Medicare Benefits Schedule - Note A46

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Category 1 - PROFESSIONAL ATTENDANCES

A46

Provision of Focussed Psychological Strategies - (Items 2721 to 2727)

Focussed psychological strategies are specific mental health care management strategies, derived from evidence based psychological therapies that have been shown to integrate the best research evidence of clinical effectiveness with general practice clinical expertise.  The decision to recommend Focussed Psychological Strategies to a patient must be made either in the context of a GP Mental Health Treatment Plan or a Psychiatrist Assessment and Management Plan.

 

Minimum Requirements

All consultations providing Focussed Psychological Strategies must be rendered by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician). 

 

To ensure appropriate standards for the provision of Focussed Psychological Strategies, payment of Medicare rebates for these items will be limited to medical practitioners who are registered with the Department of Human Services as having satisfied the requirements for higher level mental health skills for provision of the service, as determined by the General Practice Mental Health Standards Collaboration.

 

Continued access to item numbers 2721 - 2727 will be dependent on the practitioner meeting the ongoing mental health education requirements as determined by the General Practice Mental Health Standards Collaboration.

 

Patients will be permitted to claim Medicare rebates for up to ten allied mental health services under these item numbers per calendar year.  The ten services may consist of: GP focussed psychological strategies services (items 2721 to 2727); and/or psychological therapy services (items 80000 to 80015); and/or focussed psychological strategies - allied mental health services (items 80100 to 80115; 80125 to 80140; 80150 to 80165).

 

The referring practitioner may consider that in exceptional circumstances the patient may require an additional 6 services above those already provided (to a maximum total of 16 individual services per patient from 1 March 2012 to 31 December 2012). 

 

Note: Patients will be able to receive an additional six individual allied mental health services under exceptional circumstances from 1 March 2012 to 31 December 2012.  From 1 January 2013 the number of individual allied mental health services for which a person can receive a Medicare rebate will be ten services per calendar year.

 

After the patient has received 10 focussed psychological strategies services, the practitioner managing the patient under either the GP Mental Health Treatment Plan or Psychiatrist Assessment and Management Plan must conduct a review, and the conclusion of the review be noted in the patient's record, before a further 6 services may be provided in the case of exceptional circumstances.

 

'Exceptional circumstances' are defined as a significant change in the patient's clinical condition or care circumstances which make it appropriate and necessary to increase the maximum number of services.  It is up to the referring practitioner (e.g GP) to determine that that patient meets these requirements. 

 

Where referrals are provided in exceptional circumstances, both the patient's mental health treatment plan and referral should be annotated to briefly indicate the reason why the allied mental health service involved was required in excess of the 10 services permitted within a calendar year.

 

Invoices for services provided under exceptional circumstances must state that exceptional circumstances apply.

 

Out-of-Surgery Consultation

It is expected that this service would be provided only for patients who are unable to attend the practice.

 

Specific Focussed Psychological Strategies

A range of acceptable strategies has been approved for use by medical practitioners in this context.  These are:

 

1.                Psycho-education

                   (including motivational interviewing)

 

2.                Cognitive-behavioural Therapy including:

 

-                  Behavioural interventions

                   -     Behaviour modification

                   -     Exposure techniques

                   -     Activity scheduling

-                  Cognitive interventions

                   -     Cognitive therapy

                  

 

3.                Relaxation strategies

-                  Progressive muscle relaxation

-                  Controlled breathing

 

4.                Skills training

-                  Problem solving skills and training

-                  Anger management

-                  Social skills training

-                  Communication training

-                  Stress management

-                  Parent management training

 

5.                Interpersonal Therapy

 

Mental Disorder

 

A mental disorder may be defined as a significant impairment of an individual's cognitive, affective and/or relational abilities which may require intervention and may be a recognised, medically diagnosable illness or disorder - this definition is informed by the World Health Organisation, 1996, Diagnostic and Management Guidelines for Mental Disorders in Primary Care:ICD - 10 Chapter V Primary Health Care Version.

 

Dementia, delirium, tobacco use disorder and mental retardation are not regarded as mental disorders for the purposes of these items.

 

Related Items: 2721 2723 2725 2727


Related Items

Category 1 - PROFESSIONAL ATTENDANCES

2721

2721 - Additional Information

Item Start Date:
01-Nov-2002
Description Start Date:
01-Mar-2012
Schedule Fee Start Date:
01-Jul-2014

Professional attendance at consulting rooms by a medical practitioner who practises in general practice (other than a specialist or a consultant physician), for providing focussed psychological strategies for assessed mental disorders by a medical practitioner registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service, and lasting at least 30 minutes, but less than 40 minutes

Fee: $92.75 Benefit: 100% = $92.75

(See para A46 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

2723

2723 - Additional Information

Item Start Date:
01-Nov-2002
Description Start Date:
01-Jan-2013
Schedule Fee Start Date:
01-Jul-2014

Professional attendance at a place other than consulting rooms by a medical practitioner who practises in general practice (other than a specialist or a consultant physician), for providing focussed psychological strategies for assessed mental disorders by a medical practitioner registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service, and lasting at least 30 minutes, but less than 40 minutes

The fee for item 2721, plus $25.95 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 2721 plus $2.00 per patient.
Ready Reckoner

(See para A46 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

2725

2725 - Additional Information

Item Start Date:
01-Nov-2002
Description Start Date:
01-Nov-2002
Schedule Fee Start Date:
01-Jul-2014

Professional attendance at consulting rooms by a medical practitioner who practises in general practice (other than a specialist or a consultant physician), for providing focussed psychological strategies for assessed mental disorders by a medical practitioner registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service, and lasting at least 40 minutes

Fee: $132.75 Benefit: 100% = $132.75

(See para A46 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

2727

2727 - Additional Information

Item Start Date:
01-Nov-2002
Description Start Date:
01-Jan-2013
Schedule Fee Start Date:
01-Jul-2014

Professional attendance at a place other than consulting rooms by a medical practitioner who practises in general practice (other than a specialist or a consultant physician), for providing focussed psychological strategies for assessed mental disorders by a medical practitioner registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service, and lasting at least 40 minutes

The fee for item 2725, plus $25.95 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 2725 plus $2.00 per patient.
Ready Reckoner

(See para A46 of explanatory notes to this Category)


Legend

  • 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