Medicare Benefits Schedule - Item 92112

Telehealth attendance, by a general practitioner who has not undertaken mental health skills training (and not including a specialist or consultant physician), 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: $81.70 Benefit: 100% = $81.70

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

Extended Medicare Safety Net Cap: $245.10

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Associated items: 272, 276, 277, 279, 281, 282, 2700, 2701, 2712, 2713, 2715, 2717, 92112, 92113, 92114, 92115, 92116, 92117, 92118, 92119, 92120, 92121, 92122, 92123, 92126, 92127, 92132, 92133

This note provides information on the preparation and review of GP Mental Health Treatment Plans under the Better Access initiative (refer to explanatory note AN.0.78 - Better Access Initiative).

Who can provide

The GP Mental Health Treatment Plan, Review and Consultation Medicare Benefits Schedule (MBS) items are available for use in general practice by a general practitioner or prescribed medical practitioner. The term 'GP' is used in these notes as a generic reference to general practitioners able to claim these items.

Patient Eligibility

These GP services are available to patients who meet the relevant eligibility requirements (refer to explanatory note AN.0.78 - Better Access Initiative).  GP Mental Health Treatment Plan and Review services can also be provided to private inpatients (including private inpatients who are residents of aged care facilities) being discharged from hospital. Where the service is provided as part of an episode of hospital treatment, the service must be claimed at the 75% MBS benefit.

Services attracting Medicare benefits

The GP Mental Health Treatment items define services for which Medicare benefits are payable where GPs undertake early intervention, assessment, and management of patients with diagnoseable mental disorders. For information on the service requirements of these items, please see the relevant headings below.

There are 16 MBS items for the preparation of a GP Mental Health Treatment Plan. These are:

For GPs providing GP Mental Health Treatment Plans who have undertaken mental health skills training recognised through the General Practice Mental Health Standards Collaboration: 

• Face-to-face items: 2715 and 2717
• Telehealth items 92116 and 92117

For GPs who have not undertaken mental health skills training:

• Face-to-face items 2700 and 2701
• Telehealth items 92112 and 92113

For Prescribed Medical Practitioners providing GP Mental Health Treatment Plans who have undertaken mental health skills training recognised through the General Practice Mental Health Standards Collaboration:

• Face-to-face items 281 and 282
• Telehealth items 92122 and 92123

For Prescribed Medical Practitioners who have not undertaken mental health skills training:

• Face-to-face items 272 and 276
• Telehealth items 92118 and 92119

It is strongly recommended that GPs and Prescribed Medical Practitioners providing mental health treatment have appropriate mental health training. GP organisations support the value of appropriate mental health training for practitioners using these items.

Additionally, there are 6 items for the review of a GP Mental Health Treatment Plan or Psychiatrist Assessment and Management Plan. These are:

• GP face-to-face item: 2712
• GP telehealth items: 92114 and 92126 
• Prescribed medical practitioner face-to-face item: 277
• Prescribed medical practitioner telehealth items: 92120 and 92132

There are also additional items that exist for the review of Psychiatrist Assessment and Management Plans. For further information, refer to explanatory note AN.0.30 – Consultant Psychiatrist – Referred Patient Assessment and Management Plan.

There are 6 items for GP mental health treatment consultation. These are:

• GP face-to-face item: 2713
• GP telehealth items: 92115 and 92127 
• Prescribed medical practitioner face-to-face item: 279
• Prescribed medical practitioner telehealth items: 92121 and 92133

Preparation of a GP Mental Health Treatment Plan

A GP Mental Health Treatment Plan is intended to identify and document the care needs of patients with a diagnosable mental disorder to allow for a structured approach to the management of their treatment. Before proceeding with a GP Mental Health Treatment Plan service, the GP must ensure that:

• The GP Mental Health Treatment Plan preparation service and the steps involved in preparing a GP Mental Health Treatment Plan are explained to the patient and (if appropriate and with the patient's permission) to the patient's carer; and
• the patient's agreement to proceed is recorded.

The preparation of a GP Mental Health Treatment Plan involves the assessment of a patient’s mental disorder and preparation of a plan to assist the patient in managing their mental disorder. The preparation of a GP Mental Health Treatment Plan must be documented in writing, and include an assessment process consisting of:

• The administration of an outcome measurement tool (except if considered clinically inappropriate); and
• The formulation of the mental disorder, including a provisional or formal diagnosis.

An outcome measurement tool refers to a tool used to monitor changes in a patient’s health that occur in response to treatment received by the patient.

The choice of the evidence-based outcome measurement tool/s to be used is at the clinical discretion of the practitioner, however examples of appropriate outcome tools include:

• Kessler Psychological Distress Scale (K10)
• DASS 21 (Depression, Anxiety and Stress)
• Initial Assessment and Referral Decision Support Tool (IAR-DST)

GPs using such tools should be familiar with their appropriate clinical use, and if not, should seek appropriate education and training. Once a GP has completed an assessment of a patient’s mental disorder, the GP must:

• Identify and discuss referral and treatment options with the patient, including appropriate support services;
• Agree upon treatment goals with the patient and any actions the patient will take;
• Provide relevant and suitable education about the patient’s mental disorder;
• Create a plan for crisis intervention and/or for relapse prevention; and
• Make arrangements for required referrals, treatment, appropriate support services, review and follow-up.  

This information must be recorded in writing in the patient's GP Mental Health Treatment Plan. Upon completion of preparation of a GP Mental Health Treatment Plan, a copy must be offered to the patient, and where relevant and if the practitioner considers it appropriate, the patient’s carer, before a GP Mental Health Treatment Plan item may be claimed. A copy of the GP Mental Health Treatment Plan must be added to the patient’s medical records. 

A patient's GP Mental Health Treatment Plan should be treated as a living document for updating as required. In particular, the plan can be updated at any time to incorporate relevant information, such as feedback or advice from other health professionals on the diagnosis or treatment of the patient. A new plan should not be prepared unless clinically required, and generally not within 12 months of a previous plan, unless exceptional circumstances exist. Ongoing management can be provided through the GP Mental Health Treatment Consultation and standard consultation items, as required, and reviews of progress through the GP Mental Health Treatment Plan Review items.

Referral and Treatment Options

Once a GP Mental Health Treatment Plan has been completed and claimed on an appropriate Medicare service, a patient is eligible to access relevant treatment and referral options. Relevant treatment and referral options consist of support services, psychiatric services, and relevant services provided under the Better Access initiative (refer to explanatory note AN.0.78 - Better Access Initiative).

Reviewing a GP Mental Health Treatment Plan

The review item is a key component for assessing and managing the patient's progress once a GP Mental Health Treatment Plan has been prepared, along with ongoing management through the GP Mental Health Treatment Consultation item and/or standard consultation items. A patient's GP Mental Health Treatment Plan should be reviewed at least once.

A Medicare benefit can be claimed once the GP who prepared the patient's GP Mental Health Treatment Plan (or another GP in the same practice or in another practice where the patient has changed practices) has undertaken a systematic review of the patient's progress against the GP Mental Health Treatment Plan by completing the activities that must be included in a review. The review item can also be used where a psychiatrist has prepared a referred Psychiatrist Assessment and Management Plan (item 291 or 92435), as if that patient had a GP Mental Health Treatment Plan. 

Before proceeding with any GP Mental Health Treatment review service, the GP must ensure that:

• The GP Mental Health Treatment Plan review service and the steps involved are explained to the patient and (if appropriate and with the patient's permission) to the patient's carer; and
• the patient's agreement to proceed is recorded.

The review must include:

• a review of the patient's progress against the goals outlined in the GP Mental Health Treatment Plan; 
• checking, reinforcing and expanding education;
• a plan for crisis intervention and/or for relapse prevention, if appropriate and if not previously provided;
• re-administration of the outcome measurement tool used in the assessment stage, except where considered clinically inappropriate; and
• modification of the documented GP Mental Health Treatment Plan if required.

If amendments are made to the patient’s GP Mental Health Treatment Plan, a copy of the amended plan must be offered to the patient, and where relevant and appropriate, the patient’s carer, before a GP Mental Health Treatment Plan review service may be claimed. A copy of the amended plan must also be added to the patient’s medical records. 

In general, most patients should not require more than two reviews in a 12-month period, with ongoing management through the GP Mental Health Treatment Consultation and standard consultation items, as required. A benefit for a GP Mental Health Treatment Plan review service will not be paid more than once in a three-month period, or within four weeks following a claim for a GP Mental Health Treatment Plan item.

Mental Health Treatment Consultation 

The Mental Health Treatment Consultation items are for an extended consultation with a patient where the primary treating problem is related to a mental disorder, including for a patient being managed under a GP Mental Health Treatment Plan. This item may be used for ongoing management of a patient with a mental disorder. This item should not be used for the development of a GP Mental Health Treatment Plan. 

A GP Mental Health Treatment Consultation must include:

• taking relevant history and identifying the patient's presenting problem(s) (if not previously documented);
• providing treatment, advice and/or referral for other services or treatment; and
• documenting the outcomes of the consultation in the patient's medical records and other relevant mental health plan (where applicable).

A patient may be referred from a GP Mental Health Treatment Consultation for other treatment and services. This does not include referral for Better Access services, unless the patient is being managed by the GP under a GP Mental Health Treatment Plan or under a referred Psychiatrist Assessment and Management Plan (item 291 or 92435).

Additional claiming information

The GP Mental Health Treatment Plan, Review and Consultation items cover the consultations at which the relevant items are undertaken, noting that to co-claim a mental health MBS item and another item both services must be clinically relevant and distinct services.

Where an additional consultation is undertaken, both services must be clinically relevant, and all item requirements must be met. For example, for item 2700, the duration of the service must have been at least 20 minutes. The time of the preceding consultation must not be counted towards the time of the mental health service.

Where separate consultations are undertaken in conjunction with mental health consultations, the patient's invoice or Medicare voucher (assignment of benefit form) for the separate consultation should be annotated (e.g. separate consultation clinically required/indicated). 

A benefit is not claimable, and an account should not be rendered, until all components of the relevant item have been provided.

All consultations conducted as part of the GP Mental Health Treatment items must be rendered by a GP or prescribed medical practitioner. A specialist mental health nurse, other allied health practitioner, Aboriginal and Torres Strait Islander health practitioner or Aboriginal Health Worker with appropriate mental health qualifications and training may provide general assistance to GPs in provision of mental health care.

Further information

For further information on the Better Access Initiative, refer to explanatory note AN.0.78 - Better Access Initiative.

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

Further information is available for providers 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: 272 276 277 279 281 282 2700 2701 2712 2713 2715 2717 92112 92113 92114 92115 92116 92117 92118 92119 92120 92121 92122 92123 92126 92127 92132 92133

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 services provided by general practitioners (GPs), psychiatrists, prescribed medical practitioners (PMPs), psychologists (clinical and registered) and eligible social workers and occupational therapists.

Better Access Initiative Explanatory Notes

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

Explanatory Note	Relevant item numbers
AN.0.56 - GP Mental Health Treatment Plans and Consultation	272, 276, 277, 279, 281, 282, 2700, 2701, 2712, 2713, 2715, 2717, 92112, 92113, 92114, 92116, 92117, 92118, 92119, 92120, 92121, 92122, 92123, 92126, 92127, 92132, and 92133.
MN.6.2 - Provision of Psychological Therapy	80000, 80005, 80010, 80015, 80020, 80021, 80022, 80023, 80024, 80025, 91166, 91167, 91181, and 91182.
MN.7.4 - Provision of Focussed Psychological Strategies	283, 285, 286, 287, 2721, 2723, 2725, 2727, 80100, 80105, 80110, 80115, 80120, 80121, 80122, 80123, 80125, 80127, 80128,  80130, 80135, 80140, 80145, 80146, 80147, 80148,  80150, 80152, 80153, 80155, 80160, 80165, 80170, 80171, 80172, 80173, 80174, 80175, 91818, 91819, 91842, 91843, 91820, 91821, 91844, 91845, 91169, 91170, 91183, 91184, 91172, 91173, 91185, 91186, 91175, 91176, 91187 and 91188.
MN.6.3 - Referral requirements for Better Access Treatment Services	272, 276, 281, 282, 283, 285, 286, 287, 2700, 2701, 2715, 2717, 2721, 2723, 2725, 2727, 80000, 80005, 80010, 80015, 80020, 80021, 80022, 80023, 80024, 80025, 80100, 80105, 80110, 80115, 80120, 80121, 80122, 80123, 80125, 80127, 80128, 80130, 80135, 80140, 80145, 80146, 80147, 80148, 80150, 80152, 80153, 80155, 80160, 80165, 80170, 80171, 80172, 80173, 80174, 80175, 91167, 91169, 91170, 91172, 91173,  91175, 91176, 91181, 91182,91183, 91184, 91185, 91186, 91187, 91188,  91818, 91819, 91820, 91821,  91842, 91843, , 91844, 91845, 92112, 92113, 92116, 92117, 92118 and 92119. Note: for specialist psychiatrists and paediatricians these services include any of the specialist attendance items 104 through 109 and items 91822, 91823 and 91833. For consultant physician psychiatrists the relevant eligible Medicare services cover any of the consultant psychiatrist items 293 to 308, 310, 312, 314, 316, 318 or 319 through 349; while for consultant physician paediatricians the eligible services are consultant physician attendance items 110 through 133.
AN.15.1 - Mental Health Case Conferences	930, 933, 935, 937, 943, 945, 946, 948, 959, 961, 962, 964, 969, 971, 972, 973, 975, 986, 80176, 80177 and 80178.
MN.7.5 - Family and Carer Participation	309, 311, 313, 315, 2739, 2741, 2743, 2745, 80002, 80006, 80012, 80016, 80102, 80106, 80112, 80116, 80129, 80131, 80137, 80141, 80154, 80156, 80162, 80166, 91859, 91168, 91171, 91174, 91177, 91194, 91195, 91196, 91197, 91198, 91199, 91200, 91201, 91202, 91203, 91204, 91205, 91861, 91862, 91863, 91864, 91865, 91866, and 91867.

 

Services provided under Better Access

Through Better Access, eligible patients can claim a Medicare benefit for up to 10 individual and 10 group 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 GPs, PMPs and eligible psychologists, occupational therapists, and 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 an assessed 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. 

Additionally, Better Access MBS treatment items will not attract a Medicare benefit unless the patient has been referred for Better Access services by a referring practitioner. For the purposes of these services, referring practitioner means:

• 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; or
• a specialist or consultant physician specialising in the practice of their field of paediatrics.

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 GP 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.

Allied health providers can call Services Australia on 132 150 to check this information, while unsure patients can seek clarification by calling 132 011.

A patient will not be eligible to receive a Medicare benefit if they have not been appropriately referred and a relevant Medicare service 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 should, with the patient's permission, contact the referring practitioner to ensure a relevant referring service has been provided to the patient.

Better Access redesign from 1 November 2025

As announced through the 2024-25 Budget, the Australian Government is making changes to the Better Access initiative from 1 November 2025 (subject to the passage of legislation) to respond to the Better Access evaluation, better meet the needs of individuals, and improve equity of access.

As part of this, GP Mental Health Treatment Plan review and mental health consultation MBS items will be removed, and GPs will be able to use general attendance items to review and provide mental health care recognising the time spent with patients to provide quality care. GP Mental Health Treatment Plan MBS items will be retained.

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.

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.

Record keeping and reporting requirements

The Department of Health and Aged Care undertakes regular post payment auditing to ensure that 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 three regulatory instruments:

Health Insurance (Section 3C General Medical Services – Allied Health Services) Determination 2024 - Clinical psychologist, psychologist, social worker, and occupational therapist items.

Health Insurance (General Medical Services Table) Regulations 2021 – General practitioner, prescribed medical practitioner and psychiatrist items.

Health Insurance (Section 3C General Medical Services – Telehealth and Telephone Attendances) Determination 2021 – telehealth (video) and telephone attendance items – General practitioner, prescribed medical practitioner, clinical psychologist, psychologist, social worker, and occupational therapist items.

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: 272 276 277 279 281 282 283 285 286 287 309 311 313 315 930 933 935 937 943 945 946 948 959 961 962 964 969 971 972 973 975 986 2700 2701 2712 2713 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 91172 91173 91174 91175 91176 91177 91181 91182 91183 91184 91185 91186 91187 91188 91194 91195 91196 91197 91198 91199 91200 91201 91202 91203 91204 91205 91818 91819 91820 91821 91842 91843 91844 91845 91859 91861 91862 91863 91864 91865 91866 91867 92112 92113 92114 92116 92117 92118 92119 92120 92121 92122 92123 92126 92127 92132 92133