Medicare Benefits Schedule - Note MN.6.2

Associated Items: 80000, 80005, 80010, 80015, 80020, 80021, 80022, 80023, 80024, 80025, 91166, 91167, 91181, 91182.

Services attracting Medicare benefits

There are 14 Medicare Benefits Schedule (MBS) items for the provision of psychological therapy services to eligible patients by an eligible clinical psychologist. These consist of:

Individual Psychological Therapy Services:

• Face-to-Face items:  80000, 80005, 80010 and 80015
• Telehealth items: 91166, 91167, 91181 and 91182

Group Psychological Therapy Services:

• Face-to-Face items: 80020, 80022, and 80024
• Telehealth items: 80021, 80023 and 80025 

To provide these services, clinical psychologists must meet the provider eligibility requirements set out below and be registered with Services Australia.

To receive these services, patients must meet the eligibility requirements outlined in explanatory note AN.0.78 - Better Access Initiative.

For Group Psychological Therapy Services provided via Telehealth, additional restrictions apply. Please see the Group psychological therapy services - Telehealth Requirements section below for further information.

Service length and type

Services provided by eligible clinical psychologists under these items must be within the specified time period within the item descriptor.

In addition to psychoeducation, it is recommended that cognitive-behaviour therapy be provided. However, other evidence-based therapies may be used if considered clinically relevant. 

Number of services per year

Medicare benefits are available for up to 10 individual and 10 group mental health services in a calendar year. The services may consist of:

• psychological therapy services delivered by clinical psychologists; and/or
• focussed psychological strategies services delivered by eligible GPs, PMPs, psychologists, social workers and occupational therapists (refer to explanatory note MN.7.4 – Provision of Focussed Psychological Strategies) 

Course of treatment and reporting back to the referring medical practitioner

Eligible patients must be referred to psychological therapy services by a GP or medical practitioner who is managing the patient under a GP Mental Health Treatment Plan, under a referred psychiatrist assessment and management plan, or on referral from an eligible psychiatrist or paediatrician. For additional information on Better Access referral requirements, please see explanatory note MN.6.3 - Referral requirements for Better Access Treatment Services.

The clinical psychologist must be in receipt of the referral at the first mental health consultation. The clinical psychologist must also retain the referral for 2 years (24 months) from the date the service was rendered.

The referring practitioner can decide how many sessions the patient will receive in a course of treatment, within the maximum session limit for the course of treatment. The maximum session limit for each course of treatment is set out below:

• Initial course of treatment - a maximum of 6 sessions.
• Subsequent course of treatment - a maximum of 6 sessions up to the patient's cap of 10 sessions per calendar year (for example, if the patient received 6 sessions in their initial course of treatment, they could only receive 4 sessions in a subsequent course of treatment provided within the same calendar year).

On completion of the initial course of treatment, the clinical psychologist must provide a written report to the referring GP or medical practitioner, which includes information on:

• assessments carried out on the patient;
• treatment provided; and
• recommendations on future management of the patient's disorder.

A written report must also be provided to the referring GP or medical practitioner at the completion of any subsequent course(s) of treatment provided to the patient.

Group psychological therapy services

In addition to individual psychological therapy services, eligible patients may also claim up to 10 separate group psychological therapy service MBS items within a calendar year for group therapy services. Group psychological therapy service MBS items can be claimed for groups of 4 to 10 patients. However, clinical psychologists can claim these MBS items if 4 patients were due to attend and one patient is unable to attend, regardless of the reason.

Group psychological therapy services - Telehealth Requirements

Group therapy may only be delivered via telehealth in certain circumstances. To be eligible for group therapy services via telehealth, the patient must be located in a Modified Monash Model area 4-7 at the time of the consultation, and at least 15 kilometres apart by road from the allied health professional delivering the session. The patient or clinical psychologist is not permitted to travel to an area outside the minimum 15 kilometres distance in order to claim a telehealth consultation item.

More information about the Modified Monash Model, including a search tool to identify the classification of a specific location, is available at:

https://www.health.gov.au/topics/rural-health-workforce/classifications/mmm

Record Keeping

Clinical psychologists providing psychological therapy services must keep contemporaneous notes of the consultation 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. For information on what constitutes adequate and contemporaneous records, refer to explanatory note GN.15.39 - Practitioners should maintain adequate and contemporaneous records.

Allied health professional eligibility for the provision of psychological therapy services

Focussed psychological strategy services under the MBS may only be provided by eligible allied health professionals.  

A person is an eligible allied health professional in relation to the provision of a psychological therapy health service if the person:

1. holds general registration in the health profession of psychology with the Psychology Board of Australia; and
2. is endorsed by the Psychology Board of Australia to practice in clinical psychology.

Registering with the Services Australia

Advice about registering with the Services Australia to provide Better Access services is available from the Services Australia provider enquiry line on 132 150.

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: 80000 80005 80010 80015 80020 80021 80022 80023 80024 80025 91166 91167 91181 91182

• Previous - Note MN.6.1
• Next - Note MN.6.3

Psychological therapy health service provided to a patient in consulting rooms by an eligible clinical psychologist if:

(a)  the patient is referred by a referring practitioner; and

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

(c)  at the completion of a course of treatment, the referring 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 practitioner on assessments carried out, treatment provided and recommendations on future management of the patient’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.0.78, MN.6.2, MN.6.3 of explanatory notes to this Category)

Psychological therapy health service provided to a patient at a place other than consulting rooms by an eligible clinical psychologist if:

(a)  the patient is referred by a referring practitioner; and

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

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

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

Fee: $142.05 Benefit: 85% = $120.75

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

Psychological therapy health service provided to a patient in consulting rooms by an eligible clinical psychologist if:

(a)  the patient is referred by a referring practitioner; and

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

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

(e)  the service is at least 50 minutes duration

Fee: $166.85 Benefit: 85% = $141.85

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

Psychological therapy health service provided to a patient at a place other than consulting rooms by an eligible clinical psychologist if:

(a)  the patient is referred by a referring practitioner; and

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

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

(e)  the service is at least 50 minutes duration

Fee: $195.20 Benefit: 85% = $165.95

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

Psychological therapy health service provided to a patient as part of a group of 4 to 10 patients by an eligible clinical psychologist if:

(a)  the patient is referred by a referring practitioner; and

(b)  the service is provided in person; and

(c)  the service is at least 60 minutes duration

Fee: $42.35 Benefit: 85% = $36.00

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

Psychological therapy health service provided to a patient as part of a group of 4 to 10 patients by an eligible clinical psychologist if:

(a)  the patient is referred by a referring practitioner; and

(b)  the attendance is by video conference; and

(c)  the patient is located within a telehealth eligible area; and

(d)  the patient is, at the time of the attendance, at least 15 kilometres by road from the clinical psychologist; and

(e)  the service is at least 60 minutes duration

Fee: $42.35 Benefit: 85% = $36.00

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

Psychological therapy health service provided to a patient as part of a group of 4 to 10 patients by an eligible clinical psychologist if:

(a)  the patient is referred for a course of treatment by a referring practitioner; and

(b)  the service is provided in person; and

(c)  the service is at least 90 minutes duration

Fee: $57.70 Benefit: 85% = $49.05

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

Psychological therapy health service provided to a patient as part of a group of 4 to 10 patients by an eligible clinical psychologist if:

(a)  the patient is referred by a referring practitioner; and

(b)  the attendance is by video conference; and

(c)  the patient is located within a telehealth eligible area; and

(d)  the patient is, at the time of the attendance, at least 15 kilometres by road from the clinical psychologist; and

(e)  the service is at least 90 minutes duration

Fee: $57.70 Benefit: 85% = $49.05

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

Psychological therapy health service provided to a patient as part of a group of 4 to 10 patients by an eligible clinical psychologist if:

(a)  the patient is referred for a course of treatment by a referring practitioner; and

(b)  the service is provided in person; and

(c)  the service is at least 120 minutes duration

Fee: $78.40 Benefit: 85% = $66.65

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

Psychological therapy health service provided to a patient as part of a group of 4 to 10 patients by an eligible clinical psychologist if:

(a)  the patient is referred by a referring practitioner; and

(b)  the attendance is by video conference; and

(c)  the patient is located within a telehealth eligible area; and

(d)  the patient is, at the time of the attendance, at least 15 kilometres by road from the clinical psychologist; and

(e)  the service is at least 120 minutes duration

Fee: $78.40 Benefit: 85% = $66.65

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

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)

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)

Psychological therapy health service provided by phone 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.0.78, MN.6.2, MN.6.3 of explanatory notes to this Category)

Psychological therapy health service provided by phone 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.0.78, MN.6.2, MN.6.3 of explanatory notes to this Category)