Information about services eligible practitioners and allied health professionals can provide to patients under the Better Access initiative.
Make sure you read the relevant Medicare Benefits Schedule (MBS) item descriptions and explanatory notes at MBS Online.
The purpose of the Better Access initiative is to improve treatment and management of mental illness within the community. The aim is to provide patients with access to mental health professionals and team-based mental health care. Under this initiative, Medicare benefits are available to patients for selected mental health services provided by:
- general practitioners (GPs)
- non-vocationally recognised medical practitioners (non-VR MPs)
- clinical psychologists
- registered psychologists, and
- appropriately trained social workers and occupational therapists
Information for eligible Practitioners
GP and non-VR MP services under Better Access
GPs and non-VR MPs can claim these MBS items in general practice. Specialists or consultant physicians can’t claim them.
The term ‘GP’ in the item descriptions is used as a generic reference to medical practitioners eligible to claim these items.
Under Better Access, practitioners can provide and claim for the services in the table below.
|Service||MBS items||Frequency practitioners can use it|
|Prepare a GP mental health treatment plan (GPMHTP)||
272, 276, 281, 282,
|Review a mental health treatment plan||277 or 2712||
|Manage a patient’s mental health condition||279, 2713 or a general consultation item||
|Provide GP focused psychological strategies (FPS) services*||283-287 or 2721 - 2727||
*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.
Patient eligibility for mental health treatment
GPMHTPs and review services are available to:
- patients in the community
- private in-patients, including residents of aged care facilities being discharged from hospital
To be eligible, a patient 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've completed a GPMHTP you can refer your patient for a range of mental health services, including:
- psychological therapy services performed by a clinical psychologist
- allied health FPS services performed by a registered psychologist, occupational therapist or social worker
- GP FPS services performed by a GP with appropriate 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, or
- a shared care plan
Certain allied health services require that the patient’s care is being managed under a:
- GP Management Plan and Team Care Arrangements
- GPMHTP, or
- shared care plan
A practitioner may develop a shared care plan for a patient enrolled under the Health Care Home trial.
Referral format and content
There's no standard form for referrals. Eligible medical practitioners can refer patients for allied mental health services with a signed and dated letter.
The referral should include:
- the patient’s symptoms
- the number of treatment services the patient needs to receive
- a statement about whether the patient has a GPMHTP, shared care plan or a psychiatrist assessment and management plan
Referral 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 their calendar year limit of 10 services.
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. If patients have unused services at the end of the calendar year, they can use them the next year without a new referral.
Allied health professionals must keep copies of referrals for 2 years.
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.
From 1 September 2018, the limit of 10 individual and 10 group services can be made up of:
- face-to-face consultations
- telehealth consultations, or
- a combination of face-to-face and telehealth consultations
Which item applies when you bill a GP mental health treatment service
To determine which item applies when billing a GP mental health treatment service:
- ask the patient if they have a copy of the previous GPMHTP, or
- with the patient’s permission, ask their previous practitioner for a copy
You can review a patient’s previous plan if it’s been in place for more than 4 weeks. Use MBS item 277 or 2712 to bill a review service.
Only prepare a GPMHTP if you are the patient’s usual practitioner and expect to continue to manage their condition.
Confirming mental health items and limits
You can use the MBS Online Items Checker in HPOS to:
- view and check patient eligibility based on their MBS history
- check your own eligibility for claiming MBS items
- check claiming conditions for MBS items
Or you can call us to check:
- if a patient has claimed a GPMHTP
- how many allied mental health services the patient has already received in the calendar year
- which MBS item you can bill if your patient’s clinical condition or care circumstances have changed significantly
Information for allied health professionals
Allied mental health services and MBS items
To be an eligible allied health professional, you must:
- meet the eligibility criteria, and
- have a Medicare provider number
Under Better Access, eligible allied health professionals can provide the services in the table below.
|Allied health professional||Mental health services||Individual items||Group items|
|Clinical psychologists||Psychological therapy services||80000-80015||80020-80021|
|Registered psychologists||FPS services||80100-80115||80120-80121|
|Occupational therapists||FPS services||80125-80140||80145-80146|
|Social workers||FPS services||80150-80165||80170-80171|
Patient eligibility for allied mental health services
An eligible practitioner must assess the patient as having a mental disorder. The following practitioners can refer a patient:
- an eligible practitioner who is managing the patient under a
- referred psychiatrist assessment and management plan, or
- shared care 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 practitioner must claim the relevant referral item before Medicare benefits are available for psychological therapy and FPS services.
The table below explains the items that can be used as a referral pathway to allied health professionals.
|Referring medical practitioner service||Medicare items|
|Preparation of a GPMHTP||
272, 276, 281, 282,
|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 allied health items and limits
Call us to check if that patient has:
- claimed a referral service
- reached the calendar year limit of their allied mental health services
Once a patient has reached their service limit, you can keep seeing them but they can’t access Medicare benefits for your services.
Allied mental health professional reporting
Allied health professionals must provide a written report to the referring medical practitioner after completing each course of treatment.
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 patient doesn’t complete a course of treatment
If a patient doesn’t complete treatment, the allied health professional should write their report after the last service. If the patient returns later and completes the course of treatment, they’ll need to write another report.
Telehealth focused psychological strategies services
New MBS items were introduced on 1 November 2017 to provide Medicare benefits for services provided via videoconferencing. Psychologists, occupational therapists and social workers can use these items.
Unlike other telehealth items, these items are stand-alone and do not have a derived fee structure.
The patient must:
- have both a visual and audio link with the allied health professional
- be located in an area within Modified Monash Model regions 4 to 7, and
- be located at least 15km, by road, from the treating allied health professional at the time of consultation
From 1 September 2018, allied health professionals can deliver all 10 eligible services in a calendar year via videoconferencing. These changes also remove the need for 1 face-to-face consultation within the first 4 videoconferencing sessions.
Group therapy services involve 6-10 patients and can be:
- psychological therapy delivered via videoconference with a clinical psychologist - item 80021
- FPS services delivered via videoconference with a psychologist - item 80121
- FPS services delivered via videoconference with an occupational therapist - item 80146
- FPS services delivered via videoconference with a social worker - item 80171
Practitioners can’t claim telehealth attendance items for services provided to admitted hospital and hospital in-the-home patients.
To claim telehealth items there must be a visual and audio link between the patient and the practitioner. A practitioner can’t claim this rebate if they can’t establish both a video and audio link with the patient. Practitioners can’t claim telehealth benefits for telephone or email consultations.
Case study: Individual services provided in 2 calendar years
Under Better Access, a patient can claim a maximum of 10 allied mental health individual services each calendar year.
Services are counted towards the year when a patient attends the service, rather than the year they are referred. This is also the case when a patient completes 2 courses of treatment over consecutive calendar years.
For example, a medical practitioner refers a patient for a course of treatment of 5 individual allied health services.
The patient receives 2 services in calendar year 1. In calendar year 2 the patient receives the remaining 3 services. The patient has now completed the course of treatment as they have been to 5 services. 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 another course of treatment. The next course includes 4 individual allied mental health services.
The patient receives all 4 services for this course of treatment during calendar year 2. The patient has now completed the course of treatment as they have been to 4 services. 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 can claim 3 more individual services in calendar year 2.
Read more about:
- the Schedule at MBS Online
- education services for health professionals
- Better Access
- our website disclaimer
- Health Care Homes
- Health Care Homes for health professionals
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