Medicare Benefits Schedule - Item 91827

Video attendance for a person by a consultant psychiatrist; if:

(a) the attendance follows a referral of the patient to the consultant psychiatrist by a referring practitioner; and

(b) the attendance was not more than 15 minutes in duration;

if that attendance and another attendance to which item 296, 297, 299 or any of items 300, 302, 304, 306, 308, 91828 to 91831, 91837 to 91839 and 92437 applies have not exceeded 50 attendances in a calendar year

Fee: $51.30 Benefit: 85% = $43.65

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.72, AN.0.75 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $153.90

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Intention and eligibility of this service under item 137 and video equivalent item 92141

Items 137 or video equivalent item 92141 are intended for diagnosis and treatment for patients under 25 years of age with an eligible disability by a specialist or consultant physician.

Definition of eligible disabilities is found at AR.29.1.

Referral pathways:

Early identification of, and intervention for, individuals with eligible disabilities is important in promoting positive longer-term outcomes. Symptoms can cause clinically significant impairment in social, occupational or other important areas of functioning.

Where indications of eligible disability concerns have been identified and brought to the attention of the patient’s GP to initially assess these concerns and the GP considers there are persisting indications that require more specialised assessment, they are encouraged to refer to a specialist or consultant physician for a comprehensive assessment.

Diagnostic Assessment:

The assessment and diagnosis of an eligible disability should be evaluated in the context of both a physical and developmental assessment. The specialist or consultant physician may require a number of separate attendances (through usual time-tiered or subsequent attendance items 104, 105, 107, 108, 110, 116, 119, 122, 128, 131, 296, 297, 299, 300, 302, 304, 306, 308, 310, 312, 314, 316, 318, 319, 320, 324, 326, 328, 330, 332, 334, 336, 338, 341, 342, 343, 344, 345, 346, 347 or 349 or telehealth (video and phone) items 91822 to 91831, 91833, 91836 to 91839, 91868 to 91878 to 91882 to 91884, 92437 or 92455 to 92457) to complete a comprehensive accurate assessment and formulate a diagnosis, exclude other disorders or assess for co-occurring conditions.

Multi-disciplinary assistance with assessment and/or contribution to the treatment and management plan:

Depending on a range of factors, not limited to the patient’s age and nature of suspected disabilities, the specialist or consultant physician may require a multi-disciplinary approach to complete a comprehensive accurate assessment and formulate a diagnosis. 

Where the specialist or consultant physician determines the patient requires additional assessments to formulate a diagnosis, through the assistance of an allied health practitioner, they are able to refer the patient to an eligible allied health practitioner from standard attendance items 104, 105, 107, 108, 110, 116, 119, 122, 128, 131, 296, 297, 299, 300, 302, 304, 306, 308, 310, 312, 314, 316, 318, 319, 320, 324, 326, 328, 330, 332, 334, 336, 338, 341, 342, 343, 344, 345, 346, 347 or 349 or telehealth items (video and phone) 91822 to 91831, 91833, 91836 to 91839, 91868 to 91878 to 91882 to 91884, 92437 or 92455 to 92457.

Whilst MBS items provide for a total of 8 allied health assessment services per patient per lifetime, an eligible allied health practitioner can only provide up to 4 services before the need for a review (the type of review can be specified in the referral to the eligible allied health practitioner) by the referring specialist or consultant physician, who must agree to the need for any additional allied health services prior to the delivery of the remaining 4 allied health assessment services.

Eligible allied health assessment practitioners include:

• Psychologist (MBS item 82000, 93032, 93040)
• Speech pathologist (MBS item 82005, 93033, 93041)
• Occupational therapist (MBS item 82010, 93033, 93041)
• Audiologist, dietitian, exercise physiologist, optometrist, orthoptist, physiotherapist (MBS item 82030, 93033, 93041)

Requirements of the referral to allied health practitioners

The specialist or consultant physician can refer to multiple eligible allied health practitioners concurrently, but a separate referral letter must be provided to each allied health practitioner. The referral should specify the intent of the assessment and if appropriate, specify the number of services to be provided. Where the number of sessions is not specified, each allied health practitioner can provide up to 4 assessment services without the need for review or agreement to provide further assessment services. 

Review requirements following delivery of 4 allied health assessment services

Where an eligible allied health practitioner has provided 4 assessment services (through items 82000, 82005, 82010, 82030, 93032, 93033, 93040 or 93041) and considers additional assessment services are required, they must ensure the referring specialist or consultant physician undertakes a review. If the type of review is not specified by the referring specialist or consultant physician an acceptable means of review includes: a case conference, phone call, written correspondence, secure online messaging exchange or attendance of the patient with the referring psychiatrist.

Inter-disciplinary allied health referral

Eligible allied health practitioners are also able to make inter-disciplinary referrals to other eligible allied health practitioners as clinically necessary to assist with the formulation of the diagnosis or contribute to the treatment and management plan. Inter-disciplinary referrals must be undertaken in consultation and agreement with the referring specialist or consultant physician.  Whilst they do not require the need for an attendance with the patient (face-to-face/video/phone) by the referring specialist or consultant physician, they do require an agreement from the referring specialist or consultant physician. This can be undertaken (but is not limited to) an exchange by phone, written communication or secure online messaging.

Contribution to the treatment and management plan through allied health referral

In addition to referring to allied health practitioners for assistance with formulating a diagnosis, once the specialist or consultant physician makes a diagnosis, the specialist or consultant physician may require the contribution of an eligible allied health practitioner to assist with the development of the treatment and management plan (before billing item 137 or 92141).

MBS items 82000, 82005, 82010, 82030, 93032, 93033, 93040 or 93041 provide a dual function for this purpose. It is important to note that the service limit of a total of 8 services per patient per lifetime apply regardless of whether the items are used for assistance with diagnosis or contribution to the treatment and management plan, and the referring specialist or consultant physician should be mindful of this when referring to eligible allied health practitioners.

Development of the treatment and management plan

Once the specialist or consultant physician has made a diagnosis of an eligible disability, to complete the item requirements of item 137 or 92141 they must develop a treatment and management plan which includes:

• Written documentation of the patient’s confirmed diagnosis of an eligible disability, including any findings of assessments performed (which assisted with the formulation of the diagnosis or contributed to the treatment and management plan)
• A risk assessment which means assessment of:

o the risk to the patient of a contributing co‑morbidity and

o environmental, physical, social and emotional risk factors that may apply to the patient or to another individual.

• Treatment options which include:

o Recommendations using a biopsychosocial model

o Identifying major treatment goals and important milestones and objectives

o Recommendation/s and referral for treatment services provided by eligible allied health practitioners (where relevant) and who should provide this, specifying number of treatments recommended (to a maximum of 20 treatment services)

o  Indications for review or episodes requiring escalation of treatment strategies

• Documenting the treatment and management plan and providing a copy to the referring medical practitioner and relevant allied health practitioner/s.

Referral for allied health treatment services

Once a treatment and management plan is in place (after item 137 or 92141 has been claimed) the specialist or consultant physician can refer the individual to eligible allied health practitioners for the provision of treatment services. Treatment services address the functional impairments identified through the comprehensive medical assessment which are outlined in the treatment and management plan. Treatment services focus on interventions to address developmental delays/disabilities or impairments.

Eligible allied health treatment practitioners include:

• Psychologist (MBS items 82015, 93035, 93043)
• Speech pathologist (MBS items 82020, 93036, 93044)
• Occupational therapist (MBS items 82025, 93036, 93044)
• Audiologist, dietitian, exercise physiologist, optometrist, orthoptist, physiotherapist (MBS items 82035, 93036, 93044)

A total of 20 allied health treatment services per patient per lifetime are available through the MBS, which may consist of any combination of items 82015, 82020, 82025 or 82035 or equivalent video items. Whilst the specialist or consultant physician can refer to multiple eligible allied health practitioners concurrently, a separate referral letter must be provided to each allied health practitioner.

The referral must specify the goals of the treatment and if appropriate, specify the number of services to be provided. It is the responsibility of the referring psychiatrist to allocate the number of treatment services (up to a maximum of 10 services per course of treatment) in keeping with the individual’s treatment and management plan.

It is important to note, that a benefit will not be paid for the MBS allied health treatment services unless the pre-requisite items (137 or 92141) have been processed through the Medicare claiming system.

On the completion of a “course of treatment” (specified by the referring specialist or consultant physician, up to maximum of 10 services), the eligible allied health practitioner must provide a written report to the referring specialist or consultant physician, which must include information on the treatment provided, recommendations for future management of the individual’s disorder and any advice to caregivers (such as parents, carers, schoolteachers). This written report will inform the referring specialist or consultant physician’s decision to refer for further treatment services. Where subsequent courses of treatment after the initial 10 services are required (up to a maximum of 20 services per patient per lifetime) a new referral is required.

Related Items: 104 105 107 108 110 116 119 122 128 131 137 296 297 299 300 302 304 306 308 310 312 314 316 318 319 320 324 326 328 330 332 334 336 338 341 342 343 344 345 346 347 349 82000 82005 82010 82015 82020 82025 82030 82035 91822 91823 91825 91826 91827 91828 91829 91830 91831 91833 91836 91837 91838 91839 91868 91869 91870 91871 91872 91873 91874 91875 91876 91877 91878 91879 91880 91881 91882 91883 91884 92141 92437 92455 92456 92457 93032 93033 93035 93036 93040 93041 93043 93044

Intention of Item 291 and 92435:

It is expected that item 291 or 92435 will be a single attendance. The intention of this item is to provide access to psychiatry expertise and the provision of a detailed written report to the referrer, so that the medical practitioner in general practice (including a general practitioner, but not a specialist or consultant physician) or participating nurse practitioner can provide the ongoing management of the patient. The detailed report is a fundamental component of this item and must address not only a comprehensive diagnostic assessment but also the recommended management of the patient in both the immediate and longer term.

Where a patient’s clinical needs are complex and the psychiatrist assesses it is not appropriate for the referrer to provide the ongoing management of the patient, the psychiatrist should use item 296, 297 or 299 (for a new patient) or 300, 302, 304, 306 or 308 (for subsequent attendance) or telehealth equivalent items 92437, 91827 to 91831, 91837 to 91839 (refer to Note AN.0.75).

The referrer can seek a revision of this management plan once in a 12 month period, through item 293 or 92436.

Referral:

Referral for items 291 or 92435 and 293 or 92436 are required from a medical practitioner in general practice or participating nurse practitioner for the assessment and development of a management plan of a patient with mental health condition.

Note: If a specialist of a discipline outside of psychiatry, wishes to refer a patient for this item the referral should take place through the medical practitioner in general practice or participating nurse practitioner.

Claiming other psychiatry items in association with 291 or 92435:

Whilst it is not expected that additional attendance items would be routinely used prior to item 291 or 92435, there may be circumstances where a patient has been referred (by a medical practitioner in general practice or participating nurse practitioner) for an assessment or management plan, but it is not possible for the psychiatrist to determine in the initial consultation whether the patient is suitable for management under such a plan.

In those circumstances, where the psychiatrist undertakes a consultation prior to the 291 or 92435 consultation, time based consultation items can be claimed, according to the item requirements. In these cases, where clinically appropriate, items 296, 297 or 299 (for a new patient) or 300, 302, 304, 306 or 308 (for subsequent attendance) or telehealth equivalent items (92437, 91827 to 91831, 91837 to 91839) may be used. Non-patient interview items 341, 343, 345, 347 or 349 or telehealth equivalent items 91874 to 91878, 91882 to 91884 may be used, where clinically appropriate, to assist with diagnosis assessment and preparation of treatment plans.

Claiming other psychiatry items following item 291 or 92435:

Whilst it is not expected that psychiatry time-based attendance items, such as items 300 to 308, would be used following the billing of item 291 or 92435, there may be clinical circumstances where limited follow up is required to provide short term assistance to enable the medical practitioner in general practice or participating nurse practitioner to provide the ongoing management of the patient. For example, one or two consultations monitoring the titration of a Schedule 8 medication prior to transfer of care back to a medical practitioner in general practice.  As the intention of this item is to provide detailed recommendations to the referrer to manage the patient’s ongoing care, only short-term non-ongoing management which enables this intent would be considered appropriate.  

Item 293 or 92436 provides opportunity for a comprehensive review of the management plan initiated by the referrer and can be claimed once in a 12 month period following use of item 291 or 92435.

Requirements of item 291 or 92435 - Use of outcome tools:

In order to contribute to the diagnostic assessment and monitor response to therapy, where clinically appropriate, an assessment and/or outcome tool should be utilised during the assessment and review stage of treatment. The choice of the evidence-based tool/s to be used is at the clinical discretion of the practitioner, however the following outcome tools are recommended:

• Kessler Psychological Distress Scale (K10)
• Short Form Health Survey (SF12)
• Health of the Nation Outcome Scales (HoNOS)
• DASS 21 (Depression, Anxiety and Stress)
• BDI (Depression)
• BAI (Anxiety)
• BDRS (Bipolar Disorder)
• YBOCS (OCD)
• GRS (Older adults)
• EPDS (Postnatal Depression)

Requirements of item 291 or 92435 - Management Plan Report:

A written copy of the detailed management plan in consultation with the patient, must be provided to the referring GP or participating nurse practitioner within a maximum of two weeks of the assessment.

It should be noted that two weeks is the outer limit and in more serious cases more prompt provision of the plan and verbal communication with the referring GP or participating nurse practitioner may be appropriate.

The detailed Management Plan should contain:

• The findings of the comprehensive diagnostic assessment and the formulation that contributed to this assessment (including the finding of the outcome tools where clinically appropriate)
• Relevant history and Mental Status Examination
• Identification of any risks to the patient or others
• Detailed management plan which includes, as clinically appropriate, not limited to one or more of the following recommendations:

o   Biopsychosocial management

o   Non-medication recommendations including (where relevant): psychoeducation; recommendations for psychological treatment (and who should provide this); social prescribing

o   Indications for review or episode and escalation of treatment strategies

o   Longer term management goals

Review of Management Plan - Item 293 or 92436:

Item 293 or 92436 is available in instances where the referring medical practitioner in general practice or participating nurse practitioner initiates a review of the plan provided under item 291 or 92435, usually where the current plan is not achieving the anticipated outcome or there has been a change in the clinical circumstances. It is expected that when a plan is reviewed, any modifications necessary will be made. Item 293 or 92436 can only be claimed once in a 12 month period, following the provision of a service under 291 or 92435.

Related Items: 291 293 296 297 299 300 302 304 306 308 91166 91167 91169 91170 91172 91173 91175 91176 91827 91831 91837 91839 92435 92436 92437

Item 319 or 91873 provides for an attendance, by a psychiatrist, to provide intensive psychotherapy where the patient’s clinical condition requires intensive treatment. Clinical appropriateness and indications for intensive psychotherapy are determined following a comprehensive assessment and formulation of a diagnosis and should be documented in the patient’s notes. It is also expected that other appropriate psychiatric treatment has been used for a suitable period and the patient has shown little or no response to such treatment. Such treatment would include, but not be limited to: shorter term psychotherapy; less frequent but long-term psychotherapy; pharmacological therapy; and cognitive behaviour therapy. 

Once a patient is identified as meeting the criteria of item 319 or 91873, eligibility continues under that item for the duration of that course of treatment (provided that attendances under items 296, 297, 299, 300, 302, 304, 306, 308, 319, 91827 to 91831, 91837 to 91839, 91873 and 92437 do not exceed 160 in a calendar year). If the patient requires more than 160 services in a calendar year for intensive psychotherapy, then such attendances would be covered by items 310, 312, 314, 316, 318, 91868 to 91872 or 91879 to 91881. 

Related Items: 296 297 299 300 302 304 306 308 310 312 314 316 318 319 91827 91831 91837 91839 91873 92437

Intention of this service under item 289 and video equivalent item 92434

Items 289 or video equivalent item 92434 are intended for complex conditions, characterised by multi-domain cognitive and functional impairment. Patient eligibility is for neurodevelopmental disorders (NDD), which are assessed to be complex and mean that individuals require support across multiple domains.

The intention of this service is to provide access to treatment, through the development of a treatment and management plan by a psychiatrist, for individuals under 25 years of age, diagnosed with a complex NDD. The development of the treatment and management plan, follows a comprehensive medical assessment, and provides the opportunity to refer to eligible allied health practitioners for up to a total of 20 MBS treatment services per patient’s lifetime (items 82015, 82020, 82025, 82035, 93035, 93036, 93043 or 93044). This item is claimable once in a patient’s lifetime.

Eligibility:

In the context of item 289 (or 92434), the diagnosis of a complex NDD requires evidence of requiring support and showing impairment across two or more neurodevelopmental domains. Complexity is characterised by multi-domain cognitive and functional disabilities, delay or clinically significant impairment.

Neurodevelopmental domains include:

• Cognition
• Language
• Social-emotional development
• Motor skills
• Adaptive behaviour:  conceptual skills, practical skills, social skills or social communication skills

Referral pathways:

Early identification of, and intervention for, individuals with complex NDD is important in promoting positive longer-term outcomes. Symptoms can cause clinically significant impairment in social, occupational or other important areas of functioning.

Where neurodevelopmental concerns have been identified and brought to the attention of the patient’s GP to initially assess these concerns and the GP considers there are persisting indications that require more specialised assessment, they are encouraged to refer to either a consultant paediatrician or psychiatrist for a comprehensive assessment.

Diagnostic assessment:

The assessment and diagnosis of a complex NDD should be evaluated in the context of both a physical and developmental assessment. The psychiatrist may require a number of separate attendances (through usual time-tiered or subsequent attendance items 296 to 308, 310, 312, 314, 316, 318, 319 to 349, 91827 to 91831 or 91837 to 91839, 92437, 92455 to 92457) to complete a comprehensive accurate assessment and formulate a diagnosis, exclude other disorders or assess for co-occurring conditions.

Multi-disciplinary assistance with assessment and/or contribution to the treatment and management plan:

Depending on a range of factors, not limited to the patient’s age and nature of suspected disabilities, the consultant physician may require a multi-disciplinary approach to complete a comprehensive accurate assessment and formulate a diagnosis. 

Where the psychiatrist determines the patient requires additional assessments to formulate a diagnosis, through the assistance of an allied health practitioner, they are able to refer the patient to an eligible allied health provider from standard attendance items (296 to 308, 310, 312, 314, 316, 318, 319 to 349 or telehealth (video and phone) items 91827 to 91831, 91837 to 91839, 92437, 92455 to 92457).

Whilst Medicare rebates provide for a total of 8 allied health assessment services per patient per lifetime, an eligible allied health practitioner can only provide up to 4 services before the need for a review (the type of review can be specified in the referral to the eligible allied health professional) by the referring psychiatrist, who must agree to the need for any additional allied health services prior to the delivery of the remaining 4 allied health assessment services.

Eligible allied health assessment practitioners include:

• Psychologist (MBS item 82000, 93032, 93040)
• Speech pathologist (MBS item 82005, 93033, 93041)
• Occupational therapist (82010, 93033, 93041)
• Audiologist, dietitian, exercise physiologist, optometrist, orthoptist, physiotherapist (MBS item 82030, 93033, 93041)

Requirements of the referral to allied health practitioners

The psychiatrist can refer to multiple eligible allied health practitioners concurrently, but a separate referral letter must be provided to each allied health practitioner. The referral should specify the intent of the assessment and if appropriate, specify the number of services to be provided. Where the number of sessions is not specified, each allied health practitioner can provide up to 4 assessment services without the need for review or agreement to provide further assessment services.

Review requirements following delivery of four (4) allied health assessment services

Whilst an eligible allied health practitioner has provided 4 assessment services (through items 82000, 82005, 82010, 82030, 93032, 93040, 93033 or 93041) and considers additional assessment services are required, they must ensure the referring psychiatrist undertakes a review. If the type of review is not specified by the referring psychiatrist an acceptable means of review includes: a case conference, phone call, written correspondence, secure online messaging exchange or attendance of the patient with the referring psychiatrist.

Inter-disciplinary allied health referral

Eligible allied health practitioners are also able to make inter-disciplinary referrals to other eligible allied health practitioners as clinically necessary to assist with the formulation of the diagnosis or contribute to the treatment and management plan. Inter-disciplinary referrals must be undertaken in consultation and agreement with the referring psychiatrist.  Whilst they do not require the need for an attendance with the patient (face-to-face/video/phone) by the referring psychiatrist, they do require an agreement from the referring psychiatrist.  This can be undertaken (but is not limited to) an exchange by phone, written communication or secure online messaging.

Contribution to the Treatment and Management Plan through allied health referral

In addition to referring to allied health practitioners for assistance with formulating a diagnosis, once a psychiatrist makes a complex NDD diagnosis, the psychiatrist may require the contribution of an eligible allied health practitioner to assist with the development of the Treatment and Management plan (before billing item 289 or 92434).

MBS items 82000, 82005, 82010, 82030, 93032, 93033, 93040 or 93041 provide a dual function for this purpose. It is important to note that the service limit of a total of 8 services per patient per lifetime apply regardless of whether the items are used for assistance with diagnosis or contribution to the treatment and management plan, and the referring psychiatrist should be mindful of this when referring to eligible allied health practitioners.

Development of the Treatment and Management Plan

Once the psychiatrist has made a diagnosis of a complex NDD, to complete the item requirements of item 289 or 92434 they must develop a treatment and management plan which includes:

• Written documentation of the patient’s confirmed diagnosis of a complex NDD, including any findings of assessments performed (which assisted with the formulation of the diagnosis or contributed to the treatment and management plan)
• A risk assessment which means assessment of:
  • the risk to the patient of a contributing co‑morbidity and
  • environmental, physical, social and emotional risk factors that may apply to the patient or to another individual.
• Treatment options which include:
  • Recommendations using a biopsychosocial model
  • Identifying major treatment goals and important milestones and objectives
  • Recommendation/s and referral for treatment services provided by eligible allied health practitioners (where relevant) and who should provide this, specifying number of treatments recommended (to a maximum of 20 treatment services)
  • Indications for review or episodes requiring escalation of treatment strategies
• Documenting the Treatment and Management plan and providing a copy to the referring medical practitioner and relevant allied health practitioner/s.

Referral for allied health treatment services

Once a treatment and management plan is in place (after item 289 or 92434 has been claimed) the psychiatrist can refer the individual to eligible allied health practitioners for the provision of treatment services. Treatment services address the functional impairments identified through the comprehensive medical assessment which are outlined in the treatment and management plan. Treatment services focus on interventions to address developmental delays/disabilities or impairments.

Eligible allied health treatment practitioners include:

• Psychologist (MBS items 82015, 93035, 93043)
• Speech pathologist (MBS items 82020, 93036, 93044)
• Occupational therapist (MBS items 82025, 93036, 93044)
• Audiologist, dietitian, exercise physiologist, optometrist, orthoptist, physiotherapist (MBS items 82035, 93036, 93044)

A total of 20 allied health treatment services per patient per lifetime are available through the MBS, which may consist of any combination of items 82015, 82020, 82025 or 82035 or equivalent video items. Whilst the psychiatrist can refer to multiple eligible allied health practitioners concurrently, a separate referral letter must be provided to each allied health practitioner.

The referral should specify the goals of the treatment and if appropriate, specify the number of services to be provided. It is the responsibility of the referring psychiatrist to allocate the number of treatment services (up to a maximum of 10 services per course of treatment) in keeping with the individual’s treatment and management plan.

It is important to note, that a benefit will not be paid for the MBS allied health treatment services unless the pre-requisite items (289 or 92434) have been processed through the Medicare claiming system.

On the completion of a “course of treatment” (specified by the referring psychiatrist, up to maximum of 10 services), the eligible allied health practitioner must provide a written report to the referring psychiatrist, which should include information on the treatment provided, recommendations for future management of the individual’s disorder and any advice to caregivers (such as parents, carers, school teachers). This written report will inform the referring psychiatrist’s decision to refer for further treatment services. Where subsequent courses of treatment after the initial 10 services are required (up to a maximum of 20 services per patient per lifetime) a new referral is required.

Inconclusive assessment:

Where a patient does not meet the diagnostic threshold of a complex NDD and where ongoing medical management is required, patients can be managed through psychiatry attendance items 300-308, 310, 312, 314, 316, 318 or telehealth equivalent items 91827-91831 (video) or 91837-91839 (phone).

Examples include where:

• Neurodevelopment assessment is incomplete or inconclusive
• Neurodevelopmental impairment is present in fewer than two domains
• Neurodevelopmental impairment is present in two or more domains, but individuals do not require sufficient support to meet criteria
• Comprehensive, age-appropriate neurodevelopmental assessment is impossible or unavailable (e.g. in infants or young children- particularly those under 6 years of age)

These individuals may be considered “at risk of a complex NDD” and require follow-up and reassessment in the future.

Related Items: 289 296 297 299 300 301 302 303 304 306 308 310 312 314 316 318 319 320 322 324 326 328 330 332 334 336 338 341 342 343 344 345 346 347 349 82000 82005 82010 82015 82020 82025 82030 82035 91827 91828 91829 91830 91831 91837 91838 91839 92434 92437 92455 92456 92457 93032 93033 93035 93036 93040 93041 93043 93044

Referral for items 296, 297 and 299 or item 92437 may be from a participating nurse practitioner, medical practitioner practising in general practice, a specialist or another consultant physician.

It is intended that either item 296, 297, 299 or 92437 will be claimed once on the first occasion that the patient is seen by a consultant psychiatrist.

If the patient is referred by a medical practitioner in general practice or participating nurse practitioner for an assessment or management plan, item 291 or 92435 should be utilised (refer to note AN.0.30). It is not expected that 296, 297, 299 or 92437 items would be routinely used prior to item 291 or 92435.

Use of items 296, 297, 299 or 92435 by one consultant psychiatrist does not preclude them being used by another consultant psychiatrist for the same patient. The use of items 296, 297, 299 or 92437 are identical except for the location of where the service is rendered. That is: item 296 is only available for consultations rendered in consulting rooms, item 297 is only available for consultations rendered at a hospital, and item 299 is only available for consultations rendered at a place other than consulting rooms or a hospital (such as in a patient’s home) and item 92437 is available for video consultations delivered by videoconference.

For patients who have already been seen by the consultant psychiatrist in the preceding 24 months the psychiatrist can use time-tiered attendance items 300, 302, 304, 306 and 308 or telehealth equivalent consultation items 91827 to 91831 (video) and 91837 to 91839 (phone).

Related Items: 291 296 297 299 300 302 304 306 308 91827 91831 91837 91839 92435 92437