Medicare Benefits Schedule - Note AN.0.30

Search Results for Note AN.0.30

View Related Items

Category 1 - PROFESSIONAL ATTENDANCES

AN.0.30

Consultant Psychiatrist - Referred Patient Assessment and Management Plan - Items 291 or 92435 and 293 or 92436

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


Related Items

Category 1 - PROFESSIONAL ATTENDANCES

291

291 - Additional Information

Item Start Date:
01-May-2005
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2024

Professional attendance lasting more than 45 minutes at consulting rooms by a consultant physician in the practice of the consultant physician’s specialty of psychiatry, if:

(a) the attendance follows referral of the patient to the consultant, by a medical practitioner in general practice (including a general practitioner, but not a specialist or consultant physician) or a participating nurse practitioner, for an assessment or management; and

(b) during the attendance, the consultant:

(i) if it is clinically appropriate to do so—uses an appropriate outcome tool; and

(ii) carries out a mental state examination; and

(iii) undertakes a comprehensive diagnostic assessment; and

(c) the consultant decides that it is clinically appropriate for the patient to be managed by the referring practitioner without ongoing management by the consultant; and

(d) within 2 weeks after the attendance, the consultant prepares and gives to the referring practitioner a written report, which includes:

(i) the comprehensive diagnostic assessment of the patient; and

(ii) a management plan for the patient for the next 12 months that comprehensively evaluates the patient’s biopsychosocial factors and makes recommendations to the referring practitioner to manage the patient’s ongoing care in a biopsychosocial model; and

(e) if clinically appropriate, the consultant explains the diagnostic assessment and management plan, and gives a copy, to:

(i) the patient; and

(ii) the patient’s carer (if any), if the patient agrees; and

(f) in the preceding 12 months, a service to which this item or item 92435 applies has not been provided to the patient

Fee: $523.40 Benefit: 85% = $444.90

(See para AN.0.30, AN.0.32, AN.0.75, AN.40.1 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

293

293 - Additional Information

Item Start Date:
01-May-2005
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2024

Professional attendance lasting more than 30 minutes, but not more than 45 minutes, at consulting rooms by a consultant physician in the practice of the consultant physician’s specialty of psychiatry, if:

(a) the patient is being managed by a medical practitioner or a participating nurse practitioner in accordance with a management plan prepared by the consultant in accordance with item 291 or item 92435; and

(b) the attendance follows referral of the patient to the consultant, by the medical practitioner or participating nurse practitioner managing the patient, for review of the management plan and the associated comprehensive diagnostic assessment; and

(c) during the attendance, the consultant:

(i) if it is clinically appropriate to do so—uses an appropriate outcome tool; and

(ii) carries out a mental state examination; and

(iii) reviews the comprehensive diagnostic assessment and undertakes additional assessment as required; and

(iv) reviews the management plan; and

(d) within 2 weeks after the attendance, the consultant prepares and gives to the referring practitioner a written report, which includes:

(i) the revised comprehensive diagnostic assessment of the patient; and

(ii) a revised management plan including updated recommendations to the referring practitioner to manage the patient’s ongoing care in a biopsychosocial model; and

(e) if clinically appropriate, the consultant explains the diagnostic assessment and management plan, and gives a copy, to:

(i) the patient; and

(ii) the patient’s carer (if any), if the patient agrees; and

(f) in the preceding 12 months, a service to which item 291 or item 92435 applies has been provided to the patient; and

(g) in the preceding 12 months, a service to which this item or item 92436 applies has not been provided to the patient

Fee: $327.20 Benefit: 85% = $278.15

(See para AN.0.30, AN.0.32, AN.40.1 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

296

296 - Additional Information

Item Start Date:
01-Nov-2006
Description Updated:
01-Nov-2024
Schedule Fee Updated:
01-Jul-2024

Professional attendance lasting more than 45 minutes by a consultant physician in the practice of the consultant physician's speciality of psychiatry following referral of the patient to the consultant physician by a referring practitioner - an attendance at consulting rooms if the patient:

(a) is a new patient for this consultant physician; or

(b) has not received a professional attendance from this consultant physician in the preceding 24 months;

other than attendance on a patient in relation to whom this item, or any of items 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839, 92437 and 92478 to 92483 has applied in the preceding 24 months

Fee: $301.05 Benefit: 75% = $225.80 85% = $255.90

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.32, AN.0.75, AN.40.1 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

297

297 - Additional Information

Item Start Date:
01-Nov-2006
Description Updated:
01-Nov-2024
Schedule Fee Updated:
01-Jul-2024

Professional attendance lasting more than 45 minutes by a consultant physician in the practice of the consultant physician's speciality of psychiatry following referral of the patient to the consultant physician by a referring practitioner - an attendance at hospital if the patient:

(a) is a new patient for this consultant physician; or

(b) has not received a professional attendance from this consultant physician in the preceding 24 months;

other than attendance on a patient in relation to whom this item, or any of items 296, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839, 92437 and 92478 to 92483 has applied in the preceding 24 months (H)

Fee: $301.05 Benefit: 75% = $225.80

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.32, AN.0.75 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

299

299 - Additional Information

Item Start Date:
01-Nov-2006
Description Updated:
01-Nov-2024
Schedule Fee Updated:
01-Jul-2024

Professional attendance lasting more than 45 minutes by a consultant physician in the practice of the consultant physician's speciality of psychiatry following referral of the patient to the consultant physician by a referring practitioner - an attendance at a place other than consulting rooms or a hospital if the patient:

(a) is a new patient for this consultant physician; or

(b) has not received a professional attendance from this consultant physician in the preceding 24 months;

other than attendance on a patient in relation to whom this item, or any of items 296, 297, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839, 92437 and 92478 to 92483 has applied in the preceding 24 months

Fee: $359.90 Benefit: 85% = $305.95

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.32, AN.0.75 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

300

300 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2024

Professional attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry following referral of the patient to him or her by a referring practitioner-an attendance of not more than 15 minutes in duration at consulting rooms, if that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 applies have not exceeded 50 attendances in a calendar year for the patient

Fee: $50.10 Benefit: 75% = $37.60 85% = $42.60

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.32, AN.0.75, AN.40.1 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

302

302 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2024

Professional attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry following referral of the patient to him or her by a referring practitioner-an attendance of more than 15 minutes, but not more than 30 minutes, in duration at consulting rooms, if that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 applies have not exceeded 50 attendances in a calendar year for the patient

Fee: $100.00 Benefit: 75% = $75.00 85% = $85.00

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.32, AN.0.75, AN.40.1 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

304

304 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2024

Professional attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry following referral of the patient to him or her by a referring practitioner-an attendance of more than 30 minutes, but not more than 45 minutes, in duration at consulting rooms), if that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 applies have not exceeded 50 attendances in a calendar year for the patient

Fee: $153.90 Benefit: 75% = $115.45 85% = $130.85

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.32, AN.0.75, AN.40.1 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

306

306 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2024

Professional attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry following referral of the patient to him or her by a referring practitioner-an attendance of more than 45 minutes, but not more than 75 minutes, in duration at consulting rooms, if that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 applies have not exceeded 50 attendances in a calendar year for the patient

Fee: $212.40 Benefit: 75% = $159.30 85% = $180.55

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.32, AN.0.75, AN.40.1 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

308

308 - Additional Information

Item Start Date:
01-Nov-1996
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2024

Professional attendance by a consultant physician in the practice of the consultant physician's specialty of psychiatry following referral of the patient to him or her by a referring practitioner-an attendance of more than 75 minutes in duration at consulting rooms), if that attendance and another attendance to which any of items 296, 297, 299, 300, 302, 304, 306, 308, 91827 to 91831, 91837 to 91839 and 92437 applies have not exceeded 50 attendances in a calendar year for the patient

Fee: $246.50 Benefit: 75% = $184.90 85% = $209.55

(See para AN.0.25, AN.0.30, AN.0.31, AN.0.32, AN.0.75, AN.40.1 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

91827

91827 - Additional Information

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

Telehealth 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: $50.10 Benefit: 85% = $42.60

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

Category 1 - PROFESSIONAL ATTENDANCES

91831

91831 - Additional Information

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

Telehealth 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 at least 75 minutes in duration;

if that attendance and another attendance to which item 296, 297, 299 or any of items 300, 302, 304, 306 to 308, 91827 to 91830, 91837 to 91839 and 92437 applies have not exceeded 50 attendances in a calendar year.

Fee: $246.50 Benefit: 85% = $209.55

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

Category 1 - PROFESSIONAL ATTENDANCES

92435

92435 - Additional Information

Item Start Date:
06-Apr-2020
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2024

Telehealth attendance lasting more than 45 minutes by a consultant physician in the practice of the consultant physician’s specialty of psychiatry, if:

(a)    the attendance follows referral of the patient to the consultant, by a medical practitioner in general practice (including a general practitioner, but not a specialist or consultant physician) or a participating nurse practitioner for an assessment or management; and

(b)    during the attendance, the consultant:

(i)     if it is clinically appropriate to do so—uses an appropriate outcome tool; and

(ii)   carries out a mental state examination; and

(iii)  undertakes a comprehensive diagnostic assessment; and

(c)    the consultant decides that it is clinically appropriate for the patient to be managed by the referring practitioner without ongoing management by the consultant and

(d)    within 2 weeks after the attendance, the consultant prepares and gives the referring practitioner a written report, which includes:

(i)     a comprehensive diagnostic assessment of the patient; and

(ii)   a management plan for the patient for the next 12 months for the patient that comprehensively evaluates the patient’s biopsychosocial factors and makes recommendations to the referring practitioner to manage the patient’s ongoing care in a biopsychosocial model; and

(e)    if clinically appropriate, the consultant explains the diagnostic assessment and management plan, and a gives a copy, to:

(i)     the patient; and

(ii)   the patient’s carer (if any), if the patient agrees; and

(f)     in the preceding 12 months, a service to which this item or item 291 of the general medical services table applies has not been provided

Fee: $523.40 Benefit: 85% = $444.90

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

Category 1 - PROFESSIONAL ATTENDANCES

92436

92436 - Additional Information

Item Start Date:
06-Apr-2020
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2024

Telehealth attendance lasting more than 30 minutes, but not more than 45 minutes, by a consultant physician in the practice of the consultant physician’s specialty of psychiatry, if:

(a)    the patient is being managed by a medical practitioner or a participating nurse practitioner in accordance with a management plan prepared by the consultant in accordance with item 291 or 92435; and

(b)    the attendance follows referral of the patient to the consultant, by the medical practitioner or participating nurse practitioner managing the patient, for review of the management plan and the associated comprehensive diagnostic assessment; and

(c)    during the attendance, the consultant:

(i)     if it is clinically appropriate to do so—uses an appropriate outcome tool; and

(ii)   carries out a mental state examination; and

(iii)  reviews the comprehensive diagnostic assessment and undertakes additional assessment as required; and

(iv)  reviews the management plan; and

(d)    within 2 weeks after the attendance, the consultant prepares and gives to the referring practitioner a written report, which includes:

(i)     a revised comprehensive diagnostic assessment of the patient; and

(ii)   a revised management plan including updated recommendations to the referring practitioner to manage the patient’s ongoing care in a biopsychosocial model; and

(e)    if clinically appropriate, the consultant explains the diagnostic assessment and the management plan, and gives a copy, to:

(i)     the patient; and

(ii)   the patient’s carer (if any), if the patient agrees; and

(f)    in the preceding 12 months, a service to which item 291 of the general medical services table or item 92435 applies has been provided; and

(g)    in the preceding 12 months, a service to which this item or item 293 of the general medical services table applies has not been provided

Fee: $327.20 Benefit: 85% = $278.15

(See para AN.0.30 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

92437

92437 - Additional Information

Item Start Date:
06-Apr-2020
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2024

Telehealth attendance of more than 45 minutes in duration by a consultant physician in the practice of the consultant physician’s speciality of psychiatry following referral of the patient to the consultant physician by a referring practitioner:

(a) if the patient:

    (i) is a new patient for this consultant physician; or

    (ii) has not received an attendance from this consultant physician in the preceding 24 months; and

(b)  the patient has not received an attendance under this item, or item 91827 to 91831, 91837 to 91839, 92455 to 92457, 91868 to 91873, 91879 to 91881 or item 296, 297, 299, 300, 302, 304, 306 to 308, 310, 312, 314, 316, 318, 319, 320, 322, 324, 326, 328, 330, 332, 334, 336, 338, 342, 344 or 346 of the general medical services table, in the preceding 24 months

Fee: $301.05 Benefit: 85% = $255.90

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

Category 8 - MISCELLANEOUS SERVICES

91175

91175 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
01-Jan-2022
Schedule Fee Updated:
01-Jul-2024

Focussed psychological strategies health service provided by telehealth attendance by an eligible social worker if:

(a)  the person is referred by:

(i)  a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

(ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

(iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(b)  the service is provided to the person individually; and

(c)  at the completion of a course of treatment, the referring medical 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 medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

(e)  the service is at least 20 minutes but less than 50 minutes duration

Fee: $70.95 Benefit: 85% = $60.35

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

Category 8 - MISCELLANEOUS SERVICES

91176

91176 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
01-Jan-2022
Schedule Fee Updated:
01-Jul-2024

Focussed psychological strategies health service provided by telehealth attendance by an eligible social worker if:

(a)  the person is referred by:

(i)  a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

(ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

(iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(b)  the service is provided to the person individually; and

(c)  at the completion of a course of treatment, the referring medical 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 medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

(e)  the service is at least 50 minutes duration

Fee: $100.20 Benefit: 85% = $85.20

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

Category 8 - MISCELLANEOUS SERVICES

91169

91169 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
01-Jan-2022
Schedule Fee Updated:
01-Jul-2024

Focussed psychological strategies health service provided by telehealth attendance by an eligible psychologist if:

(a)  the person is referred by:

(i)  a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

(ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

(iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(b)  the service is provided to the person individually; and

(c)  at the completion of a course of treatment, the referring medical 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 medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

(e)  the service is at least 20 minutes but less than 50 minutes duration

 

 

Fee: $80.55 Benefit: 85% = $68.50

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

Category 8 - MISCELLANEOUS SERVICES

91170

91170 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
01-Jan-2022
Schedule Fee Updated:
01-Jul-2024

Focussed psychological strategies health service provided by telehealth attendance by an eligible psychologist if:

(a)  the person is referred by:

(i)  a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

(ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

(iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(b)  the service is provided to the person individually; and

(c)  at the completion of a course of treatment, the referring medical 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 medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

(e)  the service is at least 50 minutes duration

Fee: $113.65 Benefit: 85% = $96.65

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

Category 8 - MISCELLANEOUS SERVICES

91166

91166 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
01-Jan-2022
Schedule Fee Updated:
01-Jul-2024

Psychological therapy health service provided by telehealth attendance by an eligible clinical psychologist if:

(a) the person is referred by:

(i) a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

(ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

(iii)   a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(b) the service is provided to the person individually; and

(c) at the completion of a course of treatment, the referring medical 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 medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

(e)  the service is at least 30 minutes but less than 50 minutes duration

 

Fee: $113.65 Benefit: 85% = $96.65

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

Category 8 - MISCELLANEOUS SERVICES

91167

91167 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
01-Jan-2022
Schedule Fee Updated:
01-Jul-2024

Psychological therapy health service provided by telehealth attendance by an eligible clinical psychologist if:

(a) the person is referred by:

(i)  a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

(ii)   a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

(iii)  a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(b) the service is provided to the person individually; and

(c) at the completion of a course of treatment, the referring medical 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 medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

(e) the service is at least 50 minutes duration

 

 

Fee: $166.85 Benefit: 85% = $141.85

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

Category 1 - PROFESSIONAL ATTENDANCES

91837

91837 - Additional Information

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

Phone 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 duration;

Where the attendance is after the first attendance as part of a single course of treatment, if that attendance and another attendance to which item 296, 297, 299 or any of items 300, 302, 304, 306 to 308, 91827 to 91831, 91838, 91839 and 92437 applies have not exceeded 50 attendances in a calendar year

Fee: $50.10 Benefit: 85% = $42.60

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

Category 1 - PROFESSIONAL ATTENDANCES

91839

91839 - Additional Information

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

 Phone 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 at least 30 minutes, but not more than 45 minutes in duration

Where the attendance is after the first attendance as part of a single course of treatment, if that attendance and another attendance to which item 296, 297, 299 or any of items 300, 302, 304, 306 to 308, 91827 to 91831, 91837, 91838 and 92437 applies have not exceeded 50 attendances in a calendar year

Fee: $153.90 Benefit: 85% = $130.85

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

Category 8 - MISCELLANEOUS SERVICES

91172

91172 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
01-Jan-2022
Schedule Fee Updated:
01-Jul-2024

Focussed psychological strategies health service provided by telehealth attendance by an eligible occupational therapist if:

(a) the person is referred by:

(i)  a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

(ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

(iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(b)  the service is provided to the person individually; and

(c)  at the completion of a course of treatment, the referring medical 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 medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

(e)  the service is at least 20 minutes but less than 50 minutes duration

Fee: $70.95 Benefit: 85% = $60.35

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

Category 8 - MISCELLANEOUS SERVICES

91173

91173 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
01-Jan-2022
Schedule Fee Updated:
01-Jul-2024

Focussed psychological strategies health service provided by telehealth attendance by an eligible occupational therapist if:

(a) the person is referred by:

(i)  a medical practitioner, either as part of a GP Mental Health Treatment Plan or as part of a psychiatrist assessment and management plan; or

(ii) a specialist or consultant physician specialising in the practice of his or her field of psychiatry; or

(iii) a specialist or consultant physician specialising in the practice of his or her field of paediatrics; and

(b)  the service is provided to the person individually; and

(c)  at the completion of a course of treatment, the referring medical 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 medical practitioner on assessments carried out, treatment provided and recommendations on future management of the person’s condition; and

(e)  the service is at least 50 minutes in duration

 

Fee: $100.20 Benefit: 85% = $85.20

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


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