Education guide - Mental health services - supporting Indigenous health

An overview of Medicare services for managing and treating patients with mental health care needs. Includes an Indigenous patient case study.

A GP mental health treatment plan (GPMHTP) helps people with a mental health disorder access mental health services. It also helps practitioners better manage a patient's treatment by referring them to Medicare-subsidised allied mental health services. Practitioners can use a GPMHTP under the Better Access initiative.

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

This page covers:

  • preparing a GPMHTP
  • referring patients to mental health professionals
  • claiming treatment items
  • an Indigenous patient case study.

Make sure you read the relevant Medicare Benefits Schedule (MBS) item descriptions and explanatory notes at MBS Online.

Preparing a GPMHTP

Before preparing a GPMHTP, practitioners have to assess their patient’s eligibility. They must then follow all steps to complete a GPMHTP.

Patient eligibility

To be eligible the practitioner has to assess if their patient has a mental disorder. A mental disorder is a clinically diagnosable disorder that significantly interferes with an individual’s cognitive, emotional or social abilities.

A patient doesn’t have to have a chronic medical condition to have a mental disorder.

Practitioners treating in-patients must claim a GPMHTP item as an in-hospital service.

Under this initiative dementia, delirium, tobacco use disorder and mental retardation are not regarded as mental disorders.

Steps in the GPMHTP process

The practitioner must complete all actions of the GPMHTP process.

There are 2 main steps in the process:

Step 1 - Preparing a GPMHTP

  • assessment of a patient - assess and plan
  • preparation of the plan - provide or refer the patient for appropriate treatment and services.

Step 2 - Reviewing a GPMHTP

The table below details steps and requirements of the GPMHTP process.

Component Description Actions by the eligible practitioner
Step 1 - Part A Assessment of a patient

The practitioner must:

  • attend to the patient and complete all parts of the consultation
  • explain all steps involved in the service to the patient
  • explain steps to the patient’s carers if needed and with the patient’s permission
  • get and record the patient's agreement for the GPMHTP service
  • take relevant history, including biological, psychological and social history as well as details of the presenting complaint
  • conduct a mental state examination
  • assess associated risks and related illnesses
  • make a diagnosis and/or a plan
  • administer an outcome measured tool, except where not clinically needed.
Step 1 - Part B Preparation of a GPMHTP

The practitioner must:

  • discuss the assessment, including diagnosis and/or a plan, with the patient
  • identify and discuss referral and treatment options with the patient
  • agree on goals with the patient
  • provide psycho-education
  • create a plan for crisis intervention and/or relapse intervention, if needed
  • arrange for required referrals, treatment, support services, review and follow-up consultations
  • document all information in the patient's GPMHTP and keep it on their file
  • offer the patient a copy of the treatment plan
  • offer a copy of the treatment plan to the patient’s carers if needed and with the patient’s permission.
Step 2 Reviewing a GPMHTP

The practitioner must:

  • attend to the patient and complete all parts of the consultation personally
  • explain all steps to the patient
  • explain steps to the patient's carers if needed and with the patient’s permission
  • get and record the patient's agreement to proceed
  • review the patient's progress against the goals outlined in the GPMHTP
  • modify the documented GPMHTP, if required
  • check, reinforce and expand on education
  • create a plan for crisis intervention and/or relapse prevention, if needed and not previously provided
  • re-administer the outcome measurement tool used in the assessment step, unless not needed clinically
  • document all information in the patient's GPMHTP and keep it on their file
  • offer the patient a copy of the reviewed treatment plan
  • offer a copy of the reviewed treatment plan to the patient’s carers if needed and with the patient’s permission.

Practitioners can complete Step 1 for more than 1 consultation, but can only claim 1 GP mental health treatment item.

See below for claiming details for GP mental health treatment items.

Referring for allied mental health services

Under a GPMHTP, practitioners can refer eligible patients to allied mental health professionals for these services:

  • clinical psychologists for psychological therapy services
  • registered psychologists for focussed psychological strategies (FPS) services
  • occupational therapists for FPS services
  • social workers for FPS services.

All mental health professionals must register with us and meet the eligibility requirements as set out on MBS Online.

Patient entitlements for allied mental health services

Under a GPMHTP patients can have a maximum of:

  • 20 individual allied mental health services per calendar year
  • 10 group therapy services per calendar year.

Practitioners can refer a patient for a course of treatment, which can:

  • include a maximum of 6 services in any 1 referral for initial treatment services or 10 services in any 1 referral for additional treatment services
  • be for individual or group services
  • be a combination of services, such as FPS services and psychological therapy services.

Practitioners can refer a patient for multiple courses of treatment within the patient's maximum entitlement in the calendar year. It is up to the referring practitioner to determine whether this is necessary.

Referral validity

Patients need to get a new referral from their practitioner if they:

  • use all their referred services
  • haven't reached their maximum entitlements for that calendar year.

Patients with unused referred services at the end of the calendar year can use them the next year without a new referral. These services count towards their maximum of 20 individual services for the new calendar year.

Referral forms

Referring practitioners must provide a referral before an allied mental health professional has their first consultation with the patient. The referral should include similar information to medical practitioner referral requirements. Where appropriate and with the patient’s agreement, you can include a copy of the patient's GPMHTP. There are no specific referral forms.

You must keep the referral for 24 months after the date of the first service.

Allied mental health professional reporting

Allied mental health professionals must give a written report about their patient’s treatment to the referring practitioner. They should complete this report once the patient has finished their course of treatment.

Other referral pathways for allied mental health services

Eligible patients who don't have a GPMHTP can access MBS allied mental health services via referrals from:

  • psychiatrists - under an assessment and management plan item
  • specialist psychiatrists or paediatricians
  • consultant psychiatrists
  • consultant physician paediatricians.

For more information visit the MBS Online website.

Claiming details for GP mental health treatment items

The table below gives details about GP mental health treatment items and claiming them. GPs and non-VR MPs can use these MBS items in general practice. Specialists or consultant physicians can’t use them.

Note: the COVID-19 Temporary MBS Telehealth Services for mental health items are available until 30 June 2021.

Service Face-to-face and telehealth MBS items Temporary COVID-19 telehealth MBS items Temporary COVID-19 telephone MBS items Frequency
Prepare a GP mental health treatment plan (GPMHTP) 272 276
281-282
2700-2701
2715 2717
92112-92113
92116-92119
92122-92123
92124-92125
92128-92131
92134-92135
  • 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 92114
92120
92126
92132
  • 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 92115
92121
92127
92133
  • 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
91818-91819
91820-91821
91842-91843
91844-91845
  • Practitioners can use these items up to 10 times every 12 months.
Provide additional focused psychological strategies (FPS) services 93300
93303
93306
93309
93301
93304
93307
93310
93302
93305
93308
93311
  • Practitioners can use these items up to 10 times every 12 months.

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. The table below gives details about GP mental health treatment items and claiming for aged care residents.

Service Face-to-face and telehealth MBS items Temporary COVID-19 telehealth MBS items Temporary COVID-19 telephone MBS items Frequency
Prepare a GP mental health treatment plan (GPMHTP) 93400-93403
93431-93434
93404-93407
93435-93438
93408-93411
93439-93442
  • 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 93421
93451
93422
93452
93423
93453
  • Practitioners can use these items once every 3 months
  • Practitioners can’t use these items within 4 weeks of claiming a GPMHTP item.
Provide initial focused psychological strategies (FPS) services 371-372
941-942
2729-2731
2733-2735
91818-91819
91820-91821
91842-91843
91844-91845
  • Practitioners can use these items up to 10 times every 12 months.
Provide additional focused psychological strategies (FPS) services 93287-93288
93291-93292
93301
93304
93307
93310
93302
93305
93308
93311
  • Practitioners can use these items up to 10 times every 12 months.

There are minimum periods for claiming the items above unless there are exceptional circumstances, such as significant changes to a patient's clinical condition.

The health professional must determine whether the service is clinically relevant when providing these services. A clinically relevant service is one that a relevant professional accepts as necessary for appropriately treating the patient.

Case study

You are a medical practitioner with mental health skills training, practising at a remote community health service. You have an 18-year-old Indigenous patient who has:

  • a history of good physical health
  • only required minimum medical attention in the past
  • recently had a health assessment.

Assessment

The patient visits you about an ongoing sleep issue, that includes several bouts of insomnia. During your discussion, your patient becomes teary and shows signs of mood swings. You assess that they’re not experiencing any other physical health issues requiring treatment for their sleep condition. You're concerned about their mental wellbeing.

To address your patient’s mental health issues, you determine they would benefit from a GPMHTP, item 2715 or 2717. You discuss this plan and they agree. You record their acceptance to proceed.

You collect information about your patient’s past and current conditions and perform a mental health examination. During your discussion, your patient reveals that for the last 6 months they've:

  • experienced feelings of isolation and low self esteem
  • avoided social contact from friends and family
  • had periods of sadness.

You assess that your patient is displaying signs and symptoms of depression and may require psychiatric evaluation.

Preparation of the GPMHTP

As part of your strategy to improve your patient’s mental wellbeing, you determine that you should refer them for individual allied mental health services with a psychologist.

You discuss your assessment and strategy for managing their mental wellbeing, including the benefit limits for mental health services provided under Medicare. They agree with your plan.

You complete the necessary referral and arrange an appointment for your patient with the psychologist. Finally, you document all required information in their GPMHTP and provide them with a copy.

Review and ongoing support

As part of your strategy to improve your patient’s mental health you:

  • schedule an appointment for a GPMHTP review consultation in 4 weeks’ time using item 2712
  • assign follow-up services with the Aboriginal Health Practitioner to monitor risk of self-harm. The Aboriginal Health Practitioner will review the patient during weekly outreach visits to your patient’s community
  • consider the need to refer your patient for a psychiatric assessment
  • continue to provide ongoing care and management of their mental health disorder.

More information

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

Read more about:

Contact us for MBS item interpretation.

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Page last updated: 19 July 2021