Medicare Benefits Schedule - Note AN.0.76

To increase the clinical treatment options available to psychiatrists and for which a Medicare benefit is payable, patients with an assessed mental disorder (dementia, delirium, tobacco use disorder and intellectual disability are not regarded as mental disorders for the purposes of these items) a patient is eligible for up to 10 individual allied mental health services per calendar year by:

• clinical psychologists providing psychological therapies; or
• appropriately trained GPs or allied mental health professionals providing focused psychological strategy (FPS) services.

Referrals from psychiatrists to allied mental health professionals must be made under eligible MBS items. While such referrals are likely to occur for new patients seen under item 296, 297, 299 or 92437 or a referred psychiatrist assessment and management plan under item 291 or 92435, they are also available for patients at any point in treatment (under items 104 to 109, 293, 296, 297, 299, 300, 302, 304, 306, 308, 310, 312, 314, 316, 318, 319, 320, 322, 324, 326, 328, 330, 332, 334, 336, 338, 341, 342, 343, 344, 345, 346, 347, 349 or telehealth equivalent items, as clinically required, under the same arrangements and limitations as outlined above). 

The ten individual services may consist of:

• psychological therapy services (items 80000 to 80015 or telehealth equivalent items 91166, 91167, 91181 or 91182) - provided by eligible clinical psychologists; and/or
• focused psychological strategies - allied mental health services (items 80100 to 80115 or telehealth equivalent items 91169, 91170, 91183 or 91184; 80125 to 80140 or telehealth equivalent items 91172, 91173, 91185 or 91186; 80150 to 80165 or telehealth equivalent items 91175, 91176, 91187 or 91188) - provided by eligible psychologists, occupational therapists and social workers.

Within the maximum service allocation of ten services, the allied mental health professional can provide one or more courses of treatment.

Group therapy services

In addition to the above services, patients will also be eligible to claim up to ten separate services within a calendar year for group therapy services (involving 6-10 patients) to which items:

• 80020 or 80021 (psychological therapy - clinical psychologist)
• 80120 or 80121 (focused psychological strategies - psychologist)
• 80145 or 80146 (focused psychological strategies - occupational therapist); and
• 80170 or 80171 (focused psychological strategies - social worker) apply.

These group services are separate from the individual services and do not count towards the ten individual services per calendar year maximum associated with those items.

Referral Requirements for Allied Health services

A referral for treatment must be in writing (signed and dated by the psychiatrist) and may include (unless clinically inappropriate):

• the patient’s name, date of birth and address;
• the patient’s symptoms or diagnostic assessment;
• the patient needs and goals of treatment (if clinically appropriate);
• a list of any current medications (if appropriate);
• the number of sessions before a psychiatry review is required; or the allied health practitioner should provide a written report back to the psychiatrist following the completed course of treatment, confirming the patient’s need for a subsequent course of treatment if clinically needed.

Maximum session limit for each course of treatment apply:

Initial course of treatment – a maximum of six sessions. Subsequent course of treatment – a maximum of six sessions up to the patient’s cap of ten sessions (for example, if the patient received six sessions in their initial course of treatment, they can only receive four sessions in a subsequent course of treatment).

Related Items: 104 109 291 293 296 297 299 300 302 304 306 308 310 312 314 316 318 319 320 322 324 326 328 330 332 334 336 338 342 344 346 80000 80015 80020 80021 80100 80115 80120 80121 80125 80140 80145 80146 80150 80165 80170 80171 91166 91167 91169 91170 91172 91173 91175 91176 91181 91182 91183 91184 91185 91186 91187 91188 92435 92437

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Professional attendance at consulting rooms or hospital by a specialist in the practice of the specialist's specialty after referral of the patient to the specialist-each attendance, other than a second or subsequent attendance, in a single course of treatment, other than a service to which item 106, 109 or 16401 applies

Fee: $95.60 Benefit: 75% = $71.70 85% = $81.30

(See para AN.0.7, AN.0.25, AN.0.76, AN.2.1, AN.40.1, TN.1.4 of explanatory notes to this Category)

Professional attendance by a specialist in the practice of the specialist's specialty of ophthalmology following referral of the patient to the specialist-an attendance (other than a second or subsequent attendance in a single course of treatment) at which a comprehensive eye examination, including pupil dilation, is performed on:

(a) a patient aged 9 years or younger; or

(b) a patient aged 14 years or younger with developmental delay;

(other than a service to which any of items 104, 106 and 10801 to 10816 applies)

Fee: $215.40 Benefit: 75% = $161.55 85% = $183.10

(See para AN.0.76 of explanatory notes to this Category)

Professional attendance lasting more than 45 minutes at consulting rooms by a consultant physician in the practice of the consultant physician’s specialty of psychiatry, if:

(a) the attendance follows referral of the patient to the consultant, by a medical practitioner in general practice (including a general practitioner, but not a specialist or consultant physician) or a participating nurse practitioner, for an assessment or management; and

(b) during the attendance, the consultant:

(i) if it is clinically appropriate to do so—uses an appropriate outcome tool; and

(ii) carries out a mental state examination; and

(iii) undertakes a comprehensive diagnostic assessment; and

(c) the consultant decides that it is clinically appropriate for the patient to be managed by the referring practitioner without ongoing management by the consultant; and

(d) within 2 weeks after the attendance, the consultant prepares and gives to the referring practitioner a written report, which includes:

(i) the comprehensive diagnostic assessment of the patient; and

(ii) a management plan for the patient for the next 12 months that comprehensively evaluates the patient’s biopsychosocial factors and makes recommendations to the referring practitioner to manage the patient’s ongoing care in a biopsychosocial model; and

(e) if clinically appropriate, the consultant explains the diagnostic assessment and management plan, and gives a copy, to:

(i) the patient; and

(ii) the patient’s carer (if any), if the patient agrees; and

(f) in the preceding 12 months, a service to which this item or item 92435 applies has not been provided to the patient

Fee: $505.70 Benefit: 85% = $429.85

(See para AN.0.30, AN.0.32, AN.0.75, AN.0.76, AN.40.1 of explanatory notes to this Category)

Professional attendance lasting more than 30 minutes, but not more than 45 minutes, at consulting rooms by a consultant physician in the practice of the consultant physician’s specialty of psychiatry, if:

(a) the patient is being managed by a medical practitioner or a participating nurse practitioner in accordance with a management plan prepared by the consultant in accordance with item 291 or item 92435; and

(b) the attendance follows referral of the patient to the consultant, by the medical practitioner or participating nurse practitioner managing the patient, for review of the management plan and the associated comprehensive diagnostic assessment; and

(c) during the attendance, the consultant:

(i) if it is clinically appropriate to do so—uses an appropriate outcome tool; and

(ii) carries out a mental state examination; and

(iii) reviews the comprehensive diagnostic assessment and undertakes additional assessment as required; and

(iv) reviews the management plan; and

(d) within 2 weeks after the attendance, the consultant prepares and gives to the referring practitioner a written report, which includes:

(i) the revised comprehensive diagnostic assessment of the patient; and

(ii) a revised management plan including updated recommendations to the referring practitioner to manage the patient’s ongoing care in a biopsychosocial model; and

(e) if clinically appropriate, the consultant explains the diagnostic assessment and management plan, and gives a copy, to:

(i) the patient; and

(ii) the patient’s carer (if any), if the patient agrees; and

(f) in the preceding 12 months, a service to which item 291 or item 92435 applies has been provided to the patient; and

(g) in the preceding 12 months, a service to which this item or item 92436 applies has not been provided to the patient

Fee: $316.15 Benefit: 85% = $268.75

(See para AN.0.30, AN.0.32, AN.0.76, AN.40.1 of explanatory notes to this Category)

Professional attendance of more than 45 minutes in duration by a consultant physician in the practice of the consultant physician's speciality of psychiatry following referral of the patient to him or her by a referring practitioner-an attendance at consulting rooms if the patient:

(a) is a new patient for this consultant psychiatrist; or

(b) has not received a professional attendance from this consultant psychiatrist in the preceding 24 months;

other than attendance on a patient in relation to whom this item, or any of items 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 has applied in the preceding 24 months

Fee: $290.85 Benefit: 75% = $218.15 85% = $247.25

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.32, AN.0.75, AN.0.76, AN.40.1 of explanatory notes to this Category)

Professional attendance of more than 45 minutes by a consultant physician in the practice of the consultant physician's speciality of psychiatry following referral of the patient to him or her by a referring practitioner-an attendance at hospital if the patient:

(a) is a new patient for this consultant psychiatrist; or

(b) has not received a professional attendance from this consultant psychiatrist in the preceding 24 months;

other than attendance on a patient in relation to whom this item, or any of items 296, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 has applied in the preceding 24 months (H)

Fee: $290.85 Benefit: 75% = $218.15

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.32, AN.0.75, AN.0.76 of explanatory notes to this Category)

Professional attendance of more than 45 minutes by a consultant physician in the practice of the consultant physician's speciality of psychiatry following referral of the patient to him or her by a referring practitioner-an attendance at a place other than consulting rooms or a hospital if the patient:

(a) is a new patient for this consultant psychiatrist; or

(b) has not received a professional attendance from this consultant psychiatrist in the preceding 24 months;

other than attendance on a patient in relation to whom this item, or any of items 296, 297, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 has applied in the preceding 24 months

Fee: $347.75 Benefit: 85% = $295.60

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.32, AN.0.75, AN.0.76 of explanatory notes to this Category)

Professional attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry following referral of the patient to him or her by a referring practitioner-an attendance of not more than 15 minutes in duration at consulting rooms, if that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 applies have not exceeded 50 attendances in a calendar year for the patient

Fee: $48.40 Benefit: 75% = $36.30 85% = $41.15

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.32, AN.0.75, AN.0.76, AN.40.1 of explanatory notes to this Category)

Professional attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry following referral of the patient to him or her by a referring practitioner-an attendance of more than 15 minutes, but not more than 30 minutes, in duration at consulting rooms, if that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 applies have not exceeded 50 attendances in a calendar year for the patient

Fee: $96.60 Benefit: 75% = $72.45 85% = $82.15

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.32, AN.0.75, AN.0.76, AN.40.1 of explanatory notes to this Category)

Professional attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry following referral of the patient to him or her by a referring practitioner-an attendance of more than 30 minutes, but not more than 45 minutes, in duration at consulting rooms), if that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 applies have not exceeded 50 attendances in a calendar year for the patient

Fee: $148.70 Benefit: 75% = $111.55 85% = $126.40

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.32, AN.0.75, AN.0.76, AN.40.1 of explanatory notes to this Category)

Professional attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry following referral of the patient to him or her by a referring practitioner-an attendance of more than 45 minutes, but not more than 75 minutes, in duration at consulting rooms, if that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 applies have not exceeded 50 attendances in a calendar year for the patient

Fee: $205.20 Benefit: 75% = $153.90 85% = $174.45

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.32, AN.0.75, AN.0.76, AN.40.1 of explanatory notes to this Category)

Professional attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry following referral of the patient to him or her by a referring practitioner-an attendance of more than 75 minutes in duration at consulting rooms), if that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 applies have not exceeded 50 attendances in a calendar year for the patient

Fee: $238.15 Benefit: 75% = $178.65 85% = $202.45

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.32, AN.0.75, AN.0.76, AN.40.1 of explanatory notes to this Category)

Professional attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner-an attendance of not more than 15 minutes in duration at consulting rooms, if that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 applies exceed 50 attendances in a calendar year for the patient

Fee: $24.10 Benefit: 75% = $18.10 85% = $20.50

(See para AN.0.25, AN.0.31, AN.0.32, AN.0.76 of explanatory notes to this Category)

Professional attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner-an attendance of more than 15 minutes, but not more than 30 minutes, in duration at consulting rooms, if that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 applies exceed 50 attendances in a calendar year for the patient

Fee: $48.40 Benefit: 75% = $36.30 85% = $41.15

(See para AN.0.25, AN.0.31, AN.0.32, AN.0.76 of explanatory notes to this Category)

Professional attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner-an attendance of more than 30 minutes, but not more than 45 minutes, in duration at consulting rooms, if that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 applies exceed 50 attendances in a calendar year for the patient

Fee: $74.55 Benefit: 75% = $55.95 85% = $63.40

(See para AN.0.25, AN.0.31, AN.0.32, AN.0.76 of explanatory notes to this Category)

Professional attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner-an attendance of more than 45 minutes, but not more than 75 minutes, in duration at consulting rooms, if that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 applies exceed 50 attendances in a calendar year for the patient

Fee: $102.70 Benefit: 75% = $77.05 85% = $87.30

(See para AN.0.25, AN.0.31, AN.0.32, AN.0.76 of explanatory notes to this Category)

Professional attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner-an attendance of more than 75 minutes in duration at consulting rooms, if that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 applies exceed 50 attendances in a calendar year for the patient

Fee: $119.10 Benefit: 75% = $89.35 85% = $101.25

(See para AN.0.25, AN.0.31, AN.0.32, AN.0.76 of explanatory notes to this Category)

Professional attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner—an attendance lasting more than 45 minutes at consulting rooms, if:

(a) the formulation of the patient’s clinical presentation indicates intensive psychotherapy is a clinically appropriate and indicated treatment; and

(b) that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839, 91873 and 92437 applies have not exceeded 160 attendances in a calendar year for the patient

Fee: $205.20 Benefit: 75% = $153.90 85% = $174.45

(See para AN.0.25, AN.0.31, AN.0.32, AN.0.76 of explanatory notes to this Category)

Professional attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner-an attendance of not more than 15 minutes in duration at hospital

Fee: $48.40 Benefit: 75% = $36.30 85% = $41.15

(See para AN.0.25, AN.0.32, AN.0.76 of explanatory notes to this Category)

Professional attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner-an attendance of more than 15 minutes, but not more than 30 minutes, in duration at hospital

Fee: $96.60 Benefit: 75% = $72.45 85% = $82.15

(See para AN.0.32, AN.0.76 of explanatory notes to this Category)

Professional attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner-an attendance of more than 30 minutes, but not more than 45 minutes, in duration at hospital

Fee: $148.70 Benefit: 75% = $111.55 85% = $126.40

(See para AN.0.25, AN.0.32, AN.0.76 of explanatory notes to this Category)

Professional attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner-an attendance of more than 45 minutes, but not more than 75 minutes, in duration at hospital

Fee: $205.20 Benefit: 75% = $153.90 85% = $174.45

(See para AN.0.25, AN.0.32, AN.0.76 of explanatory notes to this Category)

Professional attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner-an attendance of more than 75 minutes in duration at hospital

Fee: $238.15 Benefit: 75% = $178.65 85% = $202.45

(See para AN.0.25, AN.0.32, AN.0.76 of explanatory notes to this Category)

Professional attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner-an attendance of not more than 15 minutes in duration if that attendance is at a place other than consulting rooms or hospital

Fee: $88.90 Benefit: 75% = $66.70 85% = $75.60

(See para AN.0.25, AN.0.76 of explanatory notes to this Category)

Professional attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner-an attendance of more than 15 minutes, but not more than 30 minutes, in duration if that attendance is at a place other than consulting rooms or hospital

Fee: $139.20 Benefit: 75% = $104.40 85% = $118.35

(See para AN.0.25, AN.0.76 of explanatory notes to this Category)

Professional attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner-an attendance of more than 30 minutes, but not more than 45 minutes, in duration if that attendance is at a place other than consulting rooms or hospital

Fee: $202.85 Benefit: 75% = $152.15 85% = $172.45

(See para AN.0.25, AN.0.76 of explanatory notes to this Category)

Professional attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner-an attendance of more than 45 minutes, but not more than 75 minutes, in duration if that attendance is at a place other than consulting rooms or hospital

Fee: $245.45 Benefit: 75% = $184.10 85% = $208.65

(See para AN.0.25, AN.0.76 of explanatory notes to this Category)

Professional attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry following referral of the patient to the consultant physician by a referring practitioner-an attendance of more than 75 minutes in duration if that attendance is at a place other than consulting rooms or hospital

Fee: $278.80 Benefit: 75% = $209.10 85% = $237.00

(See para AN.0.25, AN.0.76 of explanatory notes to this Category)

Group psychotherapy (including any associated consultations with a patient taking place on the same occasion and relating to the condition for which group therapy is conducted) of not less than 1 hour in duration given under the continuous direct supervision of a consultant physician in the practice of the consultant physician's specialty of psychiatry, involving a group of 2 to 9 unrelated patients or a family group of more than 3 patients, each of whom is referred to the consultant physician by a referring practitioner-each patient

Fee: $55.05 Benefit: 75% = $41.30 85% = $46.80

(See para AN.0.5, AN.0.25, AN.0.76, AN.40.1 of explanatory notes to this Category)

Group psychotherapy (including any associated consultations with a patient taking place on the same occasion and relating to the condition for which group therapy is conducted) of not less than 1 hour in duration given under the continuous direct supervision of a consultant physician in the practice of the consultant physician's specialty of psychiatry, involving a family group of 3 patients, each of whom is referred to the consultant physician by a referring practitioner-each patient

Fee: $73.10 Benefit: 75% = $54.85 85% = $62.15

(See para AN.0.5, AN.0.25, AN.0.76, AN.40.1 of explanatory notes to this Category)

Group psychotherapy (including any associated consultations with a patient taking place on the same occasion and relating to the condition for which group therapy is conducted) of not less than 1 hour in duration given under the continuous direct supervision of a consultant physician in the practice of the consultant physician's specialty of psychiatry, involving a family group of 2 patients, each of whom is referred to the consultant physician by a referring practitioner-each patient

Fee: $108.15 Benefit: 75% = $81.15 85% = $91.95

(See para AN.0.5, AN.0.25, AN.0.76, AN.0.77, AN.40.1 of explanatory notes to this Category)

Focussed psychological strategies health service provided by phone attendance by an eligible psychologist if:

(a)   the person is referred by:

(i)  a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

(ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

(iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(b)   the service is provided to the person individually; and

(c)   at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(d)   on the completion of the course of treatment, the eligible psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

(e)     the service is at least 20 minutes but less than 50 minutes duration

Fee: $77.85 Benefit: 85% = $66.20

(See para AN.0.76, MN.7.1 of explanatory notes to this Category)

Focussed psychological strategies health service provided by phone attendance by an eligible psychologist if:

(a)   the person is referred by:

(i)  a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

(ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

(iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(b)   the service is provided to the person individually; and

(c)   at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(d)   on the completion of the course of treatment, the eligible psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

(e)     the service is at least 50 minutes duration

Fee: $109.80 Benefit: 85% = $93.35

(See para AN.0.76, MN.7.1 of explanatory notes to this Category)

Telehealth attendance lasting more than 45 minutes by a consultant physician in the practice of the consultant physician’s specialty of psychiatry, if:

(a)    the attendance follows referral of the patient to the consultant, by a medical practitioner in general practice (including a general practitioner, but not a specialist or consultant physician) or a participating nurse practitioner for an assessment or management; and

(b)    during the attendance, the consultant:

(i)     if it is clinically appropriate to do so—uses an appropriate outcome tool; and

(ii)   carries out a mental state examination; and

(iii)  undertakes a comprehensive diagnostic assessment; and

(c)    the consultant decides that it is clinically appropriate for the patient to be managed by the referring practitioner without ongoing management by the consultant and

(d)    within 2 weeks after the attendance, the consultant prepares and gives the referring practitioner a written report, which includes:

(i)     a comprehensive diagnostic assessment of the patient; and

(ii)   a management plan for the patient for the next 12 months for the patient that comprehensively evaluates the patient’s biopsychosocial factors and makes recommendations to the referring practitioner to manage the patient’s ongoing care in a biopsychosocial model; and

(e)    if clinically appropriate, the consultant explains the diagnostic assessment and management plan, and a gives a copy, to:

(i)     the patient; and

(ii)   the patient’s carer (if any), if the patient agrees; and

(f)     in the preceding 12 months, a service to which this item or item 291 of the general medical services table applies has not been provided

Fee: $505.70 Benefit: 85% = $429.85

(See para AN.0.30, AN.0.75, AN.0.76 of explanatory notes to this Category)

Telehealth attendance of more than 45 minutes in duration by a consultant physician in the practice of the consultant physician’s speciality of psychiatry following referral of the patient to the consultant physician by a referring practitioner:

(a) if the patient:

    (i) is a new patient for this consultant physician; or

    (ii) has not received an attendance from this consultant physician in the preceding 24 months; and

(b)  the patient has not received an attendance under this item, or item 91827 to 91831, 91837 to 91839, 92455 to 92457, 91868 to 91873, 91879 to 91881 or item 296, 297, 299, 300, 302, 304, 306 to 308, 310, 312, 314, 316, 318, 319, 320, 322, 324, 326, 328, 330, 332, 334, 336, 338, 342, 344 or 346 of the general medical services table, in the preceding 24 months

Fee: $290.85 Benefit: 85% = $247.25

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.75, AN.0.76 of explanatory notes to this Category)

Psychological therapy health service provided to a patient in consulting rooms by an eligible clinical psychologist if:

(a)  the patient is referred by a referring practitioner; and

(b)  the service is provided to the patient individually and in person; and

(c)  at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and

(d)  on the completion of the course of treatment, the eligible clinical psychologist gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and

(e)  the service is at least 30 minutes but less than 50 minutes duration

Fee: $109.80 Benefit: 85% = $93.35

(See para AN.0.76 of explanatory notes to this Category)

Psychological therapy health service provided to a patient at a place other than consulting rooms by an eligible clinical psychologist if:

(a)  the patient is referred by a referring practitioner; and

(b)  the service is provided to the patient individually and in person; and

(c)  at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and

(d)  on the completion of the course of treatment, the eligible clinical psychologist gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and

(e)  the service is at least 50 minutes duration

Fee: $188.60 Benefit: 85% = $160.35

(See para AN.0.76 of explanatory notes to this Category)

Psychological therapy health service provided to a patient as part of a group of 4 to 10 patients by an eligible clinical psychologist if:

(a)  the patient is referred by a referring practitioner; and

(b)  the service is provided in person; and

(c)  the service is at least 60 minutes duration

Fee: $40.90 Benefit: 85% = $34.80

(See para AN.0.76, MN.6.7 of explanatory notes to this Category)

Psychological therapy health service provided to a patient as part of a group of 4 to 10 patients by an eligible clinical psychologist if:

(a)  the patient is referred by a referring practitioner; and

(b)  the attendance is by video conference; and

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

(d)  the patient is, at the time of the attendance, at least 15 kilometres by road from the clinical psychologist; and

(e)  the service is at least 60 minutes duration

Fee: $40.90 Benefit: 85% = $34.80

(See para AN.0.76, MN.6.7 of explanatory notes to this Category)

Focussed psychological strategies health service provided by telehealth attendance by an eligible social worker if:

(a)  the person is referred by:

(i)  a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

(ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

(iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(b)  the service is provided to the person individually; and

(c)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(d) on the completion of the course of treatment, the eligible social worker gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

(e)  the service is at least 20 minutes but less than 50 minutes duration

Fee: $68.55 Benefit: 85% = $58.30

(See para AN.0.30, AN.0.76, MN.7.1 of explanatory notes to this Category)

Focussed psychological strategies health service provided by telehealth attendance by an eligible social worker if:

(a)  the person is referred by:

(i)  a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

(ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

(iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(b)  the service is provided to the person individually; and

(c)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(d) on the completion of the course of treatment, the eligible social worker gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

(e)  the service is at least 50 minutes duration

Fee: $96.80 Benefit: 85% = $82.30

(See para AN.0.30, AN.0.76, MN.7.1 of explanatory notes to this Category)

Focussed psychological strategies health service provided to a patient in consulting rooms by an eligible psychologist if:

(a)  the patient is referred by a referring practitioner; and

(b)  the service is provided to the patient individually and in person; and

(c)  at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and

(d)  on the completion of the course of treatment, the eligible psychologist gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and

(e)  the service is at least 20 minutes but less than 50 minutes duration

Fee: $77.85 Benefit: 85% = $66.20

(See para AN.0.76, MN.7.1 of explanatory notes to this Category)

Focussed psychological strategies health service provided to a patient at a place other than consulting rooms by an eligible psychologist if:

(a)  the patient is referred by a referring practitioner; and

(b)  the service is provided to the patient individually and in person; and

(c)  at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and

(d)  on the completion of the course of treatment, the eligible psychologist gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and

(e)  the service is at least 50 minutes duration

Fee: $137.90 Benefit: 85% = $117.25

(See para AN.0.76, MN.7.1 of explanatory notes to this Category)

Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible psychologist if:

(a)  the patient is referred by a referring practitioner; and

(b)  the service is provided in person; and

(c)  the service is at least 60 minutes duration

Fee: $28.00 Benefit: 85% = $23.80

(See para AN.0.76, MN.7.4 of explanatory notes to this Category)

Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible psychologist if:

(a)  the patient is referred by a referring practitioner; and

(b)  the attendance is by video conference; and

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

(d)  the patient is, at the time of the attendance, at least 15 kilometres by road from the psychologist; and

(e)  the service is at least 60 minutes duration

Fee: $28.00 Benefit: 85% = $23.80

(See para AN.0.76, MN.7.4 of explanatory notes to this Category)

Focussed psychological strategies health service provided to a patient in consulting rooms by an eligible occupational therapist if:

(a)  the patient is referred by a referring practitioner; and

(b)  the service is provided to the patient individually and in person; and

(c)  at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and

(d)  on the completion of the course of treatment, the eligible occupational therapist gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and

(e)  the service is at least 20 minutes but less than 50 minutes duration

Fee: $68.55 Benefit: 85% = $58.30

(See para AN.0.76, MN.7.1 of explanatory notes to this Category)

Focussed psychological strategies health service provided to a patient at a place other than consulting rooms by an eligible occupational therapist if:

(a)  the patient is referred by a referring practitioner; and

(b)  the service is provided to the patient individually and in person; and

(c)  at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and

(d)  on the completion of the course of treatment, the eligible occupational therapist gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and

(e)  the service is at least 50 minutes duration

Fee: $124.75 Benefit: 85% = $106.05

(See para AN.0.76, MN.7.1 of explanatory notes to this Category)

Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible occupational therapist if:

(a)  the patient is referred by a referring practitioner; and

(b)  the service is provided in person; and

(c)  the service is at least 60 minutes duration

Fee: $24.55 Benefit: 85% = $20.90

(See para AN.0.76, MN.7.4 of explanatory notes to this Category)

Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible occupational therapist if:

(a)  the patient is referred by a referring practitioner; and

(b)  the attendance is by video conference; and

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

(d)  the patient is, at the time of the attendance, at least 15 kilometres by road from the occupational therapist; and

(e)  the service is at least 60 minutes duration

Fee: $24.55 Benefit: 85% = $20.90

(See para AN.0.76, MN.7.4 of explanatory notes to this Category)

Focussed psychological strategies health service provided to a patient in consulting rooms by an eligible social worker if:

(a)  the patient is referred by a referring practitioner; and

(b)  the service is provided to the patient individually and in person; and

(c)  at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and

(d)  on the completion of the course of treatment, the eligible social worker gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and

(e)  the service is at least 20 minutes but less than 50 minutes duration

Fee: $68.55 Benefit: 85% = $58.30

(See para AN.0.76, MN.7.1 of explanatory notes to this Category)

Focussed psychological strategies health service provided to a patient at a place other than consulting rooms by an eligible social worker if:

(a)  the patient is referred by a referring practitioner; and

(b)  the service is provided to the patient individually and in person; and

(c)  at the completion of a course of treatment, the referring practitioner reviews the need for a further course of treatment; and

(d)  on the completion of the course of treatment, the eligible social worker gives a written report to the referring practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’s condition; and            

(e)  the service is at least 50 minutes duration

Fee: $124.75 Benefit: 85% = $106.05

(See para AN.0.76, MN.7.1 of explanatory notes to this Category)

Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible social worker if:

(a)  the patient is referred by referring practitioner; and

(b)  the service is provided in person; and

(c)  the service is at least 60 minutes duration

Fee: $24.55 Benefit: 85% = $20.90

(See para AN.0.76, MN.7.4 of explanatory notes to this Category)

Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible social worker if:

(a)  the patient is referred by a referring practitioner; and

(b)  the attendance is by video conference; and

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

(d)  the patient is, at the time of the attendance, at least 15 kilometres by road from the social worker; and

(e)  the service is at least 60 minutes duration

Fee: $24.55 Benefit: 85% = $20.90

(See para AN.0.76, MN.7.4 of explanatory notes to this Category)

Focussed psychological strategies health service provided by telehealth attendance by an eligible psychologist if:

(a)  the person is referred by:

(i)  a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

(ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

(iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(b)  the service is provided to the person individually; and

(c)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(d)  on the completion of the course of treatment, the eligible psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

(e)  the service is at least 20 minutes but less than 50 minutes duration

Fee: $77.85 Benefit: 85% = $66.20

(See para AN.0.30, AN.0.76, MN.7.1 of explanatory notes to this Category)

Focussed psychological strategies health service provided by telehealth attendance by an eligible psychologist if:

(a)  the person is referred by:

(i)  a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

(ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

(iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(b)  the service is provided to the person individually; and

(c)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(d) on the completion of the course of treatment, the eligible psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

(e)  the service is at least 50 minutes duration

Fee: $109.80 Benefit: 85% = $93.35

(See para AN.0.30, AN.0.76, MN.7.1 of explanatory notes to this Category)

Focussed psychological strategies health service provided by phone attendance by an eligible social worker if:

(a)   the person is referred by:

(i)  a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

(ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

(iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(b)   the service is provided to the person individually; and

(c)   at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(d)   on the completion of the course of treatment, the eligible social worker gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

(e)     the service is at least 20 minutes but less than 50 minutes duration

Fee: $68.55 Benefit: 85% = $58.30

(See para AN.0.76, MN.7.1 of explanatory notes to this Category)

Focussed psychological strategies health service provided by phone attendance by an eligible social worker if:

(a)   the person is referred by:

(i)  a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

(ii)  a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

(iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(b)   the service is provided to the person individually; and

(c)   at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(d)   on the completion of the course of treatment, the eligible social worker gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

(e)     the service is at least 50 minutes duration

Fee: $96.80 Benefit: 85% = $82.30

(See para AN.0.76, MN.7.1 of explanatory notes to this Category)

Psychological therapy health service provided by telehealth attendance by an eligible clinical psychologist if:

(a) the person is referred by:

(i) a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

(ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

(iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(b) the service is provided to the person individually; and

(c) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(d) on the completion of the course of treatment, the eligible clinical psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

(e)  the service is at least 30 minutes but less than 50 minutes duration

Fee: $109.80 Benefit: 85% = $93.35

(See para AN.0.30, AN.0.76 of explanatory notes to this Category)

Psychological therapy health service provided by telehealth attendance by an eligible clinical psychologist if:

(a) the person is referred by:

(i)  a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

(ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

(iii)  a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(b) the service is provided to the person individually; and

(c) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(d) on the completion of the course of treatment, the eligible clinical psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

(e) the service is at least 50 minutes duration

Fee: $161.20 Benefit: 85% = $137.05

(See para AN.0.30, AN.0.76 of explanatory notes to this Category)

Psychological therapy health service provided by phone attendance by an eligible clinical psychologist if:

(a)   the person is referred by:

(i) a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

(ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

(iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(b)   the service is provided to the person individually; and

(c)   at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(d)   on the completion of the course of treatment, the eligible clinical psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

(e) the service is at least 30 minutes but less than 50 minutes duration

Fee: $109.80 Benefit: 85% = $93.35

(See para AN.0.76 of explanatory notes to this Category)

Psychological therapy health service provided by phone attendance by an eligible clinical psychologist if:

(a)   the person is referred by:

(i)  a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

(ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

(iii)  a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(b)   the service is provided to the person individually; and

(c)   at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(d)   on the completion of the course of treatment, the eligible clinical psychologist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

(e)     the service is at least 50 minutes duration

Fee: $161.20 Benefit: 85% = $137.05

(See para AN.0.76 of explanatory notes to this Category)

Focussed psychological strategies health service provided by phone attendance by an eligible occupational therapist if:

(a)   the person is referred by:

(i)  a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

(ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

(iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(b)   the service is provided to the person individually; and

(c)   at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(d)   on the completion of the course of treatment, the eligible occupational therapist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

(e)     the service is at least 20 minutes but less than 50 minutes duration

Fee: $68.55 Benefit: 85% = $58.30

(See para AN.0.76, MN.7.1 of explanatory notes to this Category)

Focussed psychological strategies health service provided by phone attendance by an eligible occupational therapist if:

(a)   the person is referred by:

(i)  a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

(ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

(iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(b)   the service is provided to the person individually; and

(c)   at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(d)   on the completion of the course of treatment, the eligible occupational therapist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

(e)     the service is at least 50 minutes in duration

Fee: $96.80 Benefit: 85% = $82.30

(See para AN.0.76, MN.7.1 of explanatory notes to this Category)

Focussed psychological strategies health service provided by telehealth attendance by an eligible occupational therapist if:

(a) the person is referred by:

(i)  a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

(ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

(iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(b)  the service is provided to the person individually; and

(c)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(d) on the completion of the course of treatment, the eligible occupational therapist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

(e)  the service is at least 20 minutes but less than 50 minutes duration

Fee: $68.55 Benefit: 85% = $58.30

(See para AN.0.30, AN.0.76, MN.7.1 of explanatory notes to this Category)

Focussed psychological strategies health service provided by telehealth attendance by an eligible occupational therapist if:

(a) the person is referred by:

(i)  a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

(ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

(iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(b)  the service is provided to the person individually; and

(c)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(d)  on the completion of the course of treatment, the eligible occupational therapist gives a written report to the referring medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

(e)  the service is at least 50 minutes in duration

Fee: $96.80 Benefit: 85% = $82.30

(See para AN.0.30, AN.0.76, MN.7.1 of explanatory notes to this Category)