Better Access initiative - supporting mental health care

The Better Access initiative aims to improve treatment and management of mental illness within the community. It gives patients better access to mental health professionals and team-based mental health care.

Under this initiative, patients can access Medicare benefits for selected mental health services provided by:

• general practitioners (GPs)
• non-vocationally registered medical practitioners (non-VR MPs)
• psychiatrists
• clinical psychologists
• psychologists
• social workers
• occupational therapists.

Find out more about the relevant Medicare Benefits Schedule (MBS) item descriptions, fact sheets and explanatory notes at MBS Online.

Confirming mental health items and limits

You can use the MBS items online checker in HPOS for all of the following:

• view and check patient eligibility based on their MBS history
• check your own eligibility for claiming MBS items
• check claiming conditions for MBS items.

You can call us to check both of the following:

• if a patient has claimed a GP mental health treatment plan (GPMHTP)
• how many allied mental health services the patient has already received in the calendar year.

Information for eligible practitioners

You can use these items if you’re working in general practice.

They’re not available to either of the following:

• specialists
• consultant physicians.

The term ‘GP’ in the item descriptions is used as a generic reference to medical practitioners eligible to claim these items.

Under Better Access, you can provide and claim for the services in the tables below.

You should register with us if you’ve completed the mental health skills training accredited by the General Practice Mental Health Standards Collaboration. Once you’ve registered, you can provide GP focused psychological strategies (FPS) services.

Billing GP mental health services

To determine which item applies when billing a GP mental health service you can either:

• ask the patient if they have a copy of the previous GPMHTP
• with the patient’s permission, ask their previous health professional for a copy.

You can review a patient’s previous plan if it’s been in place for more than 4 weeks.

Only prepare a GPMHTP if you’re the patient’s usual practitioner and expect to continue managing their condition.

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
• residents of aged care facilities not admitted to hospital.

To be eligible, a patient must both:

• have a mental disorder
• be likely to benefit from a structured approach to the management of their care needs.

Your patient’s treatment may also include either or both:

• Team Care Arrangements (TCAs)
• Mental Health Case conferences (MHCC).

They both require involvement of a multidisciplinary team. TCAs must both:

• be prepared by the patient’s usual medical practitioner
• involve at least 2 other eligible health providers.

Read more about Chronic disease GP Management Plans and Team Care Arrangements.

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
• FPS services performed by another practitioner with appropriate training.

You can also refer your patient for these services, if you’re managing them under either a:

• referred psychiatrist assessment and management plan
• shared care plan.

Certain allied health services require the patient’s care to be managed under a:

• GP Management Plan and Team Care Arrangements
• GPMHTP or shared care plan.

Referral course of treatment

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

The maximum number of sessions you can include on a referral for the initial course of treatment is 6 using the MBS items.

A patient can have 2 or more courses of treatment within their calendar year with a limit of 10 services.

Patients need a new referral for each course of treatment.

If you provide FPS services to your patient, they count towards the calendar year claiming limits.

Referral format and content

There’s no standard form for mental health referrals. You can refer your patient for services with a signed and dated letter.

The referral should include:

• your patient’s name
• date of birth
• address
• their symptoms or diagnosis
• the number of treatment services required
• a statement about whether the patient has a GPMHTP, shared care plan or a psychiatrist assessment and management plan.

Referral validity

Referrals are valid for the number of services shown on the referral letter or note. Mental health referrals do not expire at the end of the year.

If your patient has unused services on their referral at the end of the calendar year, they can use them the next year.

Calendar year claiming limits for mental health services

In a calendar year, your patient can receive 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.

Information for allied health professionals

Allied mental health services and MBS items

To be an eligible allied health professional, you must both:

• meet the eligibility criteria
• have a Medicare provider number.

Under Better Access, you can provide the services in the tables below.

Patient eligibility for allied mental health services

An eligible health professional must assess your patient as having a mental disorder. The following health professionals can refer allied mental health services:

• a health professional who is managing the patient under a GPMHTP, referred psychiatrist assessment and management plan or shared care plan
• a psychiatrist
• a paediatrician.

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

You must keep copies of referrals for 2 years.

Better Access Services for Family and Carer Participation

Additional MBS items allow eligible GPs, Non-VR medical practitioners, clinical psychologists, psychologists, occupational therapists and social workers to deliver up to 2 Better Access services per calendar year. These Better Access services can be provided to a person other than the patient, where:

• the patient has been referred for Better Access services (for allied health professionals delivering these services)
• the treating or referring practitioner determines it is clinically appropriate
• the patient consents for the service to be provided to the person as part of their treatment
• the service is part of the patient’s treatment
• the patient isn’t in attendance.

Any services delivered using these MBS items count towards the patient’s calendar year allocation for individual services, under Better Access. There’s a maximum of 2 services per calendar year.

These changes 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.

This table includes both face-to-face, telehealth video and phone items:

Allied mental health professional reporting

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

It must include all of the following:

• assessments carried out on the patient and, where relevant, the progress made
• treatments provided
• recommendations on future management of the patient’s disorder.

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

Reporting when a patient doesn’t complete a course of treatment

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

Telehealth restrictions

You can’t claim telehealth attendance items for services provided to admitted hospital and hospital in-the-home patients.

Telehealth MBS items can’t be used for email consultations.

Ongoing Telehealth Arrangement

MBS telehealth video and phone services introduced on a temporary basis in response to the COVID-19 pandemic are now permanent. Most of these items don’t have geographic limitations.

Find more about MBS telehealth services on MBS Online.

Telehealth for allied health

Telehealth MBS items provide Medicare benefits for allied health services provided via video conferencing. Telehealth services are the preferred alternative to face-to-face consultations. However, you can provide some services via phone if telehealth is not available. Telehealth and phone services have separate MBS item numbers.

The following health professionals can use these items:

• psychologists
• clinical psychologists
• occupational therapists
• social workers.

These items are standalone and don’t have a fee loading structure.

You can deliver all 10 services by telehealth.

Group therapy services involving 4 to 10 patients can be delivered by telehealth for:

• psychological therapy with a clinical psychologist
• FPS with a psychologist, occupational therapist or social worker.

Your patients must:

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