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Mental health assessment for young children
Developmentally appropriate assessment is key to effective mental health care for children birth to age five. In 2021, the Washington State Legislature passes a law aligning Apple Health policies with best practices for assessing young children’s mental health.
This page supports providers, billers and partners with helpful information and tools.
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Overview
About 1 in 5 young children have a mental, behavioral, or developmental disorder. When caught early, these conditions can be treated effectively. Accurate assessment is the first step for effective treatment.
Washington’s infant-early childhood mental health (IECMH) community worked together for several years to champion policy change. In 2021, state law (RCW 74.09.520(11)) and HCA rules (WAC 182-531-1400(9)(a)(ii)) were updated to:
- Allow reimbursement for multi-session assessments
- Allow reimbursement for provider travel to home or community settings
- Require use of the DC:0-5™ diagnostic manual
These changes began in January 2022, and HCA updated several different systems to support these changes. A follow-up survey in Fall 2022, focus groups in 2023, and an analysis of administrative claims data in 2025 found positive impacts for providers, families, and children.
How to bill
HCA offers guidance and support to help providers bill correctly for mental health assessments for young children.
Providers can also refer to the Apple Health Mental Health Billing Guide or HCA's Service Encounter Reporting Instructions (SERI) for more information. Providers with questions can refer to the Apple Health (Medicaid) reference guide for clinical policy and billing contact information.
For multisession assessments
Providers can bill for up to five sessions per child per calendar year, without prior authorization. Use standard Psychiatric Diagnostic Evaluation CPT®/HCPCS codes for each session.
For provider travel
Travel is reimbursable when assessments happen in the home or community.
Requirements:
- CPT®/HCPCS Code (90791, 90792, H0031)
- Child must be under age 6
- Place of Service Code: 03: (School), 04 (Shelter), 12 (Home), 99: (Other)
Mileage rates are set by the Office of Financial Management.
Claims not eligible for reimbursement
Claims with a U8 modifier, services provided to Wraparound Intensive Services (WISe) participants, are NOT eligible for MHAYC provider travel reimbursement
Travel reimbursement by coverage type
For clients enrolled in managed care
Follow the managed care organization's (MCO) policies.
For clients without a managed care plan (or fee-for-service)
Use the following instructions and form.
Caregiver only assessment sessions
During the assessment process, providers may conduct caregiver-only sessions where only the caregiver/parent is present for some or all portions of the intake evaluation session.
Collaborative assessments
Apple Health covers collaborative assessments — assessments involving two or more providers working together to evaluate the same individual — when medically necessary. For additional information, please refer to HCA’s collaborative assessment frequently asked questions (FAQ) document for more information.
Using the DC:0-5
The DC:0-5™ is a best-practice diagnostic manual for infants and young children. It is required for Apple Health assessments for children through age 5 (RCW 74.09.520). The DC:0-5™ uses criteria specific to early childhood and it is recommended by CMS.
Although the 2021 legislation didn’t set an implementation date, HCA interprets the law (House Bill 1325) to mean that all providers should be working towards using the DC:0-5™. HCA is focused on supporting providers through training and resources.
Apple Health DC:0-5™ Crosswalk
The Apple Health DC:0-5 crosswalk connects DC:0-5 diagnoses with ICD-10 codes. Washington created a DC:0-5 Crosswalk to meet billing requirements, because federal rules require ICD-10 codes on all claims, even when the DC:0-5 is used for diagnosis.
The DC:0-5 manual includes its own crosswalk, but it’s not updated regularly or aligned with Apple Health. That’s why HCA publishes its own version.
DC:0-5™ training
Many providers don’t learn about the DC:0-5 in school. Washington offers free DC:0-5 training for Apple Health providers.
Provided by the IECMH Workforce Collaborative (IECMH-WC):
- For mental health providers: DC:0-5 Clinical training, communities of practice, and other workshops
- For allied professionals: DC:0-5 overview training and other workshops
Find free training opportunities.
Questions about DC:0-5 training? Contact the IECMH-WC team.
DC:0-5™ in clinical records
As of May 1, 2023, Washington Department of Health (DOH) allows licensed behavioral health agencies to use either DSM-5 or DC:0-5 for diagnostic assessments (WAC 246-341-0640). This aligns with HCA’s Apple Health guidance.
Other resources
Doing mental health assessments for young children may be new for some providers. HCA provides additional resources to support best practices within the field.
MHAYC Provider Spotlight series
Learn how other providers are doing this work. Each spotlight focuses on a different part of implementation.
- IECMH intake forms
- Assessments in natural settings
- Screenings, collateral information, and referrals
- Structuring sessions and cultural considerations
- Workflows, staffing, electronic health records
Early Childhood referral guide
A strong assessment includes input from across a child’s life-caregivers, educators, and others, and sometimes, an assessment may indicate children have needs that a mental health provider cannot address. This guide helps providers connect families to non-mental health services when needed.
Stay connected
Want the latest news and updates?
- Join the Prenatal-25 behavioral health mailing list
- Check out the latest bulletins and resources under IECMH updates on the IECMH webpage.
(Updated March 15, 2026)