Medicare Benefits Schedule - Note MN.17.1

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Category 8 - MISCELLANEOUS SERVICES

MN.17.1

Bushfire Recovery Access Initiative – Mental Health Services Attracting Medicare Rebates

There are 36 MBS items for the provision of psychological therapy and focussed psychological strategies (FPS) services to patients who are considered to have had their mental health adversely affected by bushfire in the 2019-20 financial year, including 24 items for face-to-face consultations and 12 items for video conference consultations. 

Patient eligibility and access to mental health services

Any patient who is considered to have had their mental health adversely affected by bushfire in the 2019-20 financial year is eligible for mental health services.  Eligible patients may be identified by a medical or allied health practitioner. Alternatively, they may identify themselves and request a mental health service.  The services are available to anyone whose mental health has been affected by the bushfire crisis, including residents of residential aged care facilities. Access is not restricted to people living in areas directly affected by bushfire.

Patients are not required to have a diagnosed mental health condition, GP mental health treatment plan or a referral to access the services. 

Patients wishing to access the services via video conference are not required to have an existing relationship with the treating practitioner.  In addition, no minimum distance requirement applies to these video conference services.

Number of services per year

Under the Bushfire Recovery Access Initiative, Medicare rebates are available for up to 10 individual mental health services in a calendar year. 

The 10 services may consist of: GP/medical practitioner focussed psychological strategies services (GP items 91721 to 91731 or medical practitioner items 91283 to 91372); and/or psychological therapy services (items 91000 to 91015); and/or focussed psychological strategies - allied mental health services (items 91100 to 91115; 91125 to 91140; 91150 to 91165).

Note: Patients who meet the eligibility requirements of the Better Access to Psychiatrists, Psychologists and General Practitioners through the MBS (Better Access) initiative may receive services under that initiative and the Bushfire Recovery Access Initiative.  Services received under the Bushfire Recovery Access Initiative do not count against a patient’s quota of services under the Better Access Initiative. 

Provider Eligibility

Eligible psychological therapy services provided by a clinical psychologist: MBS items 91000, 91001, 91005, 91010, 91011, and 91015

  • An eligible clinical psychologist must be registered with Services Australia (Department of Human Services).

Focussed psychological strategies provided by an eligible GP: MBS items 91721, 91723, 91725, 91727, 91729 and 91731

Focussed psychological strategies provided by an eligible medical practitioner: 91283, 91285, 91286, 91287, 91371 and 91372

  • An eligible GP or medical practitioners must registered with Services Australia (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.

Focussed psychological strategies provided by an eligible psychologist: 91100, 91101, 91105, 91110, 91111 and 91115

  • An eligible psychologist must hold general registration in the health profession of psychology under the applicable law in force in the State or Territory in which the service is provided.

Focussed psychological strategies provided by an eligible occupational therapist: 91125, 91126, 91130, 91135, 91136 and 91140

  • An eligible occupational therapist must be registered as a person who may provide that kind of service under the applicable law in force in the State or Territory in which the service is provided, and be accredited by Occupational Therapy Australia as:
    • having a minimum of two years’ experience in mental health; and
    • having undertaken to observe the standards set out in the document published by Occupational Therapy Australia's 'Australian Competency Standards for Occupational Therapists in Mental Health' as in force on 1 November 2006.

Focussed psychological strategies provided by an eligible social worker: 91150, 91151, 91155, 91160, 91161, 91165

  • An eligible social worker must be a member of the Australian Association of Social Workers (AASW) and certified by AASW as the meeting the standards for mental health set out in the document published by AASW titled ‘Practice Standards for Mental Health Social Workers 2014’ as in force on 25 September 2014.

Note: In these notes, 'GP' means a medical practitioner, including a general practitioner, but not including a specialist or consultant physician.

Service length and type

Services provided by eligible medical and allied health practitioners under the Bushfire Recovery Access Initiative must be within the specified time period within the item descriptor.  Practitioners must personally attend the patient face-to-face (or by video conference for items 91001, 91011, 91101, 91111, 91126, 91136, 91151, 91161, 91371, 91372, 91729 and 91731).

Psychological therapy provided by clinical psychologists

In addition to psycho-education, it is recommended that cognitive-behaviour therapy be provided.  However, other evidence-based therapies ─ such as interpersonal therapy ─ may be used if considered clinically relevant.

Focussed psychological strategies

A range of acceptable strategies has been approved for use by health professionals utilising the FPS items:

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 (especially for depression)

6.       Narrative therapy

Out of pocket expenses

Charges in excess of the Medicare benefit for these items are the responsibility of the patient.

Private health insurance

Patients need to decide if they will use Medicare or their private health insurance ancillary cover to pay for services provided by allied health professionals. Patients cannot use their private health insurance ancillary cover to 'top up' the Medicare rebate paid for the services.


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