What We Learned from CYBHI in 2025: Insights from Early Adopter Data
The 2025 data is in… here's what it shows and what districts that moved early got right.
Something important happened in California in 2025.
Schools across the state were reimbursed for the mental health services they were already delivering to students. Not as a pilot but as a functioning, multi-payer reimbursement program reaching thousands of kids in real classrooms.
CYBHI is a first-of-its-kind initiative, and the work that California’s Department of Health Care Services and Carelon Behavioral Health put into designing and launching it created something California's students genuinely needed. The 2025 data shows that CYBHI is happening, here's what it tells us about how.
1. The reimbursement is real, and it's repeatable.
$2.7 million in claims submitted. $2.2 million reimbursed. 37,000+ claims paid across 34 managed care plans. Those numbers matter, but what matters more is how they got there.
Early in the year, most districts were still figuring out whether CYBHI would deliver. By Q4, the districts that had invested in their setup were seeing reimbursement arrive consistently, not as a one-time win but as a recurring funding stream. Anaheim Elementary School District recovered more than $810,000 after four months of billing. A key to their success has been their partnership with a Community-Based Organization (CBO), whose teams supported outreach, coordinated services across schools and community providers, and helped build a strong foundation for this work to continue over the long term.
2. You don't need a clinical diagnosis to bill.
CYBHI was designed this way on purpose. It reflects a genuine commitment from DHCS to meet students where they are rather than where a billing system might prefer them to be.
If your district has been waiting until students reach a threshold of clinical need before engaging with CYBHI, the 2025 data suggests that approach is leaving reimbursements, and more importantly, support for students, on the table.
3. Onboarding was the hidden variable, not district size.
The districts that reached reimbursement the fastest weren't the largest or the best-resourced. What they had in common was simpler: they treated CYBHI as an ongoing operational function rather than a one-time setup task.
The districts that stalled tended to stall at the same places: provider credentialing, student data submission, and confusion between CYBHI services and IEP-related billing. These aren't unsolvable problems. They just require someone to own them and a process built to catch them before they delay claims.
The complexity is real, and it's navigable. Districts that leaned into the learning curve came out the other side with systems that work.
4. CYBHI removes financial barriers, making it a powerful and often underused way to build trust with families.
Services delivered through CYBHI don't affect deductibles, premiums, or visit limits. Explanations of Benefits are suppressed. Families will incur no co-pays or out-of-pocket expenses when connecting their child's school support to their insurance.
What the data shows about districts that partnered with TadHealth
Across our partner portfolio, a consistent pattern emerged. Districts that approached CYBHI with preparation and onboarding as priorities reached the first payment faster and sustained participation more consistently than the state average.
The difference isn’t budget or bandwidth; it’s having a clear system, a committed internal owner, and a partner supporting the work beyond the initial setup phase.
What this means going into 2026
Only 71 LEAs submitted CYBHI claims in 2025. Hundreds more are eligible. The districts that move now and invest in setup before billing will enter 2026 with a foundation that compounds over time.
The 2025 data proved that sustainable reimbursement is achievable, and the work of DHCS and Carelon made that possible. The districts that showed up and did the operational work made it real. 2026 is an opportunity for many more to do the same.
Read TadHealth's full 2025 CYBHI Industry Report at: https://www.tadhealth.com/get-your-report
TadHealth is California's leading CYBHI implementation partner, supporting LEAs across the state with onboarding, billing operations, and ongoing technical assistance.
