Medicare Benefits Schedule - Note AN.7.23

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Category 1 - PROFESSIONAL ATTENDANCES

AN.7.23

Medical Practitioner Provision of Focussed Psychological Strategies (Items 283 to 287, 371 and 372)

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, shared care plan or a psychiatrist assessment and management plan.

Minimum Requirements

All consultations providing Focussed Psychological Strategies must be rendered by a medical 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 283 to 287, 371 and 372 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 10 allied mental health services under these item numbers per calendar year. The 10 services may consist of: GP focussed psychological strategies services (items 283 to 287, 371 and 372 or GP items 2721 to 2731); 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).

Out-of-Surgery Consultation

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

Telehealth Consultation

telehealth area means an area that is a Modified Monash 4 area, Modified Monash 5 area, Modified Monash 6 area or Modified Monash 7 area. 

Specific Modified Monash locations can be looked up at DoctorConnect

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: 283 285 286 287 371 372


Related Items

Category 1 - PROFESSIONAL ATTENDANCES

283

283 - Additional Information

Item Start Date:
01-Jul-2018
Description Start Date:
01-Jul-2018
Schedule Fee Start Date:
01-Jul-2018

Professional attendance at consulting rooms by a medical practitioner, for providing focussed psychological strategies for assessed mental disorders by a medical practitioner registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service, and lasting at least 30 minutes, but less than 40 minutes

Fee: $74.20 Benefit: 100% = $74.20

(See para AN.7.1, AN.7.23 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

285

285 - Additional Information

Item Start Date:
01-Jul-2018
Description Start Date:
01-Jul-2018
Schedule Fee Start Date:
01-Jul-2018

Professional attendance at a place other than consulting rooms by a medical practitioner, for providing focussed psychological strategies for assessed mental disorders by a medical practitioner registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service, and lasting at least 30 minutes, but less than 40 minutes

The fee for item 283, plus $20.75 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 283 plus $1.60 per patient.
Ready Reckoner

(See para AN.7.1, AN.7.23 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

286

286 - Additional Information

Item Start Date:
01-Jul-2018
Description Start Date:
01-Jul-2018
Schedule Fee Start Date:
01-Jul-2018

Professional attendance at consulting rooms by a medical practitioner, for providing focussed psychological strategies for assessed mental disorders by a medical practitioner registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service, and lasting at least 40 minutes

Fee: $106.20 Benefit: 100% = $106.20

(See para AN.7.1, AN.7.23 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

287

287 - Additional Information

Item Start Date:
01-Jul-2018
Description Start Date:
01-Jul-2018
Schedule Fee Start Date:
01-Jul-2018

Professional attendance at a place other than consulting rooms by a medical practitioner, for providing focussed psychological strategies for assessed mental disorders by a medical practitioner registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service, and lasting at least 40 minutes

The fee for item 286, plus $20.75 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 286 plus $1.60 per patient.
Ready Reckoner

(See para AN.7.1, AN.7.23 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

371

371 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Nov-2018

Professional attendance at consulting rooms by a medical practitioner, for providing focussed psychological strategies for assessed mental disorders by a medical practitioner registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service, and lasting at least 30 minutes, but less than 40 minutes if:

(a)     the attendance is by video conference; and

(b)     the patient is not an admitted patient; and

(c)     the patient is located within a telehealth area; and

(d)     the patient is, at the time of the attendance, at least 15 kilometres by road from the medical practitioner.

Fee: $74.20 Benefit: 100% = $74.20

(See para AN.7.1, AN.7.23 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

372

372 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Nov-2018

Professional attendance at consulting rooms by a medical practitioner, for providing focussed psychological strategies for assessed mental disorders by a medical practitioner registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service, and lasting at least 40 minutes if:

(a)     the attendance is by video conference; and

(b)     the patient is not an admitted patient; and

(c)     the patient is located within a telehealth area; and

(d)     the patient is, at the time of the attendance, at least 15 kilometres by road from the medical practitioner.

Fee: $106.20 Benefit: 100% = $106.20

(See para AN.7.1, AN.7.23 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