Education guide - Better Access to mental health care for general practitioners and allied health professionals
Information about services general practitioners and allied health professionals can provide to patients under the Better Access initiative.
We recommend you also read the relevant Medicare Benefits Schedule (MBS) item descriptors and explanatory notes available on the MBS Online website.
About Better Access
The Better Access initiative offers patients improved access to mental health practitioners through Medicare.
Under this initiative, Medicare benefits are available to patients for selected mental health services provided by:
- general practitioners (GP)
- clinical and registered psychologists
- eligible social workers
- occupational therapists
Information for General Practitioners
GP services under Better Access
GPs can provide the following services under Better Access:
|Service||MBS item||Frequency it can be used|
|Prepare a GP mental health treatment plan (GPMHTP)||2700, 2701, 2715 or 2717||Once every 12 months however not within 3 months of a review under item 2712|
|Review a mental health treatment plan||2712||Once every 3 months however not within 4 weeks of claiming item 2700, 2701, 2715 or 2717|
|Manage a patient’s mental health condition||2713 or a general consultation item||As often as necessary - no restrictions|
|*GP focussed psychological strategies (FPS) services||2721 - 2727||Up to 10 services every 12 months|
*You should register with us if you have completed the mental health skills training accredited by the General Practice Mental Health Standards Collaboration. Once you have registered, you can provide GP FPS services.
Eligible patients for GP mental health treatment
GP mental health treatment plan and review services are available to:
- patients in the community
- private in-patients including residents of aged care facilities being discharged from hospital
To determine if a patient is eligible, they must:
- have a mental disorder, and
- be likely to benefit from a structured approach to the management of their care needs
Referred mental health services
Once you have completed a GP mental health treatment plan for a patient you can refer them for a range of mental health services:
|Psychological therapy services||Clinical psychologists|
|Allied health FPS services||
|GP FPS services||GPs with appropriate mental health skills training|
You can also refer your patient for these services if you’re managing them under a referred psychiatrist assessment and management plan - MBS item 291.
Calendar year claiming limits for allied mental health services
In a calendar year patients can receive psychological therapy and or FPS services up to the limit of:
- 10 individual services, and
- 10 group services
A calendar year is from 1 January to 31 December, not the 12 month period from the date of the referral.
Determine what item applies if a GPMHTP is claimed
Firstly you can:
- ask the patient if they have a copy of the previous mental health treatment plan, or
- if the patient agrees, ask their previous GP for a copy
If you get a copy of the previous plan, and it was in place for more than 4 weeks, you can review it by billing MBS item 2712.
If there has been a significant change to the patient’s clinical condition or care circumstances, you can develop a new plan. Make sure you include this in the claim documents.
Only prepare a mental health treatment plan if you are the patient’s usual GP and expect to continue to manage their condition.
Confirming mental health items and limits
Call us to check:
- if a GP mental health treatment plan has previously been claimed and paid
- how many allied mental health services the patient has already received in the calendar year
- which MBS item you can bill a patient if their clinical condition or care circumstances have changed significantly
Information for allied health professionals
Allied mental health services and MBS items
Eligible allied health professionals can provide the following services under Better Access.
You must meet the eligibility criteria and have a Medicare provider number.
|Allied health professionals||Mental health services||Individual items||Group items|
|Clinical psychologists||Psychological therapy services||80000-80015||80020|
|Registered psychologists||Focussed psychological strategies (FPS) services||80100-80115||80120|
|Occupational therapists||FPS services||80125-80140||80145|
|Social workers||FPS services||80150-80165||80170|
Patient eligibility for allied mental health services
A patient must be assessed as having a mental disorder and referred by:
- a GP who is managing the patient under a GP Mental Health Treatment Plan or under a referred psychiatrist assessment and management plan
- a psychiatrist, or
- a paediatrician
If you’re not sure if your patient is eligible you can contact the referring medical practitioner.
You can continue to see patients who aren’t eligible but they can’t access Medicare benefits for the services you provide.
Referral items for claiming allied mental health services
The relevant GP, psychiatrist or paediatrician referral item must be claimed, and a Medicare benefit paid by us before Medicare benefits are available for psychological therapy and FPS services.
|Referring medical practitioner service||Medicare items|
|Preparation of a GP Mental Health Treatment Plan||2700, 2701, 2715 or 2717|
|Referred psychiatrist assessment and management plan||291|
|Specialist psychiatrist and paediatrician consultation||104-109|
|Consultant physician paediatrician consultation||110-133|
|Consultant physician psychiatrist consultation||293-370|
Confirming patient eligibility for allied mental health services
Call us to check if the referral item has been paid or if the patient has reached the calendar year limit of their allied mental health services.
Where a patient has already reached the allied mental health service limit for the calendar year, you can choose to continue to see the patient but they can’t access Medicare benefits for your services.
Better Access referrals – format and content
There is no standard form for referrals. Medical practitioners can refer patients for allied mental health services with a letter or note that you’ve signed and dated.
The referral should include:
- the patient’s diagnosis
- the number of treatment services the patient needs to receive, and
- a statement that a mental health treatment plan or a psychiatrist assessment and management plan is in place, if the referral is from a GP - GPs can also include a copy of the plan if it’s appropriate and the patient agrees
Better Access referrals – course of treatment
Medical practitioners can refer up to 6 services for a course of treatment. The number of services stated in the patient's referral is a course of treatment.
A patient can have 2 or more courses of treatment within the maximum number of services each calendar year.
Patients need a new referral for each course of treatment.
Referrals are valid for the number of services shown on the medical practitioner’s referral letter or note. Unused services don’t expire and can be used in the following calendar year.
For our auditing purposes, allied health professionals must keep copies of all written referrals for 2 years from the date of the patient’s first service.
Allied mental health professional reporting
Allied health professionals must provide a written report back to the referring medical practitioner after completing a course of treatment. Any further completed courses of treatment also requires a written report.
The report should allow referring medical practitioners to assess the patient’s need for more treatment services. It must include:
- assessments carried out on the patient and, where relevant, the progress made
- treatments provided, and
- recommendations on future management of the patient’s disorder
Allied health professionals don’t need to use an approved form to write a report.
Reporting when a course of treatment is not completed
If a patient doesn’t complete a course of treatment, the allied mental health professional should write their report after the last service they provided. If the patient returns later and completes the course of treatment, they’ll need to write another report to the medical practitioner.
Case study: services provided in 2 calendar years
Under Better Access, a maximum of 10 allied mental health individual services are payable each calendar year.
Individual services are counted towards a patient’s calendar year limit when 2 courses of treatment are provided over consecutive calendar years. Medical practitioners don’t need to provide a new referral for an existing course of treatment.
For example, a medical practitioner refers a patient for a course of treatment of 5 individual allied health services under the Better Access initiative.
The patient receives 2 services in calendar year 1. In calendar year 2 the patient receives the remaining 3 services. The course of treatment is now complete as 5 individual services have been provided. The allied health professional who treated the patient will write a report back to the medical practitioner.
The medical practitioner decides to refer the patient for a further course of treatment of 4 individual allied mental health services.
The patient receives all 4 services for this course of treatment during calendar year 2. The course of treatment is now complete as 4 individual services have been provided. The allied health professional who treated the patient will write a report back to the medical practitioner.
The patient has now received a total of 7 individual services during calendar year 2.
If the medical practitioner decides that a third course of treatment is necessary, the patient is entitled to 3 more individual services under Better Access in calendar year 2.
- MBS Online to view the Schedule
- Education services for health professionals to access other education resources
- More Better Access resources on the Department of Health website
Contact us for Medicare provider enquiries.
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