Medi-Cal Mental Health Benefits

Medi-Cal managed care plans are responsible for specific non-specialty mental health services. These services include individual and group mental health evaluation and treatment, psychological testing, certain outpatient services to include laboratory drugs, supplies, supplements, and psychiatric consultation. Carelon Behavioral Health manages mild-to-moderate behavioral health benefits and behavioral health therapy (BHT) benefits for all SFHP Medi-Cal members.

Mild to moderate mental health benefits include:

• Individual and group mental health evaluation and treatment (psychotherapy)
• Psychological testing, when clinically indicated to evaluate a mental health condition (prior authorization required)
• Outpatient services for the purpose of monitoring drug therapy
• Psychiatric consultation
• Outpatient laboratory, drugs, supplies, and supplements
• Evaluation for autism spectrum disorder
• BHT for those under 21 diagnosed with Autism Spectrum Disorder

To refer a member for mental health services, call Carelon’s toll-free Access Line at 1(855) 371-8117.

Maternal Mental Health & Depression Screening

San Francisco Health Plan (SFHP) reminds providers to screen all pregnant and postpartum members for depression. Additionally, providers must provide and/or refer members to necessary non-specialty mental health services, including individual or group counseling during pregnancy and up to 12 months after pregnancy for members with risk factors.

High-risk members are entitled to preventive counseling and must be referred and coordinated with San Francisco Behavioral Health Services (BHS) when a member may need specialty mental health services.

Additionally, pregnant members in primary care must be provided with basic substance use services and addiction treatment medication if needed.

For more information on Alcohol and Drug Screening, Assessment, Brief Interventions, and Referral to Treatment (SABIRT), please click here.

For information on Medication Assisted Treatment (MAT), please click here.

Behavioral Health Resources

Carelon Provider Search
PCP Referral Process Summary for PCP Office Staff
PCP Flier
Non-Specialty Mental Health Outreach and Education Plan 2026

ABA/BHT Referral Form – English
(Use this form if there is a known diagnosis and/or problem behavior indicating BHT/ABA Referral)
ABA/BHT Referral Form – Chinese
ABA/BHT Referral Form – Russian
ABA/BHT Referral Form – Spanish
ABA/BHT Referral Form – Tagalog
ABA/BHT Referral Form – Vietnamese

PCP Referral to Carelon Form (English)
PCP Referral to Carelon Form (Chinese)
PCP Referral to Carelon Form (Russian)
PCP Referral to Carelon Form (Spanish)
PCP Referral to Carelon Form (Tagalog)
PCP Referral to Carelon Form (Vietnamese)

Care Management Referral to Carelon Form (English)
Care Management Referral to Carelon Form (Chinese)
Care Management Referral to Carelon Form (Russian)
Care Management Referral to Carelon Form (Spanish)
Care Management Referral to Carelon Form (Tagalog)
Care Management Referral to Carelon Form (Vietnamese)

Behavioral Health Treatment for Autism Flier (English)
Behavioral Health Treatment for Autism Flier (Chinese)
Behavioral Health Treatment for Autism Flier (Russian)
Behavioral Health Treatment for Autism Flier (Spanish)
Behavioral Health Treatment for Autism Flier (Tagalog)
Behavioral Health Treatment for Autism Flier (Vietnamese)

SFHP/Carelon Behavioral Health Member FAQ (English)
SFHP/Carelon Behavioral Health Member FAQ (Chinese)
SFHP/Carelon Behavioral Health Member FAQ (Russian)
SFHP/Carelon Behavioral Health Member FAQ (Spanish)
SFHP/Carelon Behavioral Health Member FAQ (Tagalog)
SFHP/Carelon Behavioral Health Member FAQ (Vietnamese)

General Behavioral Health Flyer for Member Distribution (English)
General Behavioral Health Flyer for Member Distribution (Spanish)
General Behavioral Health Flyer for Member Distribution (Chinese)
General Behavioral Health Flyer for Member Distribution (Vietnamese)
General Behavioral Health Flyer for Member Distribution (Russian)
General Behavioral Health Flyer for Member Distribution (Tagalog)

Services for specialty mental health conditions and alcohol and drug abuse are provided by San Francisco Behavioral Health Services (SF BHS). To refer a member for specialty mental health services, call SF BHS at 1(888) 246-3333.