Medicare Benefits Schedule - Note TN.4.13

Items for the planning and management of pregnancy (16590 and 16591) and for a postnatal attendance between 4 and 8 weeks after birth (16407), include a mental health assessment of the patient, including screening for drug and alcohol use and domestic violence, to be performed by the clinician or another suitably qualified health professional on behalf of the clinician.  A mental health assessment must be offered to each patient, however, if the patient chooses not to undertake the assessment, this does not preclude a rebate being payable for these items. 

It is recommended that mental health assessments associated with items 16590, 16591, and 16407 be conducted in accordance with the National Health and Medical Research Council (NHMRC) endorsed guideline: Mental Health Care in the Perinatal Period: Australian Clinical Practice Guideline – October 2017, Centre for Perinatal Excellence.

Results of the mental health assessment must be recorded in the patient’s medical record.  A record of a patient’s decision not to undergo a mental health assessment must be recorded in the patient’s clinical notes.

Related Items: 16407 16590 16591

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Postnatal professional attendance (other than a service to which any other item applies) if the attendance:

(a) is by an obstetrician or general practitioner; and

(b) is in hospital or at consulting rooms; and

(c) is between 4 and 8 weeks after the birth; and

(d) lasts at least 20 minutes; and

(e) includes a mental health assessment (including screening for drug and alcohol use and domestic violence) of the patient; and

(f) is for a pregnancy in relation to which a service to which item 82140 applies is not provided
Payable once only for a pregnancy

Fee: $75.80 Benefit: 75% = $56.85 85% = $64.45

(See para TN.4.13, TN.4.15 of explanatory notes to this Category)

Planning and management, by a practitioner, of a pregnancy if:

(a) the practitioner intends to take primary responsibility for management of the pregnancy and any complications, and to be available for the birth; and

(b) the patient intends to be privately admitted for the birth; and

(c) the pregnancy has progressed beyond 28 weeks gestation; and

(d) the practitioner has maternity privileges at a hospital or birth centre; and

(e) the service includes a mental health assessment (including screening for drug and alcohol use and domestic violence) of the patient; and

(f) a service to which item 16591 applies is not provided in relation to the same pregnancy

Payable once only for a pregnancy

Fee: $394.05 Benefit: 75% = $295.55 85% = $334.95

(See para TN.4.9, TN.4.13 of explanatory notes to this Category)

Planning and management, by a practitioner, of a pregnancy if:

(a) the pregnancy has progressed beyond 28 weeks gestation; and

(b) the service includes a mental health assessment (including screening for drug and alcohol use and domestic violence) of the patient; and

(c) a service to which item 16590 applies is not provided in relation to the same pregnancy

Payable once only for a pregnancy

Fee: $150.75 Benefit: 75% = $113.10 85% = $128.15

(See para TN.4.9, TN.4.13 of explanatory notes to this Category)