Infant-early childhood mental health services

Infant-Early Childhood Mental Health (IECMH), sometimes referred to as social and emotional health, is the developing capacity of the child from birth to 5 years of age to form close and secure adult and peer relationships; experience, manage, and express a full range of emotions; and explore the environment and learn—all in the context of family, community, and culture.

This page helps providers, billers, and partners stay informed about how to provide infant-early childhood mental health treatment services to children enrolled in Apple Health (Medicaid).

Stay informed! Want to stay updated on work related to infant-early childhood mental health?


Approximately 1 in 6 young children has a diagnosed mental, behavioral, or developmental disorder (Cree et al., 2018). These disorders, if properly identified, can be treated with infant-early childhood mental health (IECMH) services, which are designed to alleviate the distress and suffering of a young child’s mental health problem and support the return to healthy development and behavior, by enhancing the quality of the caregiver-child relationship. IECMH treatment services are highly effective and offer a strong return on investment; every dollar spent on IECMH treatment services can yield $8.00-$15.00 in savings per child (Oppenheim & Bartlett, 2022). Mental health providers contracted with Apple Health (Medicaid) can provide mental health treatment services to children birth through age five and their families.

Medicaid contracting and billing is a complex process in general, and services for infant-early childhood mental health (IECMH) treatment and dyadic mental health services, a newer concept for care, can feel even more complex. To support providers in this work, HCA and their partners currently offer multiple resources, tools, and opportunities for connection.

IECMH office hours

The Health Care Authority (HCA) IECMH team offers quarterly virtual office hours to support providers and agencies on topics related to IECMH and Apple Health (Medicaid). This is a time for providers to build connections, ask questions, and discuss additional IECMH needs.

Join the next IECMH Office Hour: Thursday, April 27, 10-11am.

Slides from past IECMH office hours

Mental Health Assessment for Young Children (MHAYC)

When providing mental health treatment services, mental health professionals first conduct a mental health assessment (i.e., Psychiatric Diagnostic Evaluation or Intake Evaluation) to identify needs and establish whether a child meets medical necessity criteria. For children birth through age five, the DC:0-5™ is the developmentally appropriate tool for assessment and diagnosis. To find resources about billing for mental health assessment for young children and using the DC:0-5™, please visit the Mental Health Assessment for Young Children webpage for providers.

Other IECMH resources for Apple Health providers

Additional resources to support providers in aligning with Apple Health (Medicaid) policies and procedures for infant-early childhood mental health treatment services.

IECMH toolkit

In response to questions and feedback from the provider community, HCA’s IECMH team is developing an IECMH-specific resource on contracting, billing, and other IECMH resources to support Apple Health providers. HCA’s IECMH team recognizes that there are varying needs from the IECMH field, with some providers being new to Medicaid contracting and billing, whereas others may have a long-standing relationship, though they are new to mental health services and best practices. For this reason, HCA is developing an IECMH Apple Health toolkit, as a foundational resource to support providers in getting started. This toolkit is anticipated to launch in Winter/Spring of 2023.

Evidence-based practices

The use of high-quality psychotherapy services, or evidence-based practices (EBP), for children is reported using EBP codes submitted as part of routine Apple Health (Medicaid) billing data. The current EBP Reporting Guide outlines eligible training entities and documentation requirements for evidence based Infant Mental Health treatment.

WISe Birth through Five (B-5)

Mental health providers contracted with Apple Health (Medicaid) can provide intensive mental health treatment services, including WISe (or Wrap-around with Intensive Services) to children birth through age five and their families. Because intensive mental health services for young children is a newer concept for care, additional resources about this topic are available on the WISe webpage for providers.

IECMH reports and data

As outlined in HCA's data strategy, data is one of HCA's most valuable assets, helping us understand strengths and challenges, holding us accountable, and informing our efforts to champion health equity. The HCA IECMH team is committed to gathering, examining, and sharing information about our work in partnership with communities, providers, and families. The stories told in these reports help us move towards our vision of building a strong IECMH network in Washington state. 

To see more reports from HCA, visit HCA's Data and Reports page.