Medicare Benefits Schedule - Item 91819

Search Results for Item 91819

View Associated Notes

Category 1 - PROFESSIONAL ATTENDANCES

91819

91819 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
21-Jul-2021
Schedule Fee Updated:
01-Jul-2024

Group
A40 - Telehealth and phone attendance services
Subgroup
3 - Focussed Psychological Strategies telehealth services

Telehealth 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: $151.20 Benefit: 100% = $151.20

(See para AN.0.57 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $453.60


Associated Notes

Category 1 - PROFESSIONAL ATTENDANCES

AN.0.57

Provision of Focussed Psychological Strategies - (Items 2721, 2723, 2725, 2727, 91818, 91819, 91842 and 91843)

Focussed psychological strategies are specific mental health care management strategies, derived from evidence based psychological therapies that have been shown to integrate the best research evidence of clinical effectiveness with general practice clinical expertise. The decision to recommend Focussed Psychological Strategies to a patient must be made either in the context of a GP Mental Health Treatment Plan or a psychiatrist assessment and management plan.

Minimum Requirements

All consultations providing Focussed Psychological Strategies must be rendered by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician).

To ensure appropriate standards for the provision of Focussed Psychological Strategies, payment of Medicare rebates for these items will be limited to medical practitioners who are registered with Services Australia as having satisfied the requirements for higher level mental health skills for provision of the service, as determined by the General Practice Mental Health Standards Collaboration.

Continued access to item numbers 2721, 2723, 2725, 2727, 91818, 91819, 91842 and 91843 will be dependent on the practitioner meeting the ongoing mental health education requirements as determined by the General Practice Mental Health Standards Collaboration.

Patients will be permitted to claim Medicare rebates for up to 10 mental health services under these item numbers per calendar year. The 10 services may consist of: GP focussed psychological strategies services (items 2721, 2723, 2725, 2727; 91818, 91819, 91842 and 91843) or non-specialist medical practitioner items (283, 285, 286, 287, 91820, 91821, 91844 and 91845); and/or psychological therapy services (items 80000, 80005, 80010, 80015, 91166, 91167, 91181 and 91182); and/or focussed psychological strategies – allied mental health services (items 80100, 80105, 80110, 80115, 80125, 80130, 80135, 80140, 80150, 80155, 80160, 80165, 91169, 91170, 91172, 91173, 91175, 91176, 91183, 91184, 91185, 91186, 91187 and 91188).

Out-of-Surgery Consultation

It is expected that this service would be provided only for patients who are unable to attend the practice. 

 

Specific Focussed Psychological Strategies

A range of acceptable strategies has been approved for use by medical practitioners in this context. These are:

1.       Psycho-education
(including motivational interviewing)
2.       Cognitive-behavioural therapy including:
·              Behavioural interventions
-      Behaviour modification
-      Exposure techniques
-      Activity scheduling
·              Cognitive interventions
-      Cognitive therapy
3.       Relaxation strategies
-      Progressive muscle relaxation
-      Controlled breathing
4.       Skills training
-      Problem solving skills and training
-      Anger management
-      Social skills training
-      Communication training
-      Stress management
-      Parent management training
5.       Interpersonal therapy

6.       Eye-Movement Desensitisation Reprocessing (EMDR)

Mental Disorder

A mental disorder may be 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 Health Care Version.

Dementia, delirium, tobacco use disorder and mental retardation are not regarded as mental disorders for the purposes of these items.

Related Items: 2721 2723 2725 2727 91818 91819 91842 91843


Legend

  • Assist - Addition/Deletion of (Assist.)
  • Amend - Amended Description
  • Anaes - Anaesthetic Values Amended
  • Emsn - EMSN Change
  • Fee - Fee Amended
  • Renum - Item Number Change (renumbered)
  • New - New Item
  • NewMin - New Item (previous Ministerial Determination)
  • Qfe - QFE Change