CTSS in Minnesota: Children's Therapeutic Services and Supports, Explained for Parents

What is CTSS in Minnesota?

CTSS stands for Children's Therapeutic Services and Supports. It's a mental health benefit under Minnesota Health Care Programs — Medical Assistance (MA, Minnesota's Medicaid) and MinnesotaCare — set out in Minnesota Statutes section 256B.0943. The law describes it as a flexible package of mental health services for children who need varying levels of therapeutic and rehabilitative help to treat a diagnosed mental health condition.

In plain terms, CTSS pairs therapy with practical skill-building. A therapist works on what's driving your child's struggles, while skills trainers help your child practice things like calming down, coping with worry, handling frustration or getting along with classmates. It's often a good fit for kids who need more than a weekly therapy appointment and are living at home or in the community.

CTSS is one of several children's mental health services in Minnesota. Many kids start with outpatient therapy at a clinic; CTSS adds more hands-on support. Children who need even more may be referred to options such as children's intensive behavioral health services, which bring a team into the home several days a week. Your county can also provide children's mental health case management for kids with serious needs if your family requests it.

CTSS is provided by agencies approved by the Minnesota Department of Human Services (DHS), including counties, tribal nations, and private and nonprofit organizations. Depending on the agency, services can happen at a clinic, in your home, at school or out in the community, and some can be delivered by telehealth. Staff include licensed mental health professionals, supervised clinical trainees, behavioral health practitioners (formerly called mental health practitioners), certified family peer specialists and mental health behavioral aides.

What services are included in CTSS?

Minnesota law lists several service components, and your child's treatment plan uses only the ones they actually need. Providers must deliver or arrange therapy for your child's underlying condition as part of ongoing treatment, unless your family declines it or it's no longer medically necessary — skills training isn't meant to stand alone.

The CTSS components are:

• Psychotherapy — individual, family and group therapy, plus therapy focused on a crisis
• Skills training — individual, family or group sessions that teach specific skills tied to your child's mental health needs
• Crisis planning — a written plan, made ahead of time, for warning signs and what to do if things get worse suddenly
• Mental health behavioral aide services — one-on-one help practicing skills a therapist or practitioner has already taught
• Treatment plan development — building and updating your child's plan and tracking progress with standardized measures
• Children's day treatment — a structured group program at a site such as a hospital outpatient program or community mental health center, combining therapy and skills training for children who need more than weekly sessions

Who qualifies for CTSS in Minnesota?

CTSS is a Minnesota Health Care Programs benefit, so coverage comes first. Private insurance generally doesn't cover CTSS as a package; many private plans cover outpatient therapy, but coverage for in-home skills work varies, so call your plan. If your child has a disability, they may still qualify for MA as secondary coverage through MA-TEFRA, even if your family's income is above regular MA limits. Our insurance guide explains how MA, MinnesotaCare and private plans fit together.

Beyond coverage, a child or young adult generally must:

• Be under 21
• Be enrolled in Medical Assistance or MinnesotaCare
• Have a standard diagnostic assessment, done within the past year by a mental health professional or supervised clinical trainee, that identifies a mental health diagnosis
• Have CTSS documented in that assessment as medically necessary to address the child's difficulties in daily life — at home, at school, in relationships or in activities

How do you get started with CTSS?

You don't need to have everything figured out before you call. The standard diagnostic assessment is the key clinical step: a mental health professional talks with you and your child, gathers history (which can include information from school and doctors), and decides whether there's a diagnosis and what level of care fits. Describe your child's hardest days, not just the good ones.

A typical path looks like this:

1. Confirm your child's coverage. If your child isn't on MA or MinnesotaCare, apply through MNsure or your county, and ask about MA-TEFRA if your income is over the limit.
2. Share your concerns with your child's doctor. They can check for medical causes and may know CTSS agencies nearby.
3. Contact CTSS providers. Many take calls directly from parents. Ask about openings and confirm the agency works with your child's MA health plan.
4. Complete a standard diagnostic assessment. Many agencies do this at intake. If your child had one in the past year, bring a copy; the provider may be able to use or update it.
5. Build the treatment plan together. You should help choose goals, services, locations and frequency, along with a written crisis plan.
6. Review progress regularly and ask for changes as your child's needs shift.

How is CTSS different from EIDBI for autistic children?

EIDBI — Early Intensive Developmental and Behavioral Intervention — is Minnesota's MA benefit for autism and related conditions. It starts with a comprehensive multidisciplinary evaluation (CMDE) and funds developmental and behavioral therapies, including ABA. CTSS, by contrast, is built around mental health diagnoses.

Many autistic children also experience anxiety, depression, ADHD or trauma. When a co-occurring mental health condition is diagnosed and affecting daily life, CTSS may help, sometimes alongside EIDBI and sometimes instead of it. Medical Assistance won't pay twice for the same service, so when a child receives both, each program should address different needs and the agencies are expected to coordinate. Tell each provider about the other and ask how they'll share plans.

How do you find CTSS providers in Minnesota?

Openings change quickly, so it helps to cast a wide net. If you'd like help, you can tell us what your child needs and we'll share Minnesota providers accepting new clients, free for families. Other good places to look:

• Browse children's mental health providers in Minnesota in our directory, including local lists for Minneapolis and St. Paul.
• Search FastTrackerMN.org, a free statewide tool that shows mental health and substance use providers' current availability. You can search by location, services and insurance. Check each listing's last-updated date and call to confirm.
• Ask your school counselor or social worker whether your district has a school-linked behavioral health provider. Through a DHS grant program, community agencies, including CTSS providers, place therapists in schools. That's separate from special education — see our guide to IEPs and 504 plans in Minnesota.
• Call member services for your child's MA health plan and ask for in-network CTSS agencies.

What should you ask a CTSS provider?

A short phone call can tell you a lot. Consider asking:

• Do you have openings now, or how long is the wait?
• Who does the diagnostic assessment, and can you use one we already have?
• Where will services happen — home, school, clinic or telehealth?
• Who provides the therapy, and who provides skills training? How are aides supervised?
• How will you involve us as parents, and how often will we review progress?
• Do you have experience with autistic or neurodivergent kids, and with families who share our culture or language?
• How will you coordinate with our school, our child's doctor and any EIDBI provider?
• What should we do after hours if things get hard?

What should you do in a children's mental health crisis?

CTSS crisis planning helps you prepare ahead of time, but it isn't an emergency service. If your child is in immediate danger, call 911.

For a mental health crisis, call or text 988 to reach the Suicide & Crisis Lifeline, or text MN to 741741 for the Crisis Text Line. Every Minnesota county has a mental health crisis phone number that serves children and families, and DHS lists them by county and tribal nation. Crisis services are available around the clock, and mobile crisis teams can come to your home or another community setting to help calm things down and plan next steps.

Save your county's crisis number in your phone now, and keep your child's crisis plan somewhere the whole family can find it.

Keep in mind

This article is general information, not medical, legal or benefits advice. Talk with your child's doctor or a mental health professional about what level of care fits your child.

CTSS rules are changing. Under a law passed in 2026, starting January 1, 2027, skills training is capped at two hours a day and behavioral aide services at six hours a day, each up to three days a week, with prior authorization needed above 200 hours a year. The same law moves CTSS providers from DHS certification to licensing starting January 1, 2028. Confirm current details with your provider, your child's health plan, your county or the Minnesota Department of Human Services.

If Medical Assistance denies, reduces or ends a service, you have the right to appeal. The written notice explains how and by when, so read it carefully and act quickly.