Allied health referrals for mental health treatment services

Allied health professional eligibility

Under Better Access, these allied health professionals can provide mental health treatment services:

clinical psychologists
registered psychologists
occupational therapists
social workers.

If you have met the qualification requirements, you must register with us to ensure eligibility requirements are met.

You can check your own eligibility for claiming Medicare Benefit Schedule (MBS) items through the MBS items online checker in HPOS. You can also call us.

Read more about the Better Access initiative on the Department of Health, Disability and Ageing website.

Patient eligibility

If your patient is eligible to receive Better Access mental health treatments services, a referral must be made from either:

a general practitioner (GP) or prescribed medical practitioner (PMP) managing the patient under a Mental Health Treatment Plan (MHTP)
a psychiatrist managing the patient under a referred psychiatrist assessment and management plan (PAMP)
direct referral by a psychiatrist or paediatrician.

Referrals under a MHTP must have been provided by either the patient’s usual medical practitioner, or a GP or PMP at the general practice the patient visits. If the patient is enrolled in MyMedicare the referral must be from that practice.

If you’re not sure if your patient is eligible, you can contact the referring practitioner. You can continue to treat patients who aren’t eligible, but they can’t access Medicare benefits for the services you provide.

You can call us to check the following:

if a patient has claimed a MHTP, PAMP or an eligible service from a psychiatrist or paediatrician
how many mental health treatment services the patient has already claimed in the calendar year.

Referral course of treatment

The number of services stated in the referral is a ‘course of treatment’.

The maximum limit for each course of individual treatment is:

a maximum of 6 services for the initial course of treatment
the remaining services for subsequent courses of treatment, up to the maximum of 10 services per calendar year

Referring practitioners may also refer a patient for up to 10 group therapy mental health treatment services in any one referral.

Patients need a new referral for each course of individual and group therapy mental health treatment.

Referral format and content

There’s no standard form for mental health referrals. A patient can be referred for mental health treatment services with a signed and dated letter. An electronic signature from the referring practitioner is acceptable.

The referral should include:

the patient’s name
date of birth
address
their symptoms or diagnosis
any current medications
the number of treatment services the patient is being referred for
a statement about whether the patient has a MHTP or PAMP prepared.

Referral validity

Referrals are valid for the number of services shown on the referral letter, even if the patient changes their treating allied health professional.

If your patient has unused services on their referral at the end of the calendar year, they can use them the next year, but they will count towards the new year’s claiming limit.

Calendar year claiming limits

In a calendar year, your patient can get psychological therapy and FPS services up to the combined limit of:

10 individual services
10 group services.

A calendar year is from 1 January to 31 December. We calculate the yearly claiming limit on the date of service, not when the treatment was referred. Once a patient has reached their service limit, you can keep treating them, but they can’t access Medicare benefits for your services.

Better Access services for family and carer participation

Better Access services allow eligible health professionals to deliver up to a maximum of 2 services per calendar year to a family member or carer of the patient. Eligible health professionals include:

GPs
PMPs
clinical psychologists
psychologists
occupational therapists
social workers.

These Better Access services can be provided to a family member or carer, where the:

patient has been referred for Better Access mental health treatment services as part of a MHTP, PAMP or direct referral from a psychiatrist or paediatrician
treating or referring practitioner determines it is clinically appropriate
patient consents for the service to be provided to their family member or carer as part of their treatment
service is part of the patient’s treatment
patient isn’t in attendance.

Any services delivered using these MBS items count towards the patient’s Better Access calendar year allocation for individual services.

These services recognise the important role family members and carers play in supporting patients with mental illness. Involving family members and carers in treatment benefits patient outcomes.

You can check patient eligibility and claiming conditions in the MBS items online checker in HPOS.

Reporting requirements

You must provide a written report to the referring medical practitioner after completing each course of treatment.

It must include all of the following:

assessments carried out on the patient
treatments provided
recommendations on future management of the patient’s disorder.

You don’t need to use an approved form to write a report.

If your patient doesn’t complete treatment, you need to write your report after the last service. If they return later and complete the course of treatment, you’ll need to write another report.

Telehealth for mental health treatment services

Telehealth MBS items provide Medicare benefits for Better Access mental health treatment services.

Video services are the preferred alternative to face-to-face services. However, you can provide some services via phone if video is not available.

You can deliver all individual mental health treatment services by telehealth if safe and clinically appropriate to do so.

Group therapy services involving 4 to 10 patients can be delivered by video in certain circumstances for:

psychological therapy with an eligible clinical psychologist
focussed psychological strategies with an eligible registered psychologist, occupational therapist or social worker.

When delivering the group therapy video service, your patients must:

have both a visual and audio link with you
be located in an area within regions 4-7 of the Modified Monash Model
be located at least 15 km by road from you at the time of consultation.

You can read about telehealth item numbers.

You can use the MBS items online checker in HPOS to view and check patient eligibility based on their MBS history.

Read more about the Better Access Initiative at MBS Online or in the Better Access Initiative resource collection.

Read about the relevant MBS item descriptions, fact sheets and explanatory notes on the MBS Online website.