Better Access Initiative - supporting mental health care

The purpose of the Better Access initiative is to improve treatment and management of mental illness within the community. Better Access aims 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)
psychiatrists
clinical psychologists
registered psychologists
appropriately trained social workers and occupational therapists.

For more information see 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 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 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 specialists or 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.

Read more about COVID-19 temporary telehealth services on MBS Online.

Service	Patients in the community	Residents of an aged care facility	Frequency
Prepare a GP mental health treatment plan (GPMHTP)	272 276 281-282 2700-2701 2715 2717	93400-93403 93431-93434	Practitioners can use these items once every 12 months Practitioners can’t use these items within 3 months of using a review item.
Review a mental health treatment plan	277 2712	93421 93451	Practitioners can use these items once every 3 months Practitioners can’t use these items within 4 weeks of claiming a GPMHTP item.
Manage a patient’s mental health condition	279 2713 or a general consultation item		Practitioners can use these items as often as necessary. There are no restrictions.
Provide initial focused psychological strategies (FPS) services	283-287 371-372 2721-2731	371-372 941-942 2729-2731 2733-2735	Practitioners can use these items up to 10 times every 12 months.

Additional access to mental health treatment

You can refer your patients for up to 10 additional mental health treatment sessions covered by Medicare. Your patient is eligible for the sessions if all of the following apply:

they’ve got a current mental health treatment plan
they’ve used all of their previous Medicare covered sessions
they’ve had a review with their referring practitioner.

This measure is available until 30 June 2022.

Practitioners can provide and claim for the services in the tables below.

Service	Face-to-face and telehealth MBS items	Frequency
Provide additional focused psychological strategies (FPS) services	93300 93303 93306 93309	Practitioners can use these items up to 10 times every 12 months.
Provide additional focused psychological strategies (FPS) services to an aged care resident	93287-93288 93291-93292	Practitioners can use these items up to 10 times every 12 months.

Billing GP mental health services

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

ask the patient if they have a copy of the previous GPMHTP
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.

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.

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.

For further information about continuity of care for patients previously part of the Health Care Homes trial, see the Department of Health website.

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 each course of treatment is:

6 sessions using the initial MBS items
10 sessions using the additional MBS items.

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

10 initial services
10 additional services.

Patients need a new referral for each course of treatment.

If you provide FPS services to your patient, they’ll 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 patients 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 referral at the end of the calendar year, they can continue to use them the next year.

Calendar year claiming limits for mental health services

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

20 individual services
10 group services.

A calendar year is from 1 January to 31 December.

The yearly claiming limit is calculated on the date of service, not when the treatment was referred.

Once a patient has reached their service limit, you can keep seeing 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.

For more information of the COVID-19 temporary telehealth services see the factsheets on MBS Online.

Sessions	Initial	Additional	Group
Clinical psychologist	80000-80015	93330, 93333	80020-80021
Registered psychologist	80100-80115	93350, 93353	80120-80121
Occupational therapist	80125-80140	93356, 93359	80145-80146
Social worker	80150-80165	93362, 93365	80170-80171

Eligibility requirements for Better Access were expanded from 10 December 2020 to allow aged care residents access to Medicare subsidised psychological services each calendar year.

Sessions	Initial	Additional	Group
Clinical psychologist	93375-93376 80001, 80011	93312-93313	n/a
Registered psychologist	93381-93382 80101, 80111	93316, 93319	n/a
Occupational therapist	93383-93384 80126, 80136	93322-93323	n/a
Social worker	93385-93386 80151, 80161	93326-93327	n/a

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 practitioner 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 see 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.

Allied mental health professional reporting

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

It must include:

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 for allied health

Telehealth MBS items provide Medicare benefits for allied health services provided via videoconferencing. Psychologists, occupational therapists and social workers can use them.

These items are stand-alone and do not have a derived fee structure.

Your patient must:

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

You can deliver all 20 services by videoconference.

Group therapy services involving 6-10 patients and can be delivered by telehealth for:

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

Telehealth restrictions

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

If you can’t establish both a video and audio link with the patient you can’t claim these items.

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

COVID-19 Temporary MBS Telehealth Services

Temporary COVID-19 MBS telehealth and telephone items are available. These services will help reduce the risk of community transmission of COVID-19 and provide protection for patients and health care providers. These temporary items don’t have geographic limitations.

Case study: Individual services provided in 2 calendar years

You’re an occupational therapist specialising in focussed psychologies strategies.

Following a review with their GP, your patient is referred back to you for further treatment. The referral is for 10 additional focussed psychological strategies sessions.

By the end of December you’ve only provided 3 of these additional sessions. You can continue treatment in the next year using the same referral.

Under Better Access, patients can access 20 individual treatment sessions each calendar year. The remaining 7 sessions are carried over into the next year and will count towards the 20 sessions for that year.

Find out more about Referred Allied Health Services.

More information

We have eLearning modules that will help you to understand access to mental health services: