Address Barriers in Health Insurance Coverage of Infant and Early Childhood Mental Health Services to Ensure Adequate Benefits

Pathways Recommendation

Ensure that health insurance covers children’s mental health, including: 1) Language allowing use of and payment based on a diagnostic system that reflects the developmental needs of young children (the DC:0-5, rather than the DSM-5) and professional development for practitioners in the use of that system, 2) Language allowing the use of non-specific diagnosis codes for at least six initial visits when a diagnosis is uncertain, or when there are functional issues without a diagnosis, 3) A definition of “medically necessary services” to include prevention, diagnosis and treatment of infant and early childhood mental health concerns and conditions, and 4) A requirement for evidence-based approaches appropriate for infants, toddlers, and their families, such as treating families and young children together and delivering infant and early childhood mental health services in primary care settings and home visits.