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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)
- 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
|Review a mental health treatment plan||277 2712||93421
|Manage a patient’s mental health condition||279 2713 or a general consultation item||
|Provide initial focused psychological strategies (FPS) services||283-287
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
|Provide additional focused psychological strategies (FPS) services to an aged care resident||93287-93288
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
- 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.
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.
|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.
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.
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.
We have eLearning modules that will help you to understand access to mental health services:
- Access to Mental Health Services eligible medical practitioners
- Access to Mental Health Services – allied mental health professionals.
Read more about:
- the Schedule at MBS Online
- MBS and telehealth
- Better Access
- our website disclaimer
- Modified Monash areas and the Health Workforce Locator at DoctorConnect.
Contact us for MBS item interpretation.