Fee Schedule is essentially a reimbursement mechanism under Medi-Cal (among other payors) for the services you provide:
- Your LEA will need to register as a Medi-Cal provider organization.
- Individual practitioners, and any contractors you work with, will need to be actively enrolled in Medi-Cal and have a valid NPI (National Provider Identifier) to bill under CYBHI.
Here are some of the items you will need to have ready before you can bill for the first time:
- Program/Site National Provider Identifier (NPI) Instructions for getting your program/site NPI here
- Tax ID
Use the school’s Employer Identification Number (EIN) issued by the IRS. If the school doesn’t have one, apply via the IRS website - Place of service (POS)
Identify the POS code for where services are delivered (Ex. 03 = School). Verify with DHCS/CYBHI documentation that the selected POS is accepted for Fee Schedule claims - Billing type
Determine which service categories you will be billing in the fee-for-service (FFS) model. This information will be configured in your EHR or billing platform when you create your provider profile and claim templates
Here is the full list of the (2025) CYBHI Fee Schedule Program Scope of Services, Codes, and Reimbursement Rates.
Onboarding with Carelon (TPA)
Carelon’s onboarding process for CYBHI Fee Schedule providers starts once DHCS approves your application to participate in CYBHI.
Next, Carelon’s Provider Relations team will reach out, sharing onboarding guides, and collecting the required information and agreements that are needed, including the Data Use Agreement.
Note: Early in the process, you will set up an account with Availity, Carelon’s preferred clearinghouse, to handle billing routing to the payor, then pass those credentials on to your EHR.
As a provider, you’ll complete several setup steps, including:
- Submitting provider rosters and student registration files via secure transfer
- Receiving training on systems and billing workflows
- Gaining access to claims submission portals
Once onboarding is complete, Carelon provides ongoing support, training, and resources to help you stay compliant and successfully bill for CYBHI services.
To learn more, you can look at the two-party data use agreement form here and the tri-party agreement form here.
How the CYBHI Fee Schedule Works
The first step of billing for services using the CYBHI Fee Schedule is to provide both provider and student rosters. Once those are accepted, you’ll be active within the CYBHI system. All details about who will provide and receive services will be locked in and ready to go.
After that, the process gets a little more buttoned-up.
With AxiomEHR, an EHR with built-in CYBHI Fee Schedule logic, you’ll use just one system for documentation and billing. CYBHI is new, but AxiomEHR’s implementation process has been proven over many years.
This is what the process looks like:
Step 1: Gather your NPI and Provider IDs
Step 2: Register with Availity
Step 3: Tell us your service categories and professional licenses so we can personalize your fee schedule.
Step 4: Establish your Secure File Transfer Protocol (SFTP) for roster uploads.
Step 5: Students’ insurance information is imported to AxiomEHR.
Step 6: From that data, you can create charts for all students on the roster with their insurance/Payor IDs (with Carelon payor ID acting as the primary payor in all cases).
Step 7: A CYBHI profile is created for each student, and Medi-Cal eligibility is set-up.
(A Medi-Cal eligibility check can happen after that.)
Step 8: Export any non-Carelon insurance/payor information.
Step 9: Carelon will assign a Member/Payor ID within 2-3 days.
Step 10: Now you’re ready to create encounters and submit claims with minimal lift.
AxiomEHR for CYHBI Fee Schedule Management
Capability Statement | With AxiomEHR for Schools |
|---|---|
Automatically checks for cohort rules (e.g., frequency limits, duration limits) | Yes |
Automatically links counselor encounter notes to billing | Yes |
Has dashboards to alert you to missing documentation or errors | Yes |
Compliance and reporting require extra staff resources | No |
Requires an extra, separate system for documentation | No |
One Common Issue, and How to Avoid It
One common challenge we’ve encountered is schools don’t always know who to turn to during implementation. Questions start coming in, from billing setup to documentation workflows, and suddenly it’s unclear who’s responsible for finding answers or moving things forward.
This can slow down your entire process, especially when working across multiple teams or systems.
How to avoid it: Appoint a designated CYBHI implementation lead or small team within your LEA. This person (or group) should act as your internal point of contact—managing timelines, coordinating with your EHR vendor, and serving as the liaison with Carelon, Availity, or DHCS if issues arise.
Having a go-to person ensures nothing gets lost in translation and decisions can happen faster, especially as you get closer to billing readiness.
Do All EHRs Come with Built-in CYHBI Fee Schedule Requirements?
Most don’t—and that’s the problem.
Traditional EHRs weren’t built for school-based care or CYBHI’s unique structure. As a result, LEAs often end up piecing together workarounds, adding custom fields, or hiring consultants to stay compliant. This takes more time, more training, and leaves more room for error.
Axiom is different.
Our school module was built specifically for LEAs and IHEs participating in the CYBHI Fee Schedule. That includes:
- Pre-mapped service codes tied directly to CYBHI billing categories
- Built-in encounter tracking that supports both documentation and compliance
- User-friendly documentation designed for the way school-based mental health teams actually work
- Automated reporting and audit support to reduce risk and speed up reimbursement
- Ongoing updates to stay aligned with CYBHI policy changes
With Axiom, you don’t have to retrofit a medical EHR to fit your school-based program. It’s built for CYBHI, so you can focus on students, and not your software.
Everything in One Place, for a Smoother Transition
AxiomEHR isn’t just compatible with CYBHI—it’s purpose-built for it.
Our team has spent decades supporting California’s behavioral health landscape, including schools and LEAs. That experience shows up in every part of Axiom—from intuitive workflows to tools that help you work smarter, faster, and with fewer barriers.
We’ve designed Axiom to align directly with CYBHI requirements, so LEAs can transition with greater confidence—and less stress.
AxiomEHR is part of Radicle Health, a company rooted in supporting California behavioral health providers for over 20 years. If you’ve heard of Exym, that’s us too—same mission-driven team of behavioral health and tech experts, now building within the AxiomEHR framework to give you more flexibility, automation, and ease of use.
We’ve carried over what works and upgraded what saves you time—like voice-to-text session notes, an updated user experience, and streamlined workflows designed to help you care for students with fewer clicks.
Next Steps to Tackle
The transition from student support to CYBHI provider is a big one. But you don’t have to tackle everything at once—take it step by step, keep your details organized, and you’ll be through the toughest parts before you know it.
If you haven’t already, start by getting clear on your cohort deadlines. After that, the biggest choice ahead is selecting the right system to support your work.
AxiomEHR is built to make that transition smoother. With documentation and billing in one place, and a team that already knows the CYBHI process and is helping LEAs like yours get reimbursed, you can set yourself up for success. That means less back-and-forth, fewer surprises, and less extra work down the road.
Visit AxiomEHR’s Schools page to learn more.
Ready to see how it works? Request a live demonstration.
