Medicare Benefits Schedule - Note AN.7.23

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Category 1 - PROFESSIONAL ATTENDANCES

AN.7.23

Prescribed Medical Practitioner Provision of Focussed Psychological Strategies (Items 283, 285, 286, 287, 91820, 91821, 91844 and 91845)

Last reviewed: 1 November 2023

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

Minimum Requirements

All consultations providing Focussed Psychological Strategies must be rendered by a prescribed medical practitioner (see note AN.7.1).

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

Continued access to item numbers 283, 285, 286, 287, 91820, 91821, 91844 and 91845 will be dependent on the practitioner meeting the ongoing mental health education requirements as determined by the General Practice Mental Health Standards Collaboration.

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

Out-of-Surgery Consultation

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

Specific Focussed Psychological Strategies

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

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

6.       Eye-Movement Desensitisation Reprocessing (EMDR)

Mental Disorder

A mental disorder may be defined as a significant impairment of an individual’s cognitive, affective and/or relational abilities which may require intervention and may be a recognised, medically diagnosable illness or disorder – this definition is informed by the World Health Organisation, 1996, Diagnostic and Management Guidelines for Mental Disorders in Primary Care:ICD - 10 Chapter V Primary Health Care Version.

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

Related Items: 283 285 286 287 91820 91821 91844 91845


Related Items

Category 1 - PROFESSIONAL ATTENDANCES

283

283 - Additional Information

Item Start Date:
01-Jul-2018
Description Updated:
01-Nov-2023
Schedule Fee Updated:
01-Nov-2023

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

Fee: $81.70 Benefit: 100% = $81.70

(See para AN.7.1, AN.7.23 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

285

285 - Additional Information

Item Start Date:
01-Jul-2018
Description Updated:
01-Nov-2023
Schedule Fee Updated:
01-Nov-2023

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

The fee for item 283, plus $22.90 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 283 plus $1.80 per patient.
Ready Reckoner

(See para AN.7.1, AN.7.23 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

286

286 - Additional Information

Item Start Date:
01-Jul-2018
Description Updated:
01-Nov-2023
Schedule Fee Updated:
01-Nov-2023

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

Fee: $116.90 Benefit: 100% = $116.90

(See para AN.7.1, AN.7.23 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

287

287 - Additional Information

Item Start Date:
01-Jul-2018
Description Updated:
01-Nov-2023
Schedule Fee Updated:
01-Nov-2023

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

The fee for item 286, plus $22.90 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 286 plus $1.80 per patient.
Ready Reckoner

(See para AN.7.1, AN.7.23 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

91844

91844 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
01-Nov-2023
Schedule Fee Updated:
01-Nov-2023

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

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

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

Fee: $81.70 Benefit: 100% = $81.70

(See para AN.7.23 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

91845

91845 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
01-Nov-2023
Schedule Fee Updated:
01-Nov-2023

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

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

(b)    the service lasts at least 40 minutes

Fee: $116.90 Benefit: 100% = $116.90

(See para AN.7.23 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

91820

91820 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
01-Nov-2023
Schedule Fee Updated:
01-Nov-2023

Telehealth attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician), for the purpose of providing focussed psychological strategies for assessed mental disorders if:

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

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

Fee: $81.70 Benefit: 100% = $81.70

(See para AN.7.23 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

91821

91821 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
01-Nov-2023
Schedule Fee Updated:
01-Nov-2023

Telehealth attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician), for the purpose of providing focussed psychological strategies for assessed mental disorders if:

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

(b)    the service lasts at least 40 minutes

Fee: $116.90 Benefit: 100% = $116.90

(See para AN.7.23 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