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)
  • psychiatrists
  • 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:

Services Performed by
Psychological therapy services Clinical psychologists
Allied health FPS services
  • registered psychologists
  • occupational therapists
  • social workers
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.

Referral validity

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.

Case study: services provided in 2 calendar years

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.

More information

Online

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Page last updated: 24 October 2016

This information was printed Tuesday 6 December 2016 from humanservices.gov.au/health-professionals/enablers/education-guide-better-access-mental-health-care-general-practitioners-and-allied-health It may not include all of the relevant information on this topic. Please consider any relevant site notices at humanservices.gov.au/siteinformation when using this material.