Medicare Benefits Schedule - Note AN.0.66

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Category 1 - PROFESSIONAL ATTENDANCES

AN.0.66

Non-directive Pregnancy Support Counselling Service - (Item 4001)

Overview

The Pregnancy Support Counselling initiative provides for Medicare benefits to be paid for non-directive pregnancy support counselling services provided to a person who is:

·         pregnant; or

·         who has been pregnant in the 12 months preceding the first service to which this item, item 792 or item 81000, 81005 or 81010 applies in relation to that pregnancy. 

There are five MBS items for the provision of non-directive pregnancy support counselling services:

Item 4001 - services provided by an eligible GP. The term 'GP' is used hereafter as a generic reference to general practitioners;

Item 792 – services provided by an eligible medical practitioner (not including a specialist or consultant physician)

Item 81000 - services provided by an eligible psychologist;

Item 81005 - services provided by an eligible social worker; and

Item 81010 - services provided by an eligible mental health nurse. 

This notes relate to provision of a non-directive pregnancy support counselling service by an eligible GP. 

Non-directive counselling is a form of counselling based on the understanding that, in many situations, people can resolve their own problems without being provided with a solution by the counsellor.  The counsellor's role is to encourage the person to express their feelings but not suggest what decision the person should make.  By listening and reflecting back what the person reveals to them, the counsellor helps them to explore and understand their feelings. With this understanding, the person is able to make the decision which is best for them. 

The service involves the GP undertaking a safe, confidential process that helps the patient explore concerns they have about a current pregnancy or a pregnancy that occurred in the preceding 12 months.  This includes providing, on request, unbiased, evidence-based information about all options and services available to the patient.

 The service may be used to address any pregnancy related issues for which non-directive counselling is appropriate.

 Patient eligibility

Medicare rebates for non-directive pregnancy support counselling services provided using item 4001 are available to a person who is:

  • pregnant; or
  • who has been pregnant in the 12 months preceding the first service to which this item, item 792 or item 81000, 81005 or 81010 applies in relation to that pregnancy. 

Partners of eligible patients may attend each or any counselling session, however, only one fee applies to each service provided.

 Medicare benefits

Medicare benefits are payable for up to three non-directive pregnancy support counselling services per patient, per pregnancy, from any of the following items - 792, 4001, 81000, 81005 and 81010. 

Where the patient is unsure of the number of Medicare rebated non-directive pregnancy support counselling services they have already accessed, the patient may check with Services Australia on 132 011.  Alternatively, the GP may check with Services Australia (although the patient must be present to give permission). 

Item 10990 or item 10991 can also be claimed in conjunction with item 4001 provided the conditions of the relevant item, 10990 or 10991, are satisfied. 

Minimum Requirements

This service may only be provided by a GP who has completed appropriate non-directive pregnancy counselling training.

Related Items: 4001


Related Items

Category 1 - PROFESSIONAL ATTENDANCES

4001

4001 - Additional Information

Item Start Date:
01-Nov-2006
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Nov-2023

Professional attendance of at least 20 minutes in duration at consulting rooms by a general practitioner who is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service for the purpose of providing non-directive pregnancy support counselling to a patient who:

(a) is currently pregnant; or

(b) has been pregnant in the 12 months preceding the provision of the first service to which this item or item 81000, 81005 or 81010 applies in relation to that pregnancy

Note:    For items 81000, 81005 and 81010, see the determination about allied health services under subsection 3C(1) of the Act.

Fee: $84.30 Benefit: 100% = $84.30

(See para AN.0.66 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