View Associated Notes
Category 1 - PROFESSIONAL ATTENDANCES
90266 - Additional Information
Professional attendance at consulting rooms by a consultant physician in the practice of the physician’s specialty of psychiatry to review an eating disorder treatment and management plan, if:
(a) the patient is referred; and
(b) the attendance lasts at least 30 minutes
Fee: $303.65 Benefit: 85% = $258.15
(See para AN.36.1, AN.36.3, AN.40.1 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
Eating Disorders General Explanatory Notes
Eating Disorders General Explanatory Notes (items 90250-90257, 90260-90267, 90271-90278; 92182,92184, 92186 and 92188; 92194, 92196, 92198 and 92200)
This note provides a general overview of the full range of 1 November 2019 eating disorders items and supporting information more specifically on the Category 1 – Professional Attendances: Group A36 – Eating Disorders Services (90250-90257, 90260-90267; 90271-90278 92182,92184, 92186 and 92188; 92194, 92196, 92198 and 92200).
It includes an overview of the items, model of care, patient eligibility, and links to other guidance and resources.
All 1 November 2019 Eating Disorders items:
The Eating Disorders items define services for which Medicare rebates are payable where service providers undertake assessment and management of patients with a diagnosis of anorexia nervosa and patients with other specified eating disorder diagnoses who meet the eligibility criteria (see – patient eligibility). It is expected that there will be a multidisciplinary approach to patient management through these items.
The items mean eligible patients are able to receive a Medicare rebate for development of an eating disorders treatment plan by a medical practitioner in general practice (Group A36, subgroup 1 and Group A40 subgroup 21), psychiatry or paediatrics (Group A36, subgroup 2 and Group A40, subgroup 23), psychiatry or paediatrics (Group A36, subgroup 2 and Group A40, subgroup 23). Patients with an eating disorders treatment and management plan (EDP) will be eligible for comprehensive treatment and management services for a 12 month period, including:
- Up to 20 dietetic services under items 110954, 82350, 93074 and 93108.
- Up to 40 eating disorder psychological treatment services (EDPT service).
- Review and ongoing management services to ensure that the patient accesses the appropriate level of intervention (Group A36, subgroup 3).
An EDPT service includes mental health treatment services which are provided by an allied health professional or a medical practitioner in general practice with appropriate mental health training. These treatment services include:
- Medicare mental health treatment services currently provided to patients under the ‘Better Access to Psychiatrists, Psychologists and General Practitioners through the MBS (‘Better Access’) initiative.
- This includes medical practitioner items 2721, 2723, 2725, 2727, 283, 285, 286, 287 and
- Their equivalent telehealth and phone items 91818, 91819, 91820, 91844, 91821 and 91845
- This includes allied health items in Groups M6 and M7 of Category 8; and
- Items for EDPT services provided by suitably trained medical practitioners in general practice (items 90271, 90278, 92182, 92184, 92186, 92188, 92194, 92198 and 92200)
- new items for EDPT services provided by eligible clinical psychologists (items 82352-82359; 93076, 93079, 93110 and 93113), eligible psychologists (items 82360-82367; 93084, 93087, 93118 and 93121), eligible occupational therapists (items 82368-82375; 93092, 93095, 93126 and 93129) and eligible social workers (items 82376-82383; 93100, 93103, 93134 and 93137)
For the purpose of the 40 EDPT count; eating disorder psychological treatment service includes a service under provided under the following items: 90271, 90272, 90273, 90274, 90275, 90276, 90277, 90278, 92182, 92184, 92186, 92188, 92194, 92196, 92198 and 92200, 2721, 2723, 2725, 2727, 283, 285, 286, 287, 91818, 91819, 91820 91821; 91842, 91843, 91844 and 91845 and items in Groups M6, M7 and M16 (excluding items 82350 93074 and 93108)
For any particular patient, an eating disorder treatment and management plan expires at the end of a 12 month period following provision of that service. After that period, a patient will require a new EDP to continue accessing EDPT services.
The Eating Disorder items are available to eligible patients in the community. These items do not apply to services provided to admitted (in-hospital) patients.
The referring practitioner is responsible for determining that a patient is eligible for an EDP and therefore EDPT and dietetic services.
‘Eligible patient’ defines the group of patients who can access the new eating disorder services. There are two cohorts of eligible patients.
- Patients with a clinical diagnosis of anorexia nervosa; or
- Patients who meet the eligibility criteria (below), and have a clinical diagnosis of any of the following conditions:
- bulimia nervosa;
- binge-eating disorder;
- other specified feeding or eating disorder.
The eligibility criteria, for a patient, is:
- a person who has been assessed as having an Eating Disorder Examination Questionnaire score of 3 or more; and
- the condition is characterised by rapid weight loss, or frequent binge eating or inappropriate compensatory behaviour as manifested by 3 or more occurrences per week; and
- a person who has at least two of the following indicators:
- clinically underweight with a body weight less than 85% of expected weight where weight loss is directly attributable to the eating disorder;
- current or high risk of medical complications due to eating disorder behaviours and symptoms;
- serious comorbid medical or psychological conditions significantly impacting on medical or psychological health status with impacts on function;
- the person has been admitted to a hospital for an eating disorder in the previous 12 months;
- inadequate treatment response to evidence based eating disorder treatment over the past six months despite active and consistent participation.
Practitioners should have regard to the relevant diagnostic criteria set out in the Diagnostic and Statistical Manual of the American Psychiatric Association – Fifth Edition (DSM-5)
Practitioners can access the Eating Disorder Examination Questionnaire at https://www.credo-oxford.com/pdfs/EDE_17.0D.pdf
The Eating Disorders Items Stepped Model of Care
The eating disorder items incorporate a ‘stepped model’ for best practice care for eligible patients with eating disorders that comprise:
- assessment and treatment planning
- provision of and/or referral for appropriate evidence based eating disorder specific treatment services by allied mental health professionals and provision of services by dietitians
- review and ongoing management items to ensure that the patient accesses the appropriate level of intervention.
The Stepped Model
‘STEP 1’ – PLANNING (trigger Eating Disorders pathway) 90250-90257; 92146 to 92153 and 90260 or 90261
An eligible patient receives an EDP developed by a medical practitioner in general practice (items 90250-90257), psychiatry (items 90260) or paediatrics (items 90261).
‘STEP 2’ – COMMENCE INITIAL COURSE OF TREATMENT (psychological & dietetic services)
Once an eligible patient has an EDP in place, the 12 month period commences, and the patient is eligible for an initial course of treatment up to 20 dietetic services and 10 eating disorder psychological treatment (EDPT) services. A patient will be eligible for an additional 30 EDPT services in the 12 month period, subject to reviews from medical practitioners to determine appropriate intensity of treatment.
‘STEP 3” – CONTINUE ON INITIAL COURSE OF TREATMENT 90264-90267 (managing practitioner review and progress up to 20 EDPT services)
It is expected that the managing practitioner will be reviewing the patient on a regular, ongoing and as required basis. However, a patient must have a review of the EDP (90264-90267; 92170, 92171, 92175 and 92177), to assess the patient’s progress against the EDP or update the EDP, before they can access more than 10 EDPT services. This is known as the ‘first review’. The first review should be provided by the patient’s managing practitioner, where possible.
‘STEP 4’ FORMAL SPECIALIST AND PRACTITIONER REVIEW 90266 and 90267 (continue beyond 20 EDPT services)
A patient must have two additional reviews before they can access more than 20 EDPT services. One review (the ‘second review’) must be performed by a medical practitioner in general practice (who is expected to be the managing practitioner), and the other (the ‘third review’) must be performed by a paediatrician (90267 or 92173) or psychiatrist (90266 or 92172). Should both recommend the patient requires more intensive treatment, the patient would be able to access an additional 10 EDPT services in the 12 month period. These reviews are required to determine that the patient has not responded to treatment at the lower intensity levels.
The patient’s managing practitioner should be provided with a copy of the specialist review.
The specialist review by the psychiatrist or paediatrician can occur at any point before 20 EDPT services. The practitioner should refer the patient for specialist review as early in the treatment process as appropriate. If the practitioner is of the opinion that the patient should receive more than 20 EDPT services, the referral should occur at the first practitioner review (after the first course of treatment) if it has not been initiated earlier.
Practitioners should be aware that the specialist review can be provided via telehealth (92172 and 92173). Where appropriate, provision has been made for practitioner participation on the patient-end of the telehealth consultation.
It is expected that the managing practitioner will be reviewing the patient on a regular, ongoing and as required basis. However, a patient must have a review of the EDP (90264-90267), to assess the patient’s progress against the EDP or update the EDP, before they can access the next course of treatment.
‘STEP 5’ ACCESS TO MAXIMUM INTENSITY OF TREATMENT 90266-90267 (continue beyond 30 EDPT services)
To access more than 30 EDPT treatment services in the 12 month period, patients are required to have an additional review (the ‘fourth review’) to ensure the highest intensity of treatment is appropriate. Subject to this review, a patient could access the maximum of 40 EDPT treatment services in a 12 month period. The fourth review should be provided by the patient’s managing practitioner, where possible.
An Integrated Team Approach
A patient’s family and/or carers should be involved in the treatment planning and discussions where appropriate. The family can be involved in care options throughout the diagnosis and assessment, and are usually the support unit that help to bridge the gap between initial diagnosis and eating disorder specific treatment.
The National Standards for the safe treatment of eating disorders specify a multi-disciplinary treatment approach that provides coordinated psychological, physical, behavioural, nutritional and functional care to address all aspects of eating disorders. People with eating disorders require integrated inter-professional treatment that is able to work within a framework of shared goals, care plans and client and family information. Frequent communication is required between treatment providers to prevent deterioration in physical and mental health (RANZCP Clinical Guidelines: Hay et al., 2014). Consider regular case conferencing to ensure that the contributing team members are able to work within a shared care plan and with client and carers to achieve best outcomes.
Clinical guidelines and other resources
It is expected that the consultants providing services under these items should have the appropriate skills, knowledge and experience to provide eating disorders treatment. However, there are a number of resources which may be of assistance to practitioners in supporting and developing EDP and EDPT plans, these include:
- The Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of eating disorders
- The Royal Australian and New Zealand College of Psychiatrists (RANZCP) Referred Patient Assessment and Management Plan Guidelines
Note: This information is provided as a guide only and each case should be addressed according to a patient's individual needs. An electronic version of the Guidelines is available on the RANZCP website at www.ranzcp.org
National Eating Disorders Collaboration Eating Disorders: a professional resources for general practitioners available at www.nedc.com.au
Eating Disorders Training
It is expected that practitioners who are providing services under these items have appropriate training, skills and experience in treatment of patients with eating disorders and meet the national workforce core competencies for the safe and effective identification of and response to eating disorders more information available at National Eating Disorders Collaboration
Practitioners should contact their professional organisation to identify education and training which may assist to practitioners to gain the skills and knowledge to provide services under these items.
The following organisations provide training which may assist practitioners to meet the workforce competency standards:
- The Australia and New Zealand Academy of eating disorders (ANZAED) - National
- InsideOut Institute - National
- The Victorian Centre of Excellence in Eating Disorders (CEED) - VIC
- Queensland Eating Disorder Service (QuEDS) - QLD
- Statewide Eating Disorder Service (SEDS) - SA
- WA Eating Disorders Outreach & Consultation Service (WAEDOCS) – WA
This list is not exhaustive but has been included to provide examples on the types of training available which may assist practitioners to upskill in this area.
Related Items: 90250 90251 90252 90253 90254 90255 90256 90257 90260 90261 90264 90265 90266 90267 90271 90272 90273 90274 90275 90276 90277 90278
Category 1 - PROFESSIONAL ATTENDANCES
Eating Disorders Treatment and Management Plan Reviews
Eating Disorders Treatment and Management Plan Reviews (items 90264-90269)
This note provides information on Eating Disorders Treatment and Management Plan (EDP) review items and should be read in conjunction with the AN.36.1 Eating Disorders General Explanatory Notes and the AN.36.2 Eating Disorders Treatment and Management Plans Explanatory Notes
Eating Disorder Treatment Plan review (EDR) items overview
The EDR items define services for which Medicare rebates are payable where practitioners undertake to review the efficacy of the patient’s eating disorder treatment and management plan (EDP). This includes modifying the patient’s plan, where appropriate, to improve patient outcomes. The review services can be provided by medical practitioners working in general practice, psychiatry and paediatrics.
An EDR may be provided by the managing practitioner who prepared the patient's initial plan (or another practitioner in the same practice or in another practice where the patient has changed practices) and should include a systematic review of the patient's progress against the initial EDP (whether it was prepared by a GP, psychiatrist or paediatrician) and by completing the activities that must be included in a review (see below).
When to render an EDR review item
It is expected that the managing practitioner will be reviewing the patient on a regular, ongoing and as required basis. However, a patient must have a review of the EDP to assess the patient’s progress against the EDP or update the EDP, as the patient is approaching the end of each course of treatment before they can access the next course of treatment.
The eating disorder items incorporate a ‘stepped model’ for best practice care for eligible patients with eating disorders. Under the Eating Disorders Items Stepped Model of Care a course of treatment is defined as 10 eating disorder psychological treatment (EDPT) services. It is required that a patient must have a review after each course of treatment (see AN.36.1 Eating Disorders General Explanatory Notes).
Reviewing an Eating Disorders Treatment Plan
The EDR must include:
- recording the patient's agreement for this service;
- referral to a psychiatrist or paediatrician for review under items 90266-90269, if this has not been initiated at an earlier stage;
- a review of the patient's progress against the goals outlined in the EDP, including discussion with the patient/and or their family/carer as to whether the EDPT services are meeting their needs;
- modification of the documented EDP if required;
- checking, reinforcing and expanding education;
- a plan for crisis intervention and/or for relapse prevention, if appropriate and if not previously provided; and
- reviewing reports back from the allied mental health professional on the patient’s response to treatment and documenting a recommendation on whether patient should continue with another course of EDPT services with that health professional or another health professional.
Where a consultant psychiatrist or paediatrician provides an EDR, the consultant physician must give the referring practitioner a copy of the diagnosis and the revised EDP within 2 weeks after the attendance. Where a consultant psychiatrist provides an EDR service, the review must also include:
- administering an outcome measurement tool, where clinically appropriate. The choice of outcome tool to be used is at the clinical discretion of the practitioner. Practitioners using such tools should be familiar with their appropriate clinical use, and if not, should seek appropriate education and training; and
- conducting a mental state examination.
Note: It is expected there will be other consultations between the patient and the managing practitioner as part of ongoing patient and medical management, including the ordering and reviewing of the required testing for monitoring the patients’ medical and nutritional status. All other ongoing patient reviews should be claimed under the appropriate item.
Checking patient eligibility for services
Note: The 12 month period commences from the date of the EDP.
To provide an EDR service in items 90264-90269, the patient must have had an EDP 90250-90257 or 90260-90263 in the previous 12 months.
If the EDP service has not yet been claimed, the Department of Human Services will not be aware of the patient's eligibility. In this case the practitioner should, with the patient's permission, contact the referring practitioner to ensure the relevant service has been provided to the patient.
If there is any doubt about whether a patient has had a claim for an eating disorder service, health professionals can access the Health Professionals Online System (HPOS). HPOS is a fast and secure way for health professionals and administrators to check if a patient is eligible for a Medicare benefit for a specific item on the date of the proposed service. However, this system will only return advice that the service/item is payable or not payable.
Patients can also access their own claiming history with a My Health Record or by establishing a Medicare online account through myGov or the Express Plus Medicare mobile app.
Alternatively, health professionals can call the Department of Human Services on 132 150 to check this information, while patients can seek clarification by calling 132 011.
Additional Claiming Information (general conditions and limitations)
Items 90264- 90265 cannot be claimed with item 2713 and 279.
Consultant psychiatrist and paediatrician EDP items 90266- 90269 do not apply if the patient does not have a referral within the period of validity.
Before proceeding with the EDR service the medical practitioner must ensure that:
(a) the steps involved in providing the service are explained to the patient and (if appropriate and with the patient's permission) to the patient's carer; and
(b) the patient's agreement to proceed is recorded.
The medical practitioner must offer the patient a copy of the reviewed EDP and add the document to the patient's records. This should include, subject to the patient's agreement, offering a copy to their carer, where appropriate. The medical practitioner may, with the permission of the patient, provide a copy of the revised EDP, or relevant parts of the plan, to other providers involved in the patient's treatment.
The medical practitioner EDR items cover the service of reviewing an EDP. A separate consultation item can be performed with the EDP if the patient is treated for an unrelated condition to their eating disorder. Where a separate consultation is performed, it should be annotated separately on the patient’s account that a separate consultation was clinically required/indicated.
All consultations conducted as part of the EDP or review must be rendered by the medical practitioner and include a personal attendance with the patient. A specialist mental health nurse, other allied health practitioner, Aboriginal and Torres Strait Islander health practitioner or Aboriginal Health Worker with appropriate mental health qualifications and training may provide general assistance to the medical practitioner in provision of this care.
Additional Claiming Information (interaction with Better Access)
Items 90264-90265 for an EDR, performed by a medical practitioner working in general practice, should not be performed in association with a GP mental health consultation review service (item 2712 and 277).
Category 1 - PROFESSIONAL ATTENDANCES
Specialist and Consultant Physician MBS Telehealth and Telephone attendance items
From 1 January 2022, a number of telehealth items were permanently added to the MBS.
The intent of these ongoing telehealth items is to allow practitioners to provide MBS attendances remotely (by videoconference or telephone) where it is safe and clinically appropriate to do so in accordance with relevant professional standards.
Providing telehealth services by videoconference is the preferred substitution for a face-to-face consultation. However, providers can provide a consultation via telephone where it is clinically relevant (and the service is covered by a relevant telephone item).
A list of the ongoing telehealth items and the equivalent face‑to‑face items can be found at Table 1.
Table 1 – Ongoing telehealth items and equivalent face to face services (out of hospital patients)
|Video items||Telephone items|
|Specialist. Initial attendance||104||91822||-|
|Specialist. Subsequent attendance||105||91823||91833|
|Consultant Physician Services||-|
|Consultant physician. Initial attendance||110||91824||-|
|Consultant physician. Subsequent attendance||116||91825||-|
|Consultant physician. Minor attendance||119||91826||91836|
|Consultant physician. Initial assessment, patient with at least 2 morbidities, prepare a treatment and management plan, at least 45 minutes||132||92422||-|
|Consultant physician, Subsequent assessment, patient with at least 2 morbidities, review a treatment and management plan, at least 20 minutes||133||92423||-|
|Specialist and Consultant Physician Services|
|Specialist or consultant physician, develop a treatment and management plan, patient aged under 25, with an eligible disability||137||92141||-|
|Geriatrician, prepare an assessment and management plan, patient at least 65 years, more than 60 minutes||141||92623||-|
|Geriatrician, review a management plan, more than 30 minutes||143|| 92624
|Consultant Psychiatrist services|
|Consultant psychiatrist, develop a treatment and management plan, patient aged under 25, with a complex neurodevelopmental disorder (such as autism spectrum disorder), at least 45 minutes||289||92434||-|
|Consultant psychiatrist, prepare a management plan, more than 45 minutes||291||92435||-|
|Consultant psychiatrist, review management plan, 30 to 45 minutes||293||92436||-|
|Consultant psychiatrist, attendance, new patient (or has not received attendance in preceding 24 mths), more than 45 minutes||296||92437||-|
|Consultant psychiatrist. Consultation, not more than 15 minutes||300||91827||91837|
|Consultant psychiatrist. Consultation, 15 to 30 minutes||302||91828||91838|
|Consultant psychiatrist. Consultation, 30 to 45 minutes||304||91829||91839|
|Consultant psychiatrist. Consultation, 45 to 75 minutes||306||91830||-|
|Consultant psychiatrist. Consultation, more than 75 minutes||308||91831||-|
|Consultant psychiatrist, group psychotherapy, at least
1 hour, involving group of 2 to 9 unrelated patients or a family group of more than 3 patients, each referred to consultant psychiatrist
|Consultant psychiatrist, group psychotherapy, at least
1 hour, involving family group of 3 patients, each referred to consultant psychiatrist
|Consultant psychiatrist, group psychotherapy, at least
1 hour, involving family group of 2 patients, each referred to consultant psychiatrist
|Consultant psychiatrist, interview of a person other than patient, in the course of initial diagnostic evaluation of patient, 20 to 45 minutes||348||92458||-|
|Consultant psychiatrist, interview of a person other than patient, in the course of initial diagnostic evaluation of patient, 45 minutes or more||350||92459||-|
|Consultant psychiatrist, interview of a person other than patient, in the course of continuing management of patient, not less than 20 minutes, not exceeding 4 attendances per calendar year||352||92460||-|
|Consultant psychiatrist, prepare an eating disorder treatment and management plan, more than 45 minutes||90260||92162|
|Consultant psychiatrist, to review an eating disorder plan, more than 30 minutes||90266||92172|
|Paediatrician Services (also refer to consultant physician services)|
|Paediatrician, develop a treatment and management plan, patient aged under 25, with a complex neurodevelopmental disorder (such as autism spectrum disorder), at least 45 minutes||135||92140|
|Paediatrician, prepare an eating disorder treatment and management plan, more than 45 minutes||90261||92163|
|Paediatrician, to review an eating disorder plan, more than 20 minutes||90267||92173|
|Public Health Physician Services|
|Public health physician, level A attendance||410||92513||92521|
|Public health physician, level B attendance, less than 20 minutes||411||92514||92522|
|Public health physician, level C attendance, at least 20 minutes||412||92515||-|
|Public health physician, level D attendance, at least 40 minutes||413||92516||-|
|Neurosurgeon, initial attendance||6007||92610||-|
|Neurosurgeon, minor attendance||6009||92611||92618|
|Neurosurgeon, subsequent attendance, 15 to 30 minutes||6011||92612||-|
|Neurosurgeon, subsequent attendance, 30 to 45 minutes||6013||92613||-|
|Neurosurgeon, subsequent attendance, more than 45 minutes||6015||92614||-|
|Anaesthetist, professional attendance, advanced or complex||17615||92701||-|
Further information on the telehealth changes can be found at www.mbsonline.gov.au by searching under the Facts Sheets tab – July 2022.
All MBS items for referred attendances require a valid referral. However, if the specialist, consultant physician, consultant psychiatrist, paediatrician or geriatrician has previously seen the patient under a referral that is still valid, there is no need to obtain a specific referral for the purposes of claiming the video and telephone items.
All MBS telehealth and telephone attendance items are stand-alone items and are to be billed instead of a face‑to-face MBS item.
Bulk billing of specialist (and Allied Health) telehealth services is at the discretion of the provider, so long as informed financial consent is obtained prior to the provision of the service.
Further information on the assignment of benefit for bulk billed MBS telehealth services can be found in the ‘Provider Frequently Asked Questions’ at www.mbsonline.gov.au.
Relevant definitions and requirements
Specialist telehealth services (91822, 91823 and 91833) can be billed by all specialities that can currently bill items 104 and 105 or equivalent MBS items. This also includes sports and exercise medicine and occupational and environmental health medicine specialists.
Consultant physician telehealth services (91824, 91825, 91826 and 91836) can be billed by all specialities that can currently bill items 110, 116 and 119 or equivalent MBS items. This also includes pain and palliative medicine, sexual health medicine and addiction medicine.
Consultant physician telehealth services to prepare and review a management plan (92422 and 92423) can be billed by all physicians that can currently bill items 132 and 133 or equivalent MBS items. This also includes sexual health medicine, addiction medicine and paediatricians.
The specialist and consultant physician service for diagnosis and treatment for patients with an eligible disability (92141) can be billed by specialists and consultant physicians that are able to item 137.
Single course of treatment
The same conditions for a single course of treatment apply across all modalities (i.e. face‑to-face, video or telephone). Once an initial consultation is billed, all subsequent services related to the same condition are considered to be part of a single course of treatment. For example, if a patient has seen a specialist in a face‑to‑face consultation (where item 104 has been billed), item 91823 (video) or 91833 (telephone) should be billed if the patient sees the specialist remotely for the same condition.
The Anaesthetist telehealth service (92701) can be billed by practitioners that can currently bill item 17615.
At present, the service limits that apply to standard psychiatry services do not currently apply to the video and telephone attendance items for psychiatry (except for item 92460). Patients who have received more than 50 attendances under existing items are eligible to receive services under the video and telephone psychiatry items as long as they meet the item descriptor requirements.
In addition, patients who have received more than 50 attendances under item 319 are eligible to receive services under the video and telephone psychiatry items as long as they meet the item descriptor requirements.
The Department of Health and Aged Care will work with the Royal Australian and New Zealand College of Psychiatrists (RANZCP) and the Medicare Review Advisory Committee (MRAC) to review the current service limits, and ensure a consistent approach across all of the psychiatry attendance items, including services provided by face‑to‑face, video and telephone.
Interview item (92460)
Item 92460 provides for an interview with a person other than the patient. A maximum of 4 services in a calendar year can be billed under item 92460, or the equivalent face‑to‑face item (item 352), in the continuing management of a patient. That is, a consultant psychiatrist can bill for a service under item 92460 once more in the calendar year if a patient has received three MBS services under items 352 or 92460 in the same calendar year.
Management Plan items (92435 and 92436)
The MBS remote attendance preparation and review of GP management plan items have the same diagnosis, assessment and record-keeping requirements as the existing face-to-face items (291 and 293). Refer to MBS Explanatory Note AN.0.30 for further information.
Group psychotherapy items (92455, 92456 and 92457)
The MBS remote attendance group psychotherapy items have the same requirements as the existing face-to-face items (342, 344 and 346). It is the responsibility of the practitioner rendering the service to maintain privacy and confidentiality for all participants throughout the service. Practitioners should refer to the relevant professional practice standards and guidelines for technology-based consultations.
The services can be provided by telehealth and by phone. It is the responsibility of the practitioner rendering the service to maintain privacy and confidentiality for all participants throughout the service.
Telehealth attendance means a professional attendance by video conference where the medical practitioner:
- has the capacity to provide the full service through this means safely and in accordance with relevant professional standards; and
- is satisfied that it is clinically appropriate to provide the service to the patient; and
- maintains a visual and audio link with the patient; and
- is satisfied that the software and hardware used to deliver the service meets the applicable laws for security and privacy.
Note – only the time where a visual and audio link is maintained between the patient and the provider can be counted in meeting the relevant item descriptor.
No specific equipment is required to provide Medicare-compliant telehealth services. Practitioners must ensure that their chosen telecommunications solution meets their clinical requirements and satisfies privacy laws. Information on how to select a web conferencing solution is available at: www.cyber.gov.au
Phone attendance means a professional attendance by telephone where the health practitioner:
- has the capacity to provide the full service through this means safely and in accordance with professional standards; and
- is satisfied that it is clinically appropriate to provide the service to the patient; and
- maintains an audio link with the patient.
There are no longer geographic restrictions on the MBS video or telephone services provided by specialists, consultant physicians, consultant psychiatrists, paediatricians, geriatricians and anaesthetists.
Recording Clinical Notes (for specialist, consultant physician, consultant psychiatrist, neurosurgery, public health medicine, geriatrician, paediatrician and anaesthetist)
In relation to the time taken in recording appropriate details of the service, only clinical details recorded at the time of the attendance count towards the time of consultation. It does not include information added later, such as reports of investigations, or when either the visual or audio link between the patient and the practitioner is lost.
Clinicians should record the date, time and duration of the consultation, and retain these records.
Related Items: 104 105 110 116 119 132 133 135 137 141 143 289 291 293 296 300 302 304 306 308 342 344 346 348 350 352 410 411 412 413 6007 6009 6011 6013 6015 90260 90261 90266 90267 91822 91823 91824 91825 91826 91833 91836 92422 92423
- Assist - Addition/Deletion of (Assist.)
- Amend - Amended Description
- Anaes - Anaesthetic Values Amended
- Emsn - EMSN Change
- Fee - Fee Amended
- Renum - Item Number Change (renumbered)
- New - New Item
- NewMin - New Item (previous Ministerial Determination)
- Qfe - QFE Change