Medicare Benefits Schedule - Note AN.0.78

Summary

This explanatory note provides an overview of The Better Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Schedule initiative (Better Access), which commenced on 1 November 2006. Under this initiative, Medicare benefits are available to patients for selected mental health treatment services provided by eligible general practitioners (GPs), eligible prescribed medical practitioners (PMPs), psychologists (eligible clinical and eligible registered), eligible social workers and eligible occupational therapists.

Further information on the eligibility requirements of a GP can be found at 2.20.7 (Restrictions on items in Subgroup 2 of Group A20 [focussed psychological strategies]) and a PMP can be found at 2.20.7A (Restrictions on items in Subgroup 9 of Group A7 [focussed psychological strategies]). The Health Insurance (General Medical Services Table) Regulations 2021 provides further information on the legislative requirements for eligible GPs and PMPs. For further information on the qualification requirements for Allied Health Professionals who are able to provide mental health services under Medicare, refer to Schedule 1 (Qualification requirements for allied health professionals) in the Health Insurance (Section 3C General Medical Services – Allied Health and other Primary Health Care Services) Determination 2024.

All Medicare Benefits Schedule (MBS) explanatory notes that are associated with the Better Access initiative are listed below:

Services provided under Better Access

Through Better Access, eligible patients can claim a Medicare benefit for up to 10 individual and 10 group therapy mental health treatment services per calendar year. These services consist of:

• psychological therapy provided by eligible clinical psychologists (refer to explanatory note MN.6.2 - Provision of Psychological Therapy); and
• focussed psychological strategies provided by eligible GPs, eligible PMPs, eligible psychologists, eligible occupational therapists, and eligible social workers (refer to explanatory note MN.7.4 – Provision of Focussed Psychological Strategies).

A Medicare benefit is also available for a patient to involve another person, such as a family member or carer, in their treatment. Medicare benefits are available to a patient for up to 2 services provided to another person per calendar year. Any services delivered using these MBS items count towards the patient's course of treatment and calendar year allocations under Better Access. For further information on involving another person in a patient’s treatment, refer to explanatory note MN.7.5 – Family and Carer Participation.

There are also MBS items for the provision of mental health case conferencing services to establish and coordinate the management of the care needs of a patient. For further information refer to explanatory note AN.15.1– Mental Health Case Conferences.

Patient eligibility for Better Access services

Better Access services apply to people with a clinically diagnosed mental disorder. For the purposes of Better Access services, a mental disorder is defined as a significant impairment of an individual's cognitive, affective and/or relational abilities which may require intervention and may be a recognised, medically diagnosable illness or disorder. This definition is informed by the World Health Organisation, 1996, Diagnostic and Management Guidelines for Mental Disorders in Primary Care: ICD-10 Chapter V Primary Care Version. For the purposes of Better Access services, dementia, delirium, tobacco use disorder and mental retardation are not regarded as mental disorders.

When referring for treatment services under the Better Access initiative, services should be utilised for patients who require at least a moderate level of mental health support. Consideration should be given to other treatment interventions and pathways (e.g. digital mental health services, Medicare Mental Health Centres, etc) should the patient’s level of support not require psychological intervention under the Better Access initiative.

Referral requirements

Additionally, Better Access MBS treatment items will only attract a Medicare benefit where a patient has been referred for Better Access services by a GP or PMP at the patient’s MyMedicare registered practice or by their usual medical practitioner, or by a specialist or consultant physician specialising in the practice of their field of psychiatry or paediatrics. For the purposes of these services, referring practitioner means:

• usual medical practitioner, in relation to a patient, means a general practitioner or prescribed medical practitioner:

(a) who has provided the majority of services to the person in the past 12 months; or
(b) who is likely to provide the majority of services to the person in the following 12 months; or
(c) located at a medical practice that:

(i) has provided the majority of services to the person in the past 12 months; or

(ii) is likely to provide the majority of services to the person in the next 12 months.

• A GP or PMP at a MyMedicare registered practice means the registration program by that name administered by the department. A MyMedicare service means a service to which an item is provided:

(a) to a person enrolled in MyMedicare; and
(b) at the general practice at which the person is enrolled.

• a medical practitioner who has referred the patient as part of a GP Mental Health Treatment Plan (refer to explanatory note AN.0.56 – GP Mental Health Treatment Plans and Consultation) or a Psychiatrist Assessment and Management Plan (refer to explanatory note AN.0.30 - Consultant Psychiatrist – Referred Patient Assessment and Management Plan); or

• a specialist or consultant physician specialising in the practice of their field of psychiatry directly referring for Better Access services; or

• a specialist or consultant physician specialising in the practice of their field of paediatrics directly referring for Better Access services.

• the patient referral requirements, as part of a Mental Health Treatment Plan (refer to explanatory note AN.0.56 – Mental Health Treatment Plans and Consultation Items) or a Psychiatrist Assessment and Management Plan (refer to explanatory note AN.0.30 - Consultant Psychiatrist – Referred Patient Assessment and Management Plan), have been met.

Focussed psychological strategies are available to any patient from any GP or PMP who has the appropriate training recognised by the General Practice Mental Health Standards Collaboration. GPs and PMPs who provide focussed psychological strategies do so as part of an arrangement for the treatment of an assessed mental disorder under a Mental Health Treatment Plan.

For more information on referral requirements for Better Access services, refer to explanatory note MN.6.3 - Referral requirements for Better Access Treatment Services.

If there is any doubt about a patient's eligibility, Services Australia will be able to confirm whether a Mental Health Treatment Plan and/or a Psychiatrist Assessment and Management Plan is in place and claimed; or an eligible psychiatric or paediatric service has been claimed, as well as the number of Better Access services already claimed by the patient during the calendar year. Additionally, providers can also access the Health Professional Online Services (HPOS) to view a patient’s Mental Health Treatment Plan history.

Allied health professionals can call Services Australia on 132 150 to check this information, while unsure patients can seek clarification by calling 132 011 or view their care plan history in their Medicare online account through myGov to help track services that have been claimed.

A patient will not be eligible to receive a Medicare benefit if they have not been appropriately referred or if a relevant Medicare service has not been provided to them. If the referring service has not yet been claimed, Services Australia will not be aware of the patient's eligibility. In this case the treating practitioner or allied health professional should, with the patient's permission, contact the referring practitioner to ensure a relevant referring service has been provided to the patient.

Mental Health Treatment Plan review requirements

After a patient has used the allocated number of services in the initial individual course of treatment (a maximum of 6 services on the initial referral), a review of the patient’s Mental Health Treatment Plan and a new referral must be obtained from the referring practitioner for further treatment. The review will assess the patient’s progress and consider further treatment options. A review is not to be undertaken more than once in a 3 month period or within 4 weeks following the preparation of a Mental Health Treatment Plan unless exceptional circumstances exist. It is recommended a Mental Health Treatment Plan be reviewed at least once during a course of treatment, with most patients generally not requiring more than 2 reviews in a calendar year.

GPs and PMPs are to use time tiered professional (general attendance) items for the specific purpose of reviewing a Mental Health Treatment Plan. A Mental Health Treatment Plan does not expire. A new Mental Health Treatment Plan should not be created unless exceptional circumstances exist. An exceptional circumstance may be where the patient has had a significant change to their mental health or the treating practitioner or treating allied health professional is unable to obtain a copy of their Mental Health Treatment Plan.

In addition to the 10 individual services, a patient can be referred up to a maximum of 10 group therapy mental health treatment services each calendar year on any one referral. Patients will be required to have a review of their Mental Health Treatment Plan and obtain a new referral from their referring practitioner after they received the number of group therapy mental health treatment services stated on the referral (if less than 10).

The referring practitioner will use their clinical discretion when undertaking a review to determine the number of allied mental health services their patient will be referred for and if the patient requires additional MBS mental health services. Medicare benefits are only available for a maximum of 10 individual and 10 group therapy mental health treatment services each calendar year. Patients can privately fund or use other funding sources they are eligible for to access further services.

Under MyMedicare and usual medical practitioner requirements, GPs and PMPs will be able to access time-tiered professional (general) attendance items to review and provide mental health care to patients recognising the time spent with patients to provide quality care. There will be no limitation on the number of health-related issues that can be addressed as part of a general attendance consultation, as long as the requirements of the service are met, and adequate and contemporaneous records are maintained. Key principles for using time-tiered professional (general) attendance items and any specific requirements is available at AN.0.9 | Using time-tiered professional (general) attendance items. 

Out-of-pocket expenses and Medicare safety net

Charges in excess of the Medicare benefit for Better Access MBS items are the responsibility of the patient. However, any out-of-pocket costs will count towards the Medicare safety net for that patient. The out-of-pocket costs for mental health services which are not Medicare eligible do not count towards the Medicare safety net (refer to explanatory note GN.10.27 | Medicare Safety Nets.

Publicly funded services

Better Access MBS items do not apply for services that are provided by any other Commonwealth or state funded services or provided to an admitted patient of a hospital. Unless an exemption under subsection 19(2) of the Health Insurance Act 1973 applies for a Medicare benefit to be payable, all requirements of the service must be met, including registration with Services Australia.

Private health insurance

Patients need to decide if they will use Medicare or their private health insurance ancillary cover to pay for these services. Patients cannot use their private health insurance ancillary cover to 'top up' the Medicare benefit paid for the services. If a patient has exhausted their services for which a Medicare benefit is payable for the calendar year, and if they have appropriate private health insurance which covers psychological services, they may claim from their private health fund. The benefit payable to members of private health funds will vary based on the level of their ancillary cover.

Record keeping and reporting requirements

The Department of Health, Disability and Ageing undertakes regular post payment auditing to ensure MBS items are claimed appropriately. All practitioners providing Better Access services should ensure they keep adequate and contemporaneous records, including documenting the date, time and people who attended. Only clinical details recorded at the time of attendance count towards the time of the consultation. Other notes or reports added at a later time are not included. For information on what constitutes adequate and contemporaneous records, refer to explanatory note GN.15.39 - Practitioners should maintain adequate and contemporaneous records.

Relevant Legislation

Details about the legislative requirements of the Better Access initiative MBS items can be found on the Federal Register of Legislation at www.legislation.gov.au.

Attendance items are set out in 3 regulatory instruments:

• Health Insurance (Section 3C General Medical Services – Allied Health and other Primary Health Care Services) Determination 2024 - Eligible psychologist (clinical and registered), eligible social worker, and eligible occupational therapist items.
• Health Insurance (General Medical Services Table) Regulations 2021 – General practitioner, prescribed medical practitioner and psychiatrist items, including items related to Focussed Psychological Strategies for eligible general practitioners and eligible prescribed medical practitioners.
• Health Insurance (Section 3C General Medical Services – Telehealth Attendances) Determination 2021 - telehealth (video and phone) items – General practitioner, prescribed medical practitioner, eligible psychologists (clinical and registered), eligible social worker, and eligible occupational therapist items. In addition, items related to focussed psychological strategies for eligible general practitioners and eligible prescribed medical practitioners are included in this instrument.

Further information

For further information about Medicare Benefits Schedule items, please visit the MBS Online website at www.health.gov.au/mbsonline.

For providers, further information is also available from the Services Australia provider enquiry line on 132 150.

If you are a patient seeking advice about Medicare services, patient benefits, or your Medicare claims, please contact Services Australia on the Medicare General enquiry line on 132 011.

Related Items: 272 276 281 282 283 285 286 287 309 311 313 315 930 933 935 937 943 945 946 948 959 961 962 964 969 971 972 973 975 986 2700 2701 2715 2717 2721 2723 2725 2727 2739 2741 2743 2745 80000 80002 80005 80006 80010 80012 80015 80016 80020 80021 80022 80023 80024 80025 80100 80102 80105 80106 80110 80112 80115 80116 80120 80121 80122 80123 80125 80127 80128 80129 80130 80131 80135 80137 80140 80141 80145 80146 80147 80148 80150 80152 80153 80154 80155 80156 80160 80162 80165 80166 80170 80171 80172 80173 80174 80175 80176 80177 80178 91166 91167 91168 91169 91170 91171 91174 91181 91182 91183 91184 91185 91186 91187 91188 91198 91199 91200 91201 91202 91203 91204 91205 91842 91843 91844 91845 91864 91865 91866 91867

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Professional attendance at consulting rooms by a general practitioner, for providing focussed psychological strategies for assessed mental disorders by a general practitioner registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service, and lasting at least 30 minutes, but less than 40 minutes

Fee: $108.20 Benefit: 100% = $108.20

(See para AN.0.78, AN.36.2, MN.6.3, MN.7.4 of explanatory notes to this Category)

Professional attendance at a place other than consulting rooms by a general practitioner (not including a specialist or a consultant physician), for providing focussed psychological strategies for assessed mental disorders by a medical practitioner registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service, and lasting at least 30 minutes, but less than 40 minutes

The fee for item 2721, plus $30.30 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 2721 plus $2.40 per patient.
Ready Reckoner

(See para AN.0.78, AN.36.2, MN.6.3, MN.7.4 of explanatory notes to this Category)

Professional attendance at consulting rooms by a general practitioner, for providing focussed psychological strategies for assessed mental disorders by a general practitioner registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service, and lasting at least 40 minutes

Fee: $154.85 Benefit: 100% = $154.85

(See para AN.0.78, AN.36.2, MN.6.3, MN.7.4 of explanatory notes to this Category)

Professional attendance at a place other than consulting rooms by a general practitioner (not including a specialist or a consultant physician), for providing focussed psychological strategies for assessed mental disorders by a medical practitioner registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service, and lasting at least 40 minutes

The fee for item 2725, plus $30.30 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 2725 plus $2.40 per patient.
Ready Reckoner

(See para AN.0.78, AN.36.2, MN.6.3, MN.7.4 of explanatory notes to this Category)

Professional attendance at consulting rooms by a general practitioner (not including a specialist or a consultant physician) registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service:

(a) for providing focussed psychological strategies to a person other than the patient, if the service is part of the patient’s treatment; and

(b) lasting at least 30 minutes, but less than 40 minutes

Fee: $108.20 Benefit: 100% = $108.20

(See para AN.0.78, MN.7.5 of explanatory notes to this Category)

Professional attendance at a place other than consulting rooms by a general practitioner (not including a specialist or a consultant physician) registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service:

(a) for providing focussed psychological strategies to a person other than the patient, if the service is part of the patient’s treatment; and

(b) lasting at least 30 minutes, but less than 40 minutes

The fee for item 2739, plus $30.30 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 2739 plus $2.40 per patient.
Ready Reckoner

(See para AN.0.78, MN.7.5 of explanatory notes to this Category)

Professional attendance at consulting rooms by a general practitioner (not including a specialist or a consultant physician) registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service:

(a) for providing focussed psychological strategies to a person other than the patient, if the service is part of the patient’s treatment; and

(b) lasting at least 40 minutes

Fee: $154.85 Benefit: 100% = $154.85

(See para AN.0.78, MN.7.5 of explanatory notes to this Category)

Professional attendance at a place other than consulting rooms by a general practitioner (not including a specialist or a consultant physician) registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service:

(a) for providing focussed psychological strategies to a person other than the patient, if the service is part of the patient’s treatment; and

(b) lasting at least 40 minutes

The fee for item 2743, plus $30.30 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 2743 plus $2.40 per patient.
Ready Reckoner

(See para AN.0.78, MN.7.5 of explanatory notes to this Category)

Professional attendance by a general practitioner (including a general practitioner who has not undertaken mental health skills training) of at least 20 minutes but less than 40 minutes in duration for the preparation of a GP mental health treatment plan for a patient

Fee: $83.65 Benefit: 75% = $62.75 100% = $83.65

(See para AN.0.56, AN.0.78, AN.36.2 of explanatory notes to this Category)

Professional attendance by a general practitioner (including a general practitioner who has not undertaken mental health skills training) of at least 40 minutes in duration for the preparation of a GP mental health treatment plan for a patient

Fee: $123.15 Benefit: 75% = $92.40 100% = $123.15

(See para AN.0.56, AN.0.78, AN.36.2 of explanatory notes to this Category)

Professional attendance by a general practitioner (including a general practitioner who has undertaken mental health skills training of at least 20 minutes but less than 40 minutes in duration for the preparation of a GP mental health treatment plan for a patient

Fee: $106.20 Benefit: 75% = $79.65 100% = $106.20

(See para AN.0.56, AN.0.78, AN.36.2 of explanatory notes to this Category)

Professional attendance by a general practitioner (including a general practitioner who has undertaken mental health skills training) of at least 40 minutes in duration for the preparation of a GP mental health treatment plan for a patient

Fee: $156.45 Benefit: 75% = $117.35 100% = $156.45

(See para AN.0.56, AN.0.78, AN.36.2 of explanatory notes to this Category)

Psychological therapy health service provided by video attendance 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

(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: $116.40 Benefit: 85% = $98.95

(See para AN.0.30, AN.0.78, MN.6.2, MN.6.3 of explanatory notes to this Category)

Psychological therapy health service provided by video attendance 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

(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: $170.85 Benefit: 85% = $145.25

(See para AN.0.30, AN.0.78, MN.6.2, MN.6.3 of explanatory notes to this Category)

Video attendance for a psychological therapy health service provided by an eligible clinical psychologist to a person other than the patient, if:

(a)    the service is part of the patient’s treatment;

(b)    the patient has been referred to the eligible clinical psychologist by a referring practitioner; and

(c)    the service lasts at least 30 minutes but less than 50 minutes

Fee: $116.40 Benefit: 85% = $98.95

(See para AN.0.78, MN.6.3, MN.7.5 of explanatory notes to this Category)

Video attendance for a psychological therapy health service provided by an eligible clinical psychologist to a person other than the patient, if:

(a)     the service is part of the patient’s treatment;

(b)    the patient has been referred to the eligible clinical psychologist by a referring practitioner; and

(c)     the service lasts at least 50 minutes

Fee: $170.85 Benefit: 85% = $145.25

(See para AN.0.78, MN.6.3, MN.7.5 of explanatory notes to this Category)

Professional attendance by a prescribed medical practitioner (who has not undertaken mental health skills training), lasting at least 20 minutes but less than 40 minutes, for the preparation of a GP mental health treatment plan for a patient

Fee: $66.90 Benefit: 75% = $50.20 100% = $66.90

(See para AN.0.56, AN.0.78, AN.7.1, AN.36.2 of explanatory notes to this Category)

Professional attendance by a prescribed medical practitioner (who has not undertaken mental health skills training), lasting at least 40 minutes, for the preparation of a GP mental health treatment plan for a patient

Fee: $98.50 Benefit: 75% = $73.90 100% = $98.50

(See para AN.0.56, AN.0.78, AN.7.1, AN.36.2 of explanatory notes to this Category)

Professional attendance by a prescribed medical practitioner (who has undertaken mental health skills training), lasting at least 20 minutes but less than 40 minutes, for the preparation of a GP mental health treatment plan for a patient

Fee: $84.95 Benefit: 75% = $63.75 100% = $84.95

(See para AN.0.56, AN.0.78, AN.7.1, AN.36.2 of explanatory notes to this Category)

Professional attendance by a prescribed medical practitioner (who has undertaken mental health skills training), lasting at least 40 minutes, for the preparation of a GP mental health treatment plan for a patient

Fee: $125.20 Benefit: 75% = $93.90 100% = $125.20

(See para AN.0.56, AN.0.78, AN.7.1, AN.36.2 of explanatory notes to this Category)

Professional attendance at consulting rooms by a prescribed medical practitioner, registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service:
(a) for providing focussed psychological strategies for mental disorders that have been assessed by a medical practitioner; and
(b) lasting at least 30 minutes but less than 40 minutes

Fee: $86.60 Benefit: 100% = $86.60

(See para AN.0.78, AN.7.1, AN.36.2, MN.6.3, MN.7.4 of explanatory notes to this Category)

Professional attendance at a place other than consulting rooms by a prescribed medical practitioner, registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service:
(a) for providing focussed psychological strategies for mental disorders that have been assessed by a medical practitioner; and
(b) lasting at least 30 minutes but less than 40 minutes

The fee for item 283, plus $24.25 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 283 plus $1.90 per patient.
Ready Reckoner

(See para AN.0.78, AN.7.1, AN.36.2, MN.6.3, MN.7.4 of explanatory notes to this Category)

Professional attendance at consulting rooms by a prescribed medical practitioner, registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service:
(a) for providing focussed psychological strategies for mental disorders that have been assessed by a medical practitioner; and
(b) lasting at least 40 minutes

Fee: $123.90 Benefit: 100% = $123.90

(See para AN.0.78, AN.7.1, AN.36.2, MN.6.3, MN.7.4 of explanatory notes to this Category)

Professional attendance at a place other than consulting rooms by a prescribed medical practitioner, registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service:
(a) for providing focussed psychological strategies for mental disorders that have been assessed by a medical practitioner; and
(b) lasting at least 40 minutes

The fee for item 286, plus $24.25 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 286 plus $1.90 per patient.
Ready Reckoner

(See para AN.0.78, AN.7.1, AN.36.2, MN.6.3, MN.7.4 of explanatory notes to this Category)

Professional attendance at consulting rooms by a prescribed medical practitioner, registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service:
(a) for providing focussed psychological strategies for assessed mental disorders to a person other than the patient, if the service is part of the patient’s treatment; and
(b) lasting at least 30 minutes but less than 40 minutes

Fee: $86.60 Benefit: 100% = $86.60

(See para AN.0.78, MN.7.5 of explanatory notes to this Category)

Professional attendance at a place other than consulting rooms by a prescribed medical practitioner, registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service:
(a) for providing focussed psychological strategies for assessed mental disorders to a person other than the patient, if the service is part of the patient’s treatment; and
(b) lasting at least 30 minutes but less than 40 minutes

The fee for item 309, plus $24.25 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 309 plus $1.90 per patient.
Ready Reckoner

(See para AN.0.78, MN.7.5 of explanatory notes to this Category)

Professional attendance at consulting rooms by a prescribed medical practitioner, registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service:
(a) for providing focussed psychological strategies for assessed mental disorders to a person other than the patient, if the service is part of the patient’s treatment; and
(b) lasting at least 40 minutes

Fee: $123.90 Benefit: 100% = $123.90

(See para AN.0.78, MN.7.5 of explanatory notes to this Category)

Professional attendance at a place other than consulting rooms by a prescribed medical practitioner, registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service:
(a) for providing focussed psychological strategies for assessed mental disorders to a person other than the patient, if the service is part of the patient’s treatment; and
(b) lasting at least 40 minutes

The fee for item 313, plus $24.25 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 313 plus $1.90 per patient.
Ready Reckoner

(See para AN.0.78, MN.7.5 of explanatory notes to this Category)

Focussed psychological strategies health service provided by video attendance 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

(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: $82.50 Benefit: 85% = $70.15

(See para AN.0.30, AN.0.78, MN.6.3, MN.7.4 of explanatory notes to this Category)

Focussed psychological strategies health service provided by video attendance 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

(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: $116.40 Benefit: 85% = $98.95

(See para AN.0.30, AN.0.78, MN.6.3, MN.7.4 of explanatory notes to this Category)

Video attendance for a focussed psychological strategies health service provided by an eligible psychologist to a person other than the patient, if:

(a)     the service is part of the patient’s treatment;

(b)    the patient has been referred to the eligible psychologist by a referring practitioner; and

(c)     the service lasts at least 20 minutes but less than 50 minutes

Fee: $82.50 Benefit: 85% = $70.15

(See para AN.0.78, MN.7.5 of explanatory notes to this Category)

Attendance by a prescribed medical practitioner, as a member of a multidisciplinary case conference team, to organise and coordinate a mental health case conference if the conference lasts for at least 15 minutes, but for less than 20 minutes

Fee: $66.05 Benefit: 75% = $49.55 100% = $66.05

(See para AN.0.78, AN.15.1 of explanatory notes to this Category)

Attendance by a prescribed medical practitioner, as a member of a multidisciplinary case conference team, to organise and coordinate a mental health case conference if the conference lasts for at least 20 minutes, but for less than 40 minutes

Fee: $112.90 Benefit: 75% = $84.70 100% = $112.90

(See para AN.0.78, AN.15.1 of explanatory notes to this Category)

Attendance by a prescribed medical practitioner, as a member of a multidisciplinary case conference team, to organise and coordinate a mental health case conference if the conference lasts for at least 40 minutes

Fee: $188.15 Benefit: 75% = $141.15 100% = $188.15

(See para AN.0.78, AN.15.1 of explanatory notes to this Category)

Attendance by a prescribed medical practitioner, as a member of a multidisciplinary case conference team, to participate in a mental health case conference if the conference lasts for at least 15 minutes, but for less than 20 minutes

Fee: $48.50 Benefit: 75% = $36.40 100% = $48.50

(See para AN.0.78, AN.15.1 of explanatory notes to this Category)

Attendance by a prescribed medical practitioner, as a member of a multidisciplinary case conference team, to participate in a mental health case conference if the conference lasts for at least 20 minutes, but for less than 40 minutes

Fee: $83.10 Benefit: 75% = $62.35 100% = $83.10

(See para AN.0.78, AN.15.1 of explanatory notes to this Category)

Attendance by a prescribed medical practitioner, as a member of a multidisciplinary case conference team, to participate in a mental health case conference if the conference lasts for at least 40 minutes

Fee: $138.30 Benefit: 75% = $103.75 100% = $138.30

(See para AN.0.78, AN.15.1 of explanatory notes to this Category)

Focussed psychological strategies health service provided by phone attendance 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

(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: $82.50 Benefit: 85% = $70.15

(See para AN.0.78, MN.6.3, MN.7.4 of explanatory notes to this Category)

Focussed psychological strategies health service provided by phone attendance 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

(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: $116.40 Benefit: 85% = $98.95

(See para AN.0.78, MN.6.3, MN.7.4 of explanatory notes to this Category)

Phone attendance for a focussed psychological strategies health service provided by an eligible psychologist to a person other than the patient, if:

(a)     the service is part of the patient’s treatment;

(b)    the patient has been referred to the eligible psychologist by a referring practitioner; and

(c)     the service lasts at least 20 minutes but less than 50 minutes

Fee: $82.50 Benefit: 85% = $70.15

(See para AN.0.78, MN.7.5 of explanatory notes to this Category)

Phone attendance for a focussed psychological strategies health service provided by an eligible psychologist to a person other than the patient, if:

(a)     the service is part of the patient’s treatment;

(b)    the patient has been referred to the eligible psychologist by a referring practitioner; and

(c)     the service lasts at least 50 minutes

Fee: $116.40 Benefit: 85% = $98.95

(See para AN.0.78, MN.7.5 of explanatory notes to this Category)

Phone attendance by a general practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if:

(a)     the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and

(b)    the service lasts at least 30 minutes, but less than 40 minutes.

Fee: $108.20 Benefit: 100% = $108.20

(See para AN.0.78, MN.6.3, MN.7.4 of explanatory notes to this Category)

Phone attendance by a general practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if:

(a)     the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and

(b)    the service lasts at least 40 minutes.

Fee: $154.85 Benefit: 100% = $154.85

(See para AN.0.78, MN.6.3, MN.7.4 of explanatory notes to this Category)

Phone attendance by a medical practitioner (not including a General Practitioner, Specialist or Consultant Physician), for the purpose of providing focussed psychological strategies for assessed mental disorders if:

(a)       the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and

(b)       the service lasts at least 30 minutes, but less than 40 minutes

Fee: $86.60 Benefit: 100% = $86.60

(See para AN.0.78, MN.6.3, MN.7.4 of explanatory notes to this Category)

Phone attendance by a medical practitioner (not including a General Practitioner, Specialist or Consultant Physician), for the purpose of providing focussed psychological strategies for assessed mental disorders if:

(a)     the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and

(b)    the service lasts at least 40 minutes

Fee: $123.90 Benefit: 100% = $123.90

(See para AN.0.78, MN.6.3, MN.7.4 of explanatory notes to this Category)

Phone attendance by a general practitioner (not including a specialist or a consultant physician), registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service:

(a)     for providing focussed psychological strategies for assessed mental disorders to a person other than the patient, if the service is part of the patient’s treatment; and

(b)    lasting at least 30 minutes but less than 40 minutes

Fee: $108.20 Benefit: 100% = $108.20

(See para AN.0.78, MN.7.5 of explanatory notes to this Category)

Phone attendance by a general practitioner (not including a specialist or a consultant physician), registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service:

(a)     for providing focussed psychological strategies for assessed mental disorders to a person other than the patient, if the service is part of the patient’s treatment; and

(b)    lasting at least 40 minutes

Fee: $154.85 Benefit: 100% = $154.85

(See para AN.0.78, MN.7.5 of explanatory notes to this Category)

Phone attendance by a medical practitioner, registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service:

(a)     for providing focussed psychological strategies for assessed mental disorders to a person other than the patient, if the service is part of the patient’s treatment; and

(b)    lasting at least 30 minutes but less than 40 minutes

Fee: $86.55 Benefit: 100% = $86.55

(See para AN.0.78, MN.7.5 of explanatory notes to this Category)

Phone attendance by a medical practitioner, registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service:

(a)     for providing focussed psychological strategies for assessed mental disorders to a person other than the patient, if the service is part of the patient’s treatment; and

(b)    lasting at least 40 minutes

Fee: $123.90 Benefit: 100% = $123.90

(See para AN.0.78, MN.7.5 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: $116.40 Benefit: 85% = $98.95

(See para AN.0.78, MN.6.2, MN.6.3 of explanatory notes to this Category)

Psychological therapy health service provided in consulting rooms by an eligible clinical psychologist to a person other than the patient, if:

(a)   the service is part of the patient’s treatment;

(b)   the patient has been referred to the eligible clinical psychologist by a referring practitioner; and

(c)   the service lasts at least 30 minutes but less than 50 minutes

Fee: $116.40 Benefit: 85% = $98.95

(See para AN.0.78, MN.6.3, MN.7.5 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 30 minutes but less than 50 minutes duration

Fee: $145.45 Benefit: 85% = $123.65

(See para AN.0.78, MN.6.2, MN.6.3 of explanatory notes to this Category)

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

(a)   the service is part of the patient’s treatment;

(b)   the patient has been referred to the eligible clinical psychologist by a referring practitioner; and

(c)   the service lasts at least 30 minutes but less than 50 minutes

Fee: $145.45 Benefit: 85% = $123.65

(See para AN.0.78, MN.6.3, MN.7.5 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 50 minutes duration

Fee: $170.85 Benefit: 85% = $145.25

(See para AN.0.78, MN.6.2, MN.6.3 of explanatory notes to this Category)

Psychological therapy health service provided in consulting rooms by an eligible clinical psychologist to a person other than the patient, if:

(a)   the service is part of the patient’s treatment;

(b)   the patient has been referred to the eligible clinical psychologist by a referring practitioner; and

(c)   the service lasts at least 50 minutes

Fee: $170.85 Benefit: 85% = $145.25

(See para AN.0.78, MN.6.3, MN.7.5 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: $199.90 Benefit: 85% = $169.95

(See para AN.0.78, MN.6.2, MN.6.3 of explanatory notes to this Category)

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

(a)   the service is part of the patient’s treatment; 

(b)   the patient has been referred to the eligible clinical psychologist by a referring practitioner; and

(c)   the service lasts at least 50 minutes

Fee: $199.90 Benefit: 85% = $169.95

(See para AN.0.78, MN.6.3, MN.7.5 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: $43.35 Benefit: 85% = $36.85

(See para AN.0.78, MN.6.2, MN.6.3 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: $43.35 Benefit: 85% = $36.85

(See para AN.0.78, MN.6.2, MN.6.3 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 for a course of treatment by a referring practitioner; and

(b)  the service is provided in person; and

(c)  the service is at least 90 minutes duration

Fee: $59.10 Benefit: 85% = $50.25

(See para AN.0.78, MN.6.2, MN.6.3 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 90 minutes duration

Fee: $59.10 Benefit: 85% = $50.25

(See para AN.0.78, MN.6.2, MN.6.3 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 for a course of treatment by a referring practitioner; and

(b)  the service is provided in person; and

(c)  the service is at least 120 minutes duration

Fee: $80.30 Benefit: 85% = $68.30

(See para AN.0.78, MN.6.2, MN.6.3 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 120 minutes duration

Fee: $80.30 Benefit: 85% = $68.30

(See para AN.0.78, MN.6.2, MN.6.3 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: $82.50 Benefit: 85% = $70.15

(See para AN.0.78, MN.6.3, MN.7.4 of explanatory notes to this Category)

Focussed psychological strategies health service provided in consulting rooms by an eligible psychologist to a person other than the patient, if:

(a)   the service is part of the patient’s treatment;

(b)   the patient has been referred to the eligible psychologist by a referring practitioner; and

(c)   the service lasts at least 20 minutes but less than 50 minutes

Fee: $82.50 Benefit: 85% = $70.15

(See para AN.0.78, MN.7.5 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 20 minutes but less than 50 minutes duration

Fee: $112.20 Benefit: 85% = $95.40

(See para AN.0.78, MN.6.3, MN.7.4 of explanatory notes to this Category)

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

(a)   the service is part of the patient’s treatment;

(b)   the patient has been referred to the eligible psychologist by a referring practitioner; and

(c)   the service lasts at least 20 minutes but less than 50 minutes

Fee: $112.20 Benefit: 85% = $95.40

(See para AN.0.78, MN.7.5 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 50 minutes duration

Fee: $116.40 Benefit: 85% = $98.95

(See para AN.0.78, MN.6.3, MN.7.4 of explanatory notes to this Category)

Focussed psychological strategies health service provided in consulting rooms by an eligible psychologist to a person other than the patient, if:

(a)   the service is part of the patient’s treatment;

(b)   the patient has been referred to the eligible psychologist by a referring practitioner; and

(c)   the service lasts at least 50 minutes

Fee: $116.40 Benefit: 85% = $98.95

(See para AN.0.78, MN.7.5 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: $146.20 Benefit: 85% = $124.30

(See para AN.0.78, MN.6.3, MN.7.4 of explanatory notes to this Category)

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

(a)   the service is part of the patient’s treatment;

(b)   the patient has been referred to the eligible psychologist by a referring practitioner; and

(c)   the service lasts at least 50 minutes

Fee: $146.20 Benefit: 85% = $124.30

(See para AN.0.78, MN.7.5 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: $29.70 Benefit: 85% = $25.25

(See para AN.0.78, MN.6.3, 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: $29.70 Benefit: 85% = $25.25

(See para AN.0.78, MN.6.3, 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 service is provided in person; and

(c)  the service is at least 90 minutes duration

Fee: $40.45 Benefit: 85% = $34.40

(See para AN.0.78, MN.6.3, 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 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 90 minutes duration

Fee: $40.45 Benefit: 85% = $34.40

(See para AN.0.78, MN.6.3, 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: $72.65 Benefit: 85% = $61.80

(See para AN.0.78, MN.6.3, 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 service is provided in person; and

(c)  the service is at least 120 minutes duration

Fee: $54.95 Benefit: 85% = $46.75

(See para AN.0.78, MN.6.3, 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 120 minutes duration

Fee: $54.95 Benefit: 85% = $46.75

(See para AN.0.78, MN.6.3, MN.7.4 of explanatory notes to this Category)

Focussed psychological strategies health service provided in consulting rooms by an eligible occupational therapist to a person other than the patient, if:

(a)   the service is part of the patient’s treatment;

(b)   the patient has been referred to the eligible occupational therapist by a referring practitioner; and

(c)   the service lasts at least 20 minutes but less than 50 minutes

Fee: $72.65 Benefit: 85% = $61.80

(See para AN.0.78, MN.7.5 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 20 minutes but less than 50 minutes duration

Fee: $102.35 Benefit: 85% = $87.00

(See para AN.0.78, MN.6.3, MN.7.4 of explanatory notes to this Category)

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

(a)   the service is part of the patient’s treatment;

(b)   the patient has been referred to the eligible occupational therapist by a referring practitioner; and

(c)   the service lasts at least 20 minutes but less than 50 minutes

Fee: $102.35 Benefit: 85% = $87.00

(See para AN.0.78, MN.7.5 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 50 minutes duration

Fee: $102.60 Benefit: 85% = $87.25

(See para AN.0.78, MN.6.3, MN.7.4 of explanatory notes to this Category)

Focussed psychological strategies health service provided in consulting rooms by an eligible occupational therapist to a person other than the patient, if:

(a)   the service is part of the patient’s treatment;

(b)   the patient has been referred to the eligible occupational therapist by a referring practitioner; and

(c)   the service lasts at least 50 minutes

Fee: $102.60 Benefit: 85% = $87.25

(See para AN.0.78, MN.7.5 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: $132.20 Benefit: 85% = $112.40

(See para AN.0.78, MN.6.3, MN.7.4 of explanatory notes to this Category)

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

(a)   the service is part of the patient’s treatment;

(b)   the patient has been referred to the eligible occupational therapist by a referring practitioner; and

(c)   the service lasts at least 50 minutes

Fee: $132.20 Benefit: 85% = $112.40

(See para AN.0.78, MN.7.5 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: $26.00 Benefit: 85% = $22.10

(See para AN.0.78, MN.6.3, 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: $26.00 Benefit: 85% = $22.10

(See para AN.0.78, MN.6.3, 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 service is provided in person; and

(c)  the service is at least 90 minutes duration

Fee: $35.40 Benefit: 85% = $30.10

(See para AN.0.78, MN.6.3, 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 90 minutes duration

Fee: $35.40 Benefit: 85% = $30.10

(See para AN.0.78, MN.6.3, 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: $72.65 Benefit: 85% = $61.80

(See para AN.0.78, MN.6.3, 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 service is provided in person; and

(c)  the service is at least 120 minutes duration

Fee: $48.25 Benefit: 85% = $41.05

(See para AN.0.78, MN.6.3, 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 120 minutes duration

Fee: $48.25 Benefit: 85% = $41.05

(See para AN.0.78, MN.6.3, MN.7.4 of explanatory notes to this Category)

Focussed psychological strategies health service provided in consulting rooms by an eligible social worker to a person other than the patient, if:

(a)   the service is part of the patient’s treatment;

(b)   the patient has been referred to the eligible social worker by a referring practitioner; and

(c)   the service lasts at least 20 minutes but less than 50 minutes

Fee: $72.65 Benefit: 85% = $61.80

(See para AN.0.78, MN.7.5 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 20 minutes but less than 50 minutes duration

Fee: $102.35 Benefit: 85% = $87.00

(See para AN.0.78, MN.6.3, MN.7.4 of explanatory notes to this Category)

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

(a)   the service is part of the patient’s treatment;

(b)   the patient has been referred to the eligible social worker by a referring practitioner; and

(c)   the service lasts at least 20 minutes but less than 50 minutes

Fee: $102.35 Benefit: 85% = $87.00

(See para AN.0.78, MN.7.5 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 50 minutes duration

Fee: $102.60 Benefit: 85% = $87.25

(See para AN.0.78, MN.6.3, MN.7.4 of explanatory notes to this Category)

Focussed psychological strategies health service provided in consulting rooms by an eligible social worker to a person other than the patient, if:

(a)   the service is part of the patient’s treatment;

(b)   the patient has been referred to the eligible social worker by a referring practitioner; and

(c)   the service lasts at least 50 minutes

Fee: $102.60 Benefit: 85% = $87.25

(See para AN.0.78, MN.7.5 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: $132.20 Benefit: 85% = $112.40

(See para AN.0.78, MN.6.3, MN.7.4 of explanatory notes to this Category)

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

(a)   the service is part of the patient’s treatment;

(b)   the patient has been referred to the eligible social worker by a referring practitioner; and

(c)   the service lasts at least 50 minutes

Fee: $132.20 Benefit: 85% = $112.40

(See para AN.0.78, MN.7.5 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: $26.00 Benefit: 85% = $22.10

(See para AN.0.78, MN.6.3, 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: $26.00 Benefit: 85% = $22.10

(See para AN.0.78, MN.6.3, 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 service is provided in person; and

(c)  the service is at least 90 minutes duration

Fee: $35.40 Benefit: 85% = $30.10

(See para AN.0.78, MN.6.3, 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 90 minutes duration

Fee: $35.40 Benefit: 85% = $30.10

(See para AN.0.78, MN.6.3, 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 service is provided in person; and

(c)  the service is at least 120 minutes duration

Fee: $48.25 Benefit: 85% = $41.05

(See para AN.0.78, MN.6.3, 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 120 minutes duration

Fee: $48.25 Benefit: 85% = $41.05

(See para AN.0.78, MN.6.3, MN.7.4 of explanatory notes to this Category)

Focussed psychological strategies health service provided by phone attendance 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

(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: $72.65 Benefit: 85% = $61.80

(See para AN.0.78, MN.6.3, MN.7.4 of explanatory notes to this Category)

Focussed psychological strategies health service provided by phone attendance 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

(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: $102.60 Benefit: 85% = $87.25

(See para AN.0.78, MN.6.3, MN.7.4 of explanatory notes to this Category)

Phone attendance for a focussed psychological strategies health service provided by an eligible social worker to a person other than the patient, if:

(a)     the service is part of the patient’s treatment;

(b)    the patient has been referred to the eligible social worker by a referring practitioner; and

(c)     the service lasts at least 20 minutes but less than 50 minutes

Fee: $72.65 Benefit: 85% = $61.80

(See para AN.0.78, MN.7.5 of explanatory notes to this Category)

Phone attendance for a focussed psychological strategies health service provided by an eligible social worker to a person other than the patient, if:

(a)     the service is part of the patient’s treatment;

(b)    the patient has been referred to the eligible social worker by a referring practitioner; and

(c)     the service lasts at least 50 minutes

Fee: $102.60 Benefit: 85% = $87.25

(See para AN.0.78, MN.7.5 of explanatory notes to this Category)

Attendance by a general practitioner, as a member of a multidisciplinary case conference team, to organise and coordinate a mental health case conference, if the conference lasts for at least 15 minutes, but for less than 20 minutes

Fee: $82.50 Benefit: 75% = $61.90 100% = $82.50

(See para AN.0.78, AN.15.1 of explanatory notes to this Category)

Attendance by a general practitioner, as a member of a multidisciplinary case conference team, to organise and coordinate a mental health case conference, if the conference lasts for at least 20 minutes, but for less than 40 minutes

Fee: $141.05 Benefit: 75% = $105.80 100% = $141.05

(See para AN.0.78, AN.15.1 of explanatory notes to this Category)

Attendance by a general practitioner, as a member of a multidisciplinary case conference team, to organise and coordinate a mental health case conference, if the conference lasts for at least 40 minutes

Fee: $235.15 Benefit: 75% = $176.40 100% = $235.15

(See para AN.0.78, AN.15.1 of explanatory notes to this Category)

Attendance by a general practitioner, as a member of a multidisciplinary case conference team, to participate in a mental health case conference, if the conference lasts for at least 15 minutes, but for less than 20 minutes

Fee: $60.60 Benefit: 75% = $45.45 100% = $60.60

(See para AN.0.78, AN.15.1 of explanatory notes to this Category)

Attendance by a general practitioner, as a member of a multidisciplinary case conference team, to participate in a mental health case conference, if the conference lasts for at least 20 minutes, but for less than 40 minutes

Fee: $103.90 Benefit: 75% = $77.95 100% = $103.90

(See para AN.0.78, AN.15.1 of explanatory notes to this Category)

Attendance by a general practitioner, as a member of a multidisciplinary case conference team, to participate in a mental health case conference, if the conference lasts for at least 40 minutes

Fee: $172.85 Benefit: 75% = $129.65 100% = $172.85

(See para AN.0.78, AN.15.1 of explanatory notes to this Category)

Attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry or paediatrics, as a member of a multidisciplinary case conference team, to organise and coordinate a mental health case conference of at least 15 minutes but less than 30 minutes, with the multidisciplinary case conference team

Fee: $164.65 Benefit: 75% = $123.50 85% = $140.00

(See para AN.0.78, AN.15.1 of explanatory notes to this Category)

Attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry or paediatrics, as a member of a multidisciplinary case conference team, to organise and coordinate a mental health case conference of at least 30 minutes but less than 45 minutes, with the multidisciplinary case conference team

Fee: $247.15 Benefit: 75% = $185.40 85% = $210.10

(See para AN.0.78, AN.15.1 of explanatory notes to this Category)

Attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry or paediatrics, as a member of a multidisciplinary case conference team, to organise and coordinate a mental health case conference of at least 45 minutes, with the multidisciplinary case conference team

Fee: $329.25 Benefit: 75% = $246.95 85% = $279.90

(See para AN.0.78, AN.15.1 of explanatory notes to this Category)

Attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry or paediatrics, as a member of a multidisciplinary case conference team, to participate in a mental health case conference of at least 15 minutes but less than 30 minutes, with the multidisciplinary case conference team

Fee: $118.25 Benefit: 75% = $88.70 85% = $100.55

(See para AN.0.78, AN.15.1 of explanatory notes to this Category)

Attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry or paediatrics, as a member of a multidisciplinary case conference team, to participate in a mental health case conference of at least 30 minutes but less than 45 minutes, with the multidisciplinary case conference team

Fee: $188.65 Benefit: 75% = $141.50 85% = $160.40

(See para AN.0.78, AN.15.1 of explanatory notes to this Category)

Attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry or paediatrics, as a member of a multidisciplinary case conference team, to participate in a mental health case conference of at least 45 minutes, with the multidisciplinary case conference team

Fee: $259.00 Benefit: 75% = $194.25 85% = $220.15

(See para AN.0.78, AN.15.1 of explanatory notes to this Category)

Psychological therapy health service provided by phone attendance 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

(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: $116.40 Benefit: 85% = $98.95

(See para AN.0.78, MN.6.2, MN.6.3 of explanatory notes to this Category)

Psychological therapy health service provided by phone attendance 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

(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: $170.85 Benefit: 85% = $145.25

(See para AN.0.78, MN.6.2, MN.6.3 of explanatory notes to this Category)

Phone attendance for a psychological therapy health service provided by an eligible clinical psychologist to a person other than the patient, if:

(a)     the service is part of the patient’s treatment;

(b)    the patient has been referred to the eligible clinical psychologist by a referring practitioner; and

(c)     the service lasts at least 30 minutes but less than 50 minutes

Fee: $116.40 Benefit: 85% = $98.95

(See para AN.0.78, MN.6.3, MN.7.5 of explanatory notes to this Category)

Phone attendance for a psychological therapy health service provided by an eligible clinical psychologist to a person other than the patient, if:

(a)     the service is part of the patient’s treatment;

(b)    the patient has been referred to the eligible clinical psychologist by a referring practitioner; and

(c)     the service lasts at least 50 minutes

Fee: $170.85 Benefit: 85% = $145.25

(See para AN.0.78, MN.6.3, MN.7.5 of explanatory notes to this Category)

Focussed psychological strategies health service provided by phone attendance 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

(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: $72.65 Benefit: 85% = $61.80

(See para AN.0.78, MN.6.3, MN.7.4 of explanatory notes to this Category)

Focussed psychological strategies health service provided by phone attendance 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

(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 in duration

Fee: $102.60 Benefit: 85% = $87.25

(See para AN.0.78, MN.6.3, MN.7.4 of explanatory notes to this Category)

Phone attendance for a focussed psychological strategies health service provided by an eligible occupational therapist to a person other than the patient, if:

(a)     the service is part of the patient’s treatment;

(b)    the patient has been referred to the eligible occupational therapist by a referring practitioner; and

(c)     the service lasts at least 20 minutes but less than 50 minutes

Fee: $72.65 Benefit: 85% = $61.80

(See para AN.0.78, MN.7.5 of explanatory notes to this Category)

Phone attendance for a focussed psychological strategies health service provided by an eligible occupational therapist to a person other than the patient, if:

(a)     the service is part of the patient’s treatment;

(b)    the patient has been referred to the eligible occupational therapist by a referring practitioner; and

(c)     the service lasts at least 50 minutes

Fee: $102.60 Benefit: 85% = $87.25

(See para AN.0.78, MN.7.5 of explanatory notes to this Category)

Attendance by an eligible allied health practitioner, as a member of a multidisciplinary case conference team, to participate in a mental health case conference if the conference lasts for at least 15 minutes, but for less than 20 minutes 

Fee: $57.00 Benefit: 85% = $48.45

(See para AN.0.78, AN.15.1 of explanatory notes to this Category)

Attendance by an eligible allied health practitioner, as a member of a multidisciplinary case conference team, to participate in a mental health case conference if the conference lasts for at least 20 minutes, but for less than 40 minutes

Fee: $97.75 Benefit: 85% = $83.10

(See para AN.0.78, AN.15.1 of explanatory notes to this Category)

Attendance by an eligible allied health practitioner, as a member of a multidisciplinary case conference team, to participate in a mental health case conference if the conference lasts for at least 40 minutes

Fee: $162.60 Benefit: 85% = $138.25

(See para AN.0.78, AN.15.1 of explanatory notes to this Category)