Dyadic Care Services

Dyadic Services and dyadic caregiver services were added as Medi-Cal benefits in January 2023. The dyadic services benefit is designed to support implementation of comprehensive models of dyadic care that work within the pediatric clinic setting to identify and address caregiver and family risk factors for the benefit of the child. Dyadic services are preventive behavioral health services for recipients ages 0 to 20 years and/or their caregivers. 

Dyadic care refers to serving both parent(s) or caregiver(s) and child together as a dyad and is a form of treatment that targets family well-being as a mechanism to support healthy child development and mental health. It is provided within pediatric primary care settings whenever possible and can help identify behavioral health interventions and other behavioral health issues, provide referrals to services, and help guide the parent-child or caregiver-child relationship. Dyadic care fosters team-based approaches to meeting family needs, including addressing mental health and social support concerns, and it broadens and improves the delivery of pediatric preventive care.

• Dyadic Behavioral Health (DBH) Well-Child visits 
  • DBH well-child visits are provided for the child and caregiver(s) or parent(s) at medical visits. Through the DBH well-child visits and other dyadic services listed below, a child and caregiver(s) or parent(s) can be screened for behavioral health problems, interpersonal safety, tobacco and substance misuse, and social drivers of health (SDOH), such as food insecurity and housing instability, as well as provided referrals for appropriate follow-up care.  

• Dyadic Comprehensive Community Supports Services 
  • Dyadic Comprehensive Community Supports Services help the child (Member under age 21) and their parent(s) or caregiver(s) gain access to needed medical, social, educational, and other health-related services. Dyadic Psychoeducational Services are planned, structured interventions that involve presenting or demonstrating information with the goal of preventing the development or worsening of behavioral health.

• Dyadic Psychoeducational Services
  • Dyadic psychoeducational services are provided to the child under age 21 and/or parent(s) or caregiver(s). These services must be planned, structured interventions that involve presenting or demonstrating information with the goal of preventing the development or worsening of behavioral health conditions and achieving optimal mental health and long-term resilience.

• Dyadic Family Training and Counseling for Child Development
  • for family training and counseling provided to both the child under age 21 and parent(s) or caregiver(s). These services include brief training and counseling related to a child’s behavioral issues, developmentally appropriate parenting strategies, parent/child interactions, and other related issues.

• Dyadic Parent or Caregiver Services
  • Dyadic parent or caregiver services are services delivered to a parent or caregiver during a child’s visit that is attended by the child and parent or caregiver, including the following assessment, screening, counseling, and brief intervention services provided to the parent or caregiver for the benefit of the child (Member under age 21) as appropriate: 
    • Brief Emotional/Behavioral Assessment 
    • ACEs Screening 
    • Alcohol and Drug Screening, Assessment, Brief Interventions, and Referral to Treatment 
    • Depression Screening 
    • Health Behavior Assessments and Interventions 
    • Psychiatric Diagnostic Evaluation 
    • Tobacco Cessation Counseling   

Children (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, and when medically necessary, in accordance with Medi-Cal’s Early and Periodic Screening, Diagnostic and Treatment (EPSDT) standards in Title 42 of the United States Code (USC), Section 1396d(r).4 Under EPSDT standards, a diagnosis is not required to qualify for services.

Dyadic Services may be provided by 

• Licensed Clinical Social Workers 
• Licensed Professional Clinical Counselors
• Licensed Marriage and Family Therapists
• Licensed Psychologists
• Psychiatric Physician Assistants 
• Psychiatric Nurse Practitioners
• Psychiatrists
• Associate Marriage and Family Therapists, Associate Professional Clinical Counselors, Associate Clinical Social Workers, and Registered Psychological Associates may render services under a supervising clinician. 
• Appropriately trained nonclinical staff, including Community Health Workers (CHW), are not precluded from screening Members for issues related to SDOH or performing other nonclinical support tasks as a component of the DBH visit, as long as the screening is not separately billed. Under the supervision of a supervising Provider from one of the provider types listed above, CHWs who meet the qualifications listed in the Community Health Worker (CHW) Preventive Services section of the Provider Manual can assist a dyad to gain access to needed services to support their health, through the CHW benefit for health navigation services described in APL 22-016, or any superseding APL.
• Dyadic caregiver services may be provided by the medical well-child Provider, in addition to the Provider types listed above.

If you are an IEHP Provider, new Provider, or any of the Provider types listed above and are interested in providing dyadic care services, please fill out the IEHP Dyadic Services Provider Inquiry form below and reach out to IEHP Provider Services.

• IEHP Dyadic Services Provider Inquiry (PDF)

For more information about dyadic services, dyadic caregiver services, and psychotherapy updates, refer to the Non-Specialty Mental Health Services: Psychiatric and Psychological Services section of the provider manual or see DHCS APL 22-029.