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Medi-Cal & Therapy Glossary.
Plain-English definitions of the coverage, billing, and therapy terms you will see when starting care.
Last updated: October 2026
Medi-Cal, plans, and cards
Coverage & Medi-Cal
- Medi-Cal
- California’s Medicaid program, run by the Department of Health Care Services. It provides free or low-cost health coverage, including mental health care, to eligible Californians.
- Managed care plan
- A health plan that manages Medi-Cal benefits for its members. Most Medi-Cal members are enrolled in one, and the plan’s name appears on their member card.
- Partnership HealthPlan of California (PHP)
- The Medi-Cal managed care plan for 24 Northern California counties. PMHS is contracted with Partnership, so outpatient therapy is a covered benefit for its members.
- Carelon Behavioral Health
- The company Partnership HealthPlan has partnered with to help with mental health benefits. If you see the Carelon name on a letter or hear it on the phone, it is part of your Partnership coverage, not a separate plan.
- Member ID
- The number on your health plan card that identifies you. Partnership Member Services at (800) 863-4155 can confirm it if you cannot find your card.
- BenefitsCal
- California’s website for applying for, renewing, and managing Medi-Cal. Your account shows the name of your Medi-Cal plan.
- Annual renewal
- Medi-Cal is renewed once a year. Coverage can stop if renewal paperwork is missed, so it is worth confirming your coverage is active.
- Medi-Medi
- Having both Medicare and Medi-Cal, also called dual eligible. PMHS can see you when Partnership HealthPlan is listed as your primary plan.
- Primary plan
- The plan that is billed first when you have more than one. PMHS bills Partnership HealthPlan directly, so Partnership must be your primary plan for PMHS to see you.
- EPSDT
- Early and Periodic Screening, Diagnostic, and Treatment. A Medi-Cal benefit for members under 21 that covers medically necessary care, including mental health care.
- No Wrong Door
- A California Medi-Cal policy that lets covered mental health care start before a diagnosis is made, so you can get help without first being sent somewhere else.
- Specialty mental health services
- Medi-Cal services for significant impairment, such as crisis intervention and targeted case management. Your county mental health plan covers these. PMHS provides outpatient therapy for mild to moderate symptoms.
- County mental health plan
- The county program that provides Medi-Cal specialty mental health services. It is separate from Partnership HealthPlan, which covers outpatient therapy for mild to moderate symptoms.
- Mild to moderate
- How Medi-Cal describes symptoms that affect daily life without causing significant impairment. Outpatient therapy at this level is covered through your Medi-Cal managed care plan.
- Interpreter services
- Language help provided at no cost. California law requires health plans to offer it (Health & Safety Code § 1367.04). Note your language preference when you submit the intake form.
Referrals, approvals, and your first session
Getting Started
- Referral
- A recommendation from a doctor or other provider to see a specialist. You do not need a referral to start therapy with PMHS.
- Prior authorization
- Approval a health plan gives before certain care can start. Outpatient therapy with PMHS does not require prior authorization for Partnership HealthPlan members.
- Medical necessity
- A clinical decision that care is needed for your health. For therapy, your clinician makes this determination during your first session. It is not a hurdle you clear beforehand.
- Intake
- Your first session. Your clinician asks about your history, your goals, and what support looks like for you. You are not asked to commit to a treatment plan that day.
- Informed consent
- Paperwork that explains how therapy works, including confidentiality and its limits. At PMHS you complete it before your first session through a secure patient portal.
- Telehealth
- Health care delivered by secure video or phone instead of in person. Every PMHS session is telehealth, and you must be physically in California during each session.
- Telehealth parity
- California law requires Medi-Cal managed care plans to cover telehealth on equal terms with in-person care, so a video or phone session is not a lesser benefit.
- Patient portal
- The secure SimplePractice site where you complete intake paperwork and consent forms. New patients receive an email invitation, and the paperwork typically takes about ten minutes.
- Treatment plan
- The goals you and your clinician agree on and how you will work toward them. It is reviewed and updated as therapy moves forward.
- Screening tool
- A short questionnaire that measures symptoms, such as the PHQ-9 for depression or the GAD-7 for anxiety. A screener is not a diagnosis. The PHQ-9 is free on the PMHS Therapy Tools page.
- Session length
- Standard PMHS sessions are 50 to 60 minutes. Your clinician sets the frequency that best supports your treatment goals.
- Cancellation policy
- PMHS asks you to cancel or reschedule at least 24 hours in advance. Late cancellations and no-shows may be subject to a fee per your informed consent agreement.
What you may pay and why
Costs & Billing
- Copay
- A set amount paid at each visit. Covered therapy sessions are typically free for Partnership HealthPlan Medi-Cal members, with no copay.
- Private pay
- Paying for sessions yourself instead of using insurance. PMHS shares private pay rates when you reach out.
- Sliding scale
- Fees adjusted to what you can afford, based on financial need. Ask about it during intake.
- Superbill
- An itemized receipt for your sessions that you can send to your insurance company to request possible reimbursement.
- Good Faith Estimate
- A written estimate of expected charges that providers must give patients who are uninsured or not using insurance. If your bill is $400 or more above it, you can dispute the charge.
- HSA and FSA
- Health savings and flexible spending accounts. PMHS accepts both, and therapy is an eligible medical expense under most plans.
- Deductible
- The amount you pay each year before an insurance plan starts paying. Partnership HealthPlan members have no deductible for medically necessary therapy.
- Coinsurance
- A percentage of a service’s cost that you pay after meeting your deductible. Some commercial plans use it. Covered Partnership HealthPlan therapy has no coinsurance.
- CPT code
- A five-digit code that describes the service billed. PMHS sessions of 53 minutes or more bill as 90837, and sessions of 38 to 52 minutes bill as 90834.
- Explanation of Benefits (EOB)
- A statement an insurance company sends after it processes a claim. It is not a bill. With employer insurance it may arrive at your home address, which matters if privacy at home is a concern.
Who provides your care
Clinicians & Credentials
- BBS
- The California Board of Behavioral Sciences. It licenses therapists such as LMFTs and registers associates who are working toward a license.
- LMFT
- Licensed Marriage and Family Therapist, licensed by the BBS to provide psychotherapy independently. Ryan Frost is an LMFT (LMFT #51777).
- APCC
- Associate Professional Clinical Counselor. A BBS-registered associate who provides therapy under a licensed supervisor while completing hours toward licensure. Dmitri Kolpacoff is an APCC (APCC #20355).
- Clinical supervisor
- A licensed clinician who oversees an associate’s work and meets the BBS supervision requirements. Ryan Frost has been a clinical supervisor for more than 12 years.
- NPI
- National Provider Identifier, a unique 10-digit number assigned to health care providers in the United States and used for billing.
- HIPAA
- The federal law that protects the privacy of your health information. PMHS sessions run on Doxy.me, a HIPAA-compliant platform.
- LPCC
- Licensed Professional Clinical Counselor, licensed by the BBS to provide psychotherapy independently. An APCC is working toward this license.
- AMFT
- Associate Marriage and Family Therapist. A BBS-registered associate who provides therapy under a licensed supervisor while working toward the LMFT license.
- LCSW
- Licensed Clinical Social Worker, licensed by the BBS to provide psychotherapy independently.
- Psychologist
- A doctoral-level clinician (PhD or PsyD) licensed to diagnose and administer psychological testing.
- Psychiatrist
- A medical doctor whose primary role is medication management. PMHS is a therapy-only practice. With your written consent, PMHS can coordinate a referral for a medication evaluation.
- CACREP
- The Council for Accreditation of Counseling and Related Educational Programs. It accredits graduate counseling programs that meet national training standards.
Approaches you may hear about
Therapy Methods
- CBT
- Cognitive Behavioral Therapy. A structured approach that helps you notice and change the thoughts and habits that keep anxiety, depression, and stress going.
- DBT
- Dialectical Behavior Therapy. Builds skills for handling intense emotions, distress, and relationships, often used for personality patterns and emotional overwhelm.
- EMDR
- Eye Movement Desensitization and Reprocessing. A structured trauma therapy that helps the brain process distressing memories so they feel less overwhelming.
- ACT
- Acceptance and Commitment Therapy. Helps you make room for difficult thoughts and feelings while taking steps toward what matters to you.
- Gottman Method
- A research-based approach to couples therapy that focuses on friendship, managing conflict, and shared meaning.
- EFT
- Emotionally Focused Therapy. A couples approach that helps partners understand the emotional needs underneath recurring conflict.
- Motivational Interviewing
- A conversational approach for times you feel unsure about change. It helps you sort through mixed feelings and find your own reasons to move forward.
- Solution-Focused Therapy
- A brief approach centered on what you want your life to look like and what is already working, instead of dwelling on what went wrong.
- Narrative Therapy
- A collaborative approach that helps you separate your identity from your problems and rewrite the story you tell about yourself.
- Person-centered therapy
- An approach built on empathy and acceptance, where you lead the conversation and your clinician follows what matters most to you.
- Trauma-informed care
- Care that accounts for how trauma affects people and moves at the pace you set. Your clinician does not push for details before you are ready.
- Family systems therapy
- An approach that looks at how family relationships and communication patterns shape each person’s struggles.
Confidentiality and crisis support
Privacy & Safety
- Confidentiality
- Keeping what you share in therapy private. PMHS does not disclose your information without your written authorization, except in situations the law requires.
- Mandated reporter
- A professional the law requires to report suspected abuse. All PMHS clinicians report suspected child abuse (Penal Code § 11166) and elder or dependent adult abuse (Welfare & Institutions Code § 15630).
- Duty to warn
- A clinician’s legal duty to take reasonable steps when a patient discloses a serious threat of harm to an identifiable person. In California it is known as the Tarasoff duty.
- Release of Information (ROI)
- A signed form that lets PMHS share specific information with a person you choose, such as your doctor or a family member.
- Safety plan
- A personalized crisis coping plan based on the Stanley-Brown Safety Planning Intervention. You complete it with your clinician and keep it accessible.
- 988 Suicide & Crisis Lifeline
- Call or text 988, 24/7, to reach the national crisis line. Call 911 if you are in immediate danger.