Contract Providers

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Welcome to the Fresno County Mental Health Plan, we have provided the following links for your convenience.

If you have additional questions please feel free to contact a Utilization Review Specialist at (559) 600-4645.

Overview of Medi-Cal Mental Health Managed Care of Fresno County

STRTP Process for Licensure, Program Approval, Medi-Cal Certification

Assessment Form

Reassessment Forms

Clinical Face Sheet

Progress Notes 

Plan of Care - Option No. 1

Plan of Care - Option No. 2

Discharge Summary

Notice of Action - A - English (NOA-A)

Notice of Action - A - Spanish (NOA-A) 

Notice of Action - A - Hmong  (NOA-A)

Medication Referral Form

Individual/Group Site Certification Tool

Notice of Action - E - English (NOA-E)

Notice of Action - E - Spanish (NOA-E)

Notice of Action - E - Hmong (NOA-E)                                                                                                              

Provider Manuals

FCMHP Clinical Documentation and Billing Manual, 2019

Outpatient ICD-10 Medi-Cal Billable Codes - Updated

Inpatient ICD-10 Medi-Cal Billable Codes - Updated

California Child and Adolescent Needs and Strengths Form (CANS-50-English Only)

Pediatric Symptom Checklist (PSC-35-English)

Pediatric Symptom Checklist (PSC-35-Hmong)

Pediatric Symptom Checklist (PSC-35-Spanish)

5150 Re-Certification Training

Organizational Provider Site Certification Tool

TBS Referral Form

Individual and Group Provider Fee Schedule

Psychological Testing Referral Form

Frequently Asked Questions

FCMHP Chart Review Documentation Checklist for Outpatient Services

County Acceptable Abbreviations

Medication Consent Forms

Fresno County Avatar Service Codes

Contact Us                                                               


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