Medicare Benefits Schedule - Note M6.1

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Category 8 - MISCELLANEOUS SERVICES

M6.1

Provision of Psychological Therapy Services by Clinical Psychologists - (Items 80000 TO 80020)

OVERVIEW

The Better Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Schedule initiative commenced on 1 November 2006.  Under the Better Access initiative MBS items provide Medicare benefits for the following allied mental health services:

 

·         psychological therapy (items 80000 to 80020) - provided by eligible clinical psychologists; and

  • focussed psychological strategies - allied mental health (items 80100 to 80170) - provided by eligible psychologists, occupational therapists and social workers.

 

Related Items: 80000 80005 80010 80015 80020


Related Items

Category 8 - MISCELLANEOUS SERVICES

80000

80000 - Additional Information

Item Start Date:
01-Nov-2006
Description Start Date:
01-Mar-2012
Schedule Fee Start Date:
01-Nov-2012

Professional attendance for the purpose of providing psychological assessment and therapy for a mental disorder by a clinical psychologist registered with Medicare Australia as meeting the credentialing requirements for provision of this service, lasting more than 30 minutes but less than 50 minutes, where the patient is referred by a medical practitioner, as part of a GP Mental Health Treatment Plan; or referred by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) who is managing the patient under a referred psychiatrist assessment and management plan; or referred by a specialist or consultant physician in the practice of his or her field of psychiatry or paediatrics.

These therapies are time limited, being deliverable in up to ten planned sessions in a calendar year (including services to which items 2721 to 2727; 80000 to 80015; 80100 to 80115; 80125 to 80140; 80150 to 80165 apply).


Claims for this service may exceed this maximum session limit, however, where exceptional circumstances apply (to a maximum total of 16 individual services per patient from 1 March 2012 to 31 December 2012).


(Professional attendance at consulting rooms)

Fee: $99.75 Benefit: 85% = $84.80

(See para M6.1 of explanatory notes to this Category)

Category 8 - MISCELLANEOUS SERVICES

80005

80005 - Additional Information

Item Start Date:
01-Nov-2006
Description Start Date:
01-Nov-2006
Schedule Fee Start Date:
01-Nov-2012

Professional attendance at a place other than consulting rooms.


As per the service requirements outlined for item 80000.

Fee: $124.65 Benefit: 85% = $106.00

(See para M6.1 of explanatory notes to this Category)

Category 8 - MISCELLANEOUS SERVICES

80010

80010 - Additional Information

Item Start Date:
01-Nov-2006
Description Start Date:
01-Mar-2012
Schedule Fee Start Date:
01-Nov-2012

Professional attendance for the purpose of providing psychological assessment and therapy for a mental disorder by a clinical psychologist registered with Medicare Australia as meeting the credentialing requirements for provision of this service, lasting at least 50 minutes, where the patient is referred by a medical practitioner, as part of a GP Mental Health Treatment Plan; or referred by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) who is managing the patient under a referred psychiatrist assessment and management plan; or referred by a specialist or consultant physician in the practice of his or her field of psychiatry or paediatrics.

These therapies are time limited, being deliverable in up to ten planned sessions in a calendar year (including services to which items 2721 to 2727; 80000 to 80015; 80100 to 80115; 80125 to 80140; 80150 to 80165 apply).


Claims for this service may exceed this maximum session limit, however, where exceptional circumstances apply (to a maximum total of 16 individual services per patient from 1 March 2012 to 31 December 2012).


(Professional attendance at consulting rooms)

Fee: $146.45 Benefit: 85% = $124.50

(See para M6.1 of explanatory notes to this Category)

Category 8 - MISCELLANEOUS SERVICES

80015

80015 - Additional Information

Item Start Date:
01-Nov-2006
Description Start Date:
01-Nov-2006
Schedule Fee Start Date:
01-Nov-2012

Professional attendance at a place other than consulting rooms


As per the service requirements outlined for item 80010.

Fee: $171.35 Benefit: 85% = $145.65

(See para M6.1 of explanatory notes to this Category)

Category 8 - MISCELLANEOUS SERVICES

80020

80020 - Additional Information

Item Start Date:
01-Nov-2006
Description Start Date:
01-Nov-2011
Schedule Fee Start Date:
01-Nov-2012

Professional attendance for the purpose of providing psychological therapy for a mental disorder by a clinical psychologist registered with Medicare Australia as meeting the credentialing requirements for provision of this service, lasting for at least 60 minutes duration where the patients are referred by a medical practitioner, as part of a GP Mental Health Treatment Plan; or referred by a medical practitioner (including a general practitioner, but not a specialist or consultant physician) who is managing the patient under a referred psychiatrist assessment and management plan; or referred by a specialist or consultant physician in the practice of his or her field of psychiatry or paediatrics.


These therapies are time limited, being deliverable in up to ten planned sessions in a calendar year (including services to which items 80120, 80145 and 80170 apply).


- GROUP THERAPY with a group of 6 to 10 patients, EACH PATIENT

Fee: $37.20 Benefit: 85% = $31.65

(See para M6.1 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