Medicare Benefits Schedule - Note MN.6.3

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Category 8 - MISCELLANEOUS SERVICES

MN.6.3

Referral Requirements for Better Access Treatment Services

Associated items: 2721, 2723, 2725, 2727, 91818, 91819, 91842, 91843, 283, 285, 286, 287, 91820, 91821, 91844, 91845, 80100, 80105, 80110, 80115, 91169, 91170, 91183, 91184, 80125, 80130, 80135, 80140, 91172, 91173, 91185, 91186, 80150, 80155, 80160, 80165, 91175, 91176, 91187, 91188, 80120, 80122, 80127, 80121, 80123, 80128, 80145, 80147, 80152, 80146, 80148, 80153, 80170, 80172, 80174, 80171, 80173, 80175, 80000, 80010, 80005, 80015, 91166, 91167, 91181, 91182, 80020, 80021, 80022, 80023, 80024, 80025, 80002, 80006, 80012, 80016, 91171, 91199, 91168, 91198

Services requiring referral

Medicare Benefits Schedule (MBS) treatment services under the Better Access initiative (refer to explanatory note AN.0.78 – Better Access Initiative) require an eligible referral for a Medicare benefit to be claimed. Medicare benefits are available for up to 10 individual and 10 group mental health services in a calendar year. These services may consist of:

Up to 2 of a patient’s individual mental health services may be used for family and carer participation items per calendar year. For additional information, refer to explanatory note MN.7.5 – Family and Carer Participation.  

Eligible Referral Services

For the purposes of Better Access treatment services (refer to explanatory notes MN.6.2 -Provision of Psychological Therapy and MN.7.4 - Provision of Focussed Psychological Strategies), a Medicare benefit will not be payable unless:

Referrals from psychiatrists and paediatricians must be made from eligible Medicare services. 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.

Course of Treatment and Specifying the Number of Sessions in a Referral

Under the Better Access Initiative, a patient may be referred for up to 10 individual and 10 group mental health services within a calendar year.  The referring practitioner can decide how many mental health services a 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 treating practitioner or allied health professional providing the service 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. 

This report will aid the referring practitioner in determining whether another course of treatment is appropriate for the management of the patient’s mental disorder.

If, in their referral, the referring practitioner:

  • Does not specify the number of sessions
  • Specifies a number of sessions above the maximum allowed for the course of treatment
  • Specifies a number of sessions above the maximum allowed for the calendar year (including any sessions the patient has already received that year)

Then the treating practitioner or allied health professional can use their clinical judgment to provide services under the referral, noting the patient cannot receive more than:

  • the maximum number of sessions allowed for that particular course of treatment (as set out above); and
  • the maximum number of sessions allowed in a calendar year.

The treating practitioner or allied health professional must still provide a report at the end of a course of treatment in line with standard practice for these services. The referring medical practitioner should therefore consider the treating practitioner or allied health professional’s report on the services provided to the patient, and the need for further treatment.

Referral Requirements

Referring practitioners are not required to use a specific form to refer patients for these services. However, a referral for mental health services should be in writing (signed and dated by the referring practitioner) and include:

  • the patient's name, date of birth and address;
  • the patient's symptoms or diagnosis and a statement on whether a mental health treatment plan has been prepared;
  • a list of any current medications;
  • the number of sessions the patient is being referred for; and
  • a statement about whether the patient has a mental health treatment plan or a psychiatrist assessment and management plan. 

A referral should include all the above details, to assist with any auditing undertaken by the Department of Health and Aged Care. Where appropriate, and with the patient's agreement, the GP can also attach a copy of the mental health treatment plan to the referral.

Use of Referrals across Different Calendar Years

If a patient has not used all their psychological therapy services and/or focussed psychological strategies services covered by a referral within the calendar year, it is not necessary to obtain a new referral for the "unused" services. However, any "unused" services received from 1 January in the following year under that referral will count as part of the total services for which the patient is eligible in that calendar year.

When a patient has used all of their referred services, they will need to obtain a new referral from their referring practitioner if they are eligible for further services.

It is not necessary to have a new GP Mental Health Treatment Plan and/or psychiatrist assessment and management plan prepared each calendar year in order to access a new referral(s) for group therapy services and/or focussed psychological strategies services.  Patients continue to be eligible for benefits for psychological therapy services and/or focussed psychological strategies services while they are being managed under a GP Mental Health Treatment Plan and/or a psychiatrist assessment and management plan as long as the need for eligible services continues to be recommended in their plan.

Receipt of referral

The practitioner or allied health professional providing the relevant treatment service (refer to explanatory notes MN.6.2 – Provision of Psychological Therapy and MN.7.4 – Provision of Focussed Psychological Strategies) must be in receipt of the referral at the first consultation. The allied health provider must also retain the referral for a period of 2 years (24 months) from the date the service was rendered. For more information on record keeping and reporting requirements, refer to explanatory note AN.0.78 – Better Access Initiative.

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: 283 285 286 287 2721 2723 2725 2727 80000 80002 80005 80006 80010 80012 80015 80016 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 80160 80165 80170 80171 80172 80173 80174 80175 91166 91167 91168 91169 91170 91171 91172 91173 91175 91176 91181 91182 91183 91184 91185 91186 91187 91188 91198 91199 91818 91819 91820 91821 91842 91843 91844 91845


Related Items

Category 1 - PROFESSIONAL ATTENDANCES

2721

2721 - Additional Information

Item Start Date:
01-Nov-2002
Description Updated:
01-Jul-2018
Schedule Fee Updated:
01-Jul-2024

Professional attendance at consulting rooms by a general practitioner, for providing focussed psychological strategies for assessed mental disorders by a general practitioner registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service, and lasting at least 30 minutes, but less than 40 minutes

Fee: $105.65 Benefit: 100% = $105.65

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

Category 1 - PROFESSIONAL ATTENDANCES

2723

2723 - Additional Information

Item Start Date:
01-Nov-2002
Description Updated:
01-Jul-2018
Schedule Fee Updated:
01-Jul-2024

Professional attendance at a place other than consulting rooms by a general practitioner, for providing focussed psychological strategies for assessed mental disorders by a general practitioner registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service, and lasting at least 30 minutes, but less than 40 minutes

The fee for item 2721, plus $29.60 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 2721 plus $2.35 per patient.
Ready Reckoner

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

Category 1 - PROFESSIONAL ATTENDANCES

2725

2725 - Additional Information

Item Start Date:
01-Nov-2002
Description Updated:
01-Jul-2018
Schedule Fee Updated:
01-Jul-2024

Professional attendance at consulting rooms by a general practitioner, for providing focussed psychological strategies for assessed mental disorders by a general practitioner registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service, and lasting at least 40 minutes

Fee: $151.20 Benefit: 100% = $151.20

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

Category 1 - PROFESSIONAL ATTENDANCES

2727

2727 - Additional Information

Item Start Date:
01-Nov-2002
Description Updated:
01-Jul-2018
Schedule Fee Updated:
01-Jul-2024

Professional attendance at a place other than consulting rooms by a general practitioner, for providing focussed psychological strategies for assessed mental disorders by a general practitioner registered with the Chief Executive Medicare as meeting the credentialling requirements for provision of this service, and lasting at least 40 minutes

The fee for item 2725, plus $29.60 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 2725 plus $2.35 per patient.
Ready Reckoner

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

Category 1 - PROFESSIONAL ATTENDANCES

283

283 - Additional Information

Item Start Date:
01-Jul-2018
Description Updated:
01-Nov-2023
Schedule Fee Updated:
01-Jul-2024

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: $84.55 Benefit: 100% = $84.55

(See para AN.0.78, AN.7.1, MN.6.3, MN.7.4 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-Jul-2024

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 $23.70 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 $1.85 per patient.
Ready Reckoner

(See para AN.0.78, AN.7.1, MN.6.3, MN.7.4 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-Jul-2024

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: $121.00 Benefit: 100% = $121.00

(See para AN.0.78, AN.7.1, MN.6.3, MN.7.4 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-Jul-2024

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 $23.70 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 $1.85 per patient.
Ready Reckoner

(See para AN.0.78, AN.7.1, MN.6.3, MN.7.4 of explanatory notes to this Category)

Category 8 - MISCELLANEOUS SERVICES

91183

91183 - 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 phone 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.0.78, MN.6.3, MN.7.4 of explanatory notes to this Category)

Category 8 - MISCELLANEOUS SERVICES

91184

91184 - 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 phone 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.0.78, MN.6.3, MN.7.4 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

91842

91842 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
21-Jul-2021
Schedule Fee Updated:
01-Jul-2024

Phone attendance by a general practitioner, 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: $105.65 Benefit: 100% = $105.65

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

Category 1 - PROFESSIONAL ATTENDANCES

91843

91843 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
21-Jul-2021
Schedule Fee Updated:
01-Jul-2024

Phone attendance by a general practitioner, 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: $151.20 Benefit: 100% = $151.20

(See para AN.0.78, MN.6.3, MN.7.4 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-Jul-2024

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: $84.55 Benefit: 100% = $84.55

(See para AN.0.78, MN.6.3, MN.7.4 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-Jul-2024

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: $121.00 Benefit: 100% = $121.00

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

Category 8 - MISCELLANEOUS SERVICES

80000

80000 - Additional Information

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

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)

Category 8 - MISCELLANEOUS SERVICES

80002

80002 - Additional Information

Item Start Date:
01-Mar-2023
Description Updated:
01-Mar-2023
Schedule Fee Updated:
01-Jul-2024

Psychological therapy health service provided in consulting rooms by an eligible clinical psychologist to a person other than the patient, if:

(a)   the service is part of the patient’s treatment;

(b)   the patient has been referred to the eligible clinical psychologist by a referring practitioner; and

(c)   the service lasts at least 30 minutes but less than 50 minutes

Fee: $113.65 Benefit: 85% = $96.65

(See para AN.0.78, MN.6.3, MN.7.5 of explanatory notes to this Category)

Category 8 - MISCELLANEOUS SERVICES

80005

80005 - Additional Information

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

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)

Category 8 - MISCELLANEOUS SERVICES

80006

80006 - Additional Information

Item Start Date:
01-Mar-2023
Description Updated:
01-Mar-2023
Schedule Fee Updated:
01-Jul-2024

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

(a)   the service is part of the patient’s treatment;

(b)   the patient has been referred to the eligible clinical psychologist by a referring practitioner; and

(c)   the service lasts at least 30 minutes but less than 50 minutes

Fee: $142.05 Benefit: 85% = $120.75

(See para AN.0.78, MN.6.3, MN.7.5 of explanatory notes to this Category)

Category 8 - MISCELLANEOUS SERVICES

80010

80010 - Additional Information

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

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)

Category 8 - MISCELLANEOUS SERVICES

80012

80012 - Additional Information

Item Start Date:
01-Mar-2023
Description Updated:
01-Mar-2023
Schedule Fee Updated:
01-Jul-2024

Psychological therapy health service provided in consulting rooms by an eligible clinical psychologist to a person other than the patient, if:

(a)   the service is part of the patient’s treatment;

(b)   the patient has been referred to the eligible clinical psychologist by a referring practitioner; and

(c)   the service lasts at least 50 minutes

Fee: $166.85 Benefit: 85% = $141.85

(See para AN.0.78, MN.6.3, MN.7.5 of explanatory notes to this Category)

Category 8 - MISCELLANEOUS SERVICES

80015

80015 - Additional Information

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

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)

Category 8 - MISCELLANEOUS SERVICES

80016

80016 - Additional Information

Item Start Date:
01-Mar-2023
Description Updated:
01-Mar-2023
Schedule Fee Updated:
01-Jul-2024

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

(a)   the service is part of the patient’s treatment; 

(b)   the patient has been referred to the eligible clinical psychologist by a referring practitioner; and

(c)   the service lasts at least 50 minutes

Fee: $195.20 Benefit: 85% = $165.95

(See para AN.0.78, MN.6.3, MN.7.5 of explanatory notes to this Category)

Category 8 - MISCELLANEOUS SERVICES

80020

80020 - Additional Information

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

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)

Category 8 - MISCELLANEOUS SERVICES

80021

80021 - Additional Information

Item Start Date:
01-Nov-2017
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2024

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)

Category 8 - MISCELLANEOUS SERVICES

80022

80022 - Additional Information

Item Start Date:
01-Nov-2022
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2024

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)

Category 8 - MISCELLANEOUS SERVICES

80023

80023 - Additional Information

Item Start Date:
01-Nov-2022
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2024

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)

Category 8 - MISCELLANEOUS SERVICES

80024

80024 - Additional Information

Item Start Date:
01-Nov-2022
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2024

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)

Category 8 - MISCELLANEOUS SERVICES

80025

80025 - Additional Information

Item Start Date:
01-Nov-2022
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2024

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)

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

80100

80100 - Additional Information

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

Focussed psychological strategies health service provided to a patient in consulting rooms by an eligible 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 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 20 minutes but less than 50 minutes duration

Fee: $80.55 Benefit: 85% = $68.50

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

Category 8 - MISCELLANEOUS SERVICES

80105

80105 - Additional Information

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

Focussed psychological strategies health service provided to a patient at a place other than consulting rooms by an eligible 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 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 20 minutes but less than 50 minutes duration

Fee: $109.55 Benefit: 85% = $93.15

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

Category 8 - MISCELLANEOUS SERVICES

80110

80110 - Additional Information

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

Focussed psychological strategies health service provided to a patient in consulting rooms by an eligible 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 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: $113.65 Benefit: 85% = $96.65

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

Category 8 - MISCELLANEOUS SERVICES

80115

80115 - Additional Information

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

Focussed psychological strategies health service provided to a patient at a place other than consulting rooms by an eligible 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 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: $142.75 Benefit: 85% = $121.35

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

Category 8 - MISCELLANEOUS SERVICES

80120

80120 - Additional Information

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

Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible 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: $29.00 Benefit: 85% = $24.65

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

Category 8 - MISCELLANEOUS SERVICES

80121

80121 - Additional Information

Item Start Date:
01-Nov-2017
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2024

Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible 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 psychologist; and

(e)  the service is at least 60 minutes duration

Fee: $29.00 Benefit: 85% = $24.65

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

Category 8 - MISCELLANEOUS SERVICES

80122

80122 - Additional Information

Item Start Date:
01-Nov-2022
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2024

Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible 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 90 minutes duration

Fee: $39.50 Benefit: 85% = $33.60

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

Category 8 - MISCELLANEOUS SERVICES

80123

80123 - Additional Information

Item Start Date:
01-Nov-2022
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2024

Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 by an eligible 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 psychologist; and

(e)  the service is at least 90 minutes duration

Fee: $39.50 Benefit: 85% = $33.60

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

Category 8 - MISCELLANEOUS SERVICES

80125

80125 - Additional Information

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

Focussed psychological strategies health service provided to a patient in consulting rooms by an eligible occupational therapist 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 occupational therapist 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 20 minutes but less than 50 minutes duration

Fee: $70.95 Benefit: 85% = $60.35

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

Category 8 - MISCELLANEOUS SERVICES

80127

80127 - Additional Information

Item Start Date:
01-Nov-2022
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2024

Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible 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 120 minutes duration

Fee: $53.65 Benefit: 85% = $45.65

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

Category 8 - MISCELLANEOUS SERVICES

80128

80128 - Additional Information

Item Start Date:
01-Nov-2022
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2024

Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible 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 psychologist; and

(e)  the service is at least 120 minutes duration

Fee: $53.65 Benefit: 85% = $45.65

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

Category 8 - MISCELLANEOUS SERVICES

80130

80130 - Additional Information

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

Focussed psychological strategies health service provided to a patient at a place other than consulting rooms by an eligible occupational therapist 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 occupational therapist 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 20 minutes but less than 50 minutes duration

Fee: $99.95 Benefit: 85% = $85.00

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

Category 8 - MISCELLANEOUS SERVICES

80135

80135 - Additional Information

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

Focussed psychological strategies health service provided to a patient in consulting rooms by an eligible occupational therapist 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 occupational therapist 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: $100.20 Benefit: 85% = $85.20

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

Category 8 - MISCELLANEOUS SERVICES

80140

80140 - Additional Information

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

Focussed psychological strategies health service provided to a patient at a place other than consulting rooms by an eligible occupational therapist 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 occupational therapist 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: $129.10 Benefit: 85% = $109.75

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

Category 8 - MISCELLANEOUS SERVICES

80145

80145 - Additional Information

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

Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible occupational therapist 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: $25.40 Benefit: 85% = $21.60

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

Category 8 - MISCELLANEOUS SERVICES

80146

80146 - Additional Information

Item Start Date:
01-Nov-2017
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2024

Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible occupational therapist 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 occupational therapist; and

(e)  the service is at least 60 minutes duration

Fee: $25.40 Benefit: 85% = $21.60

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

Category 8 - MISCELLANEOUS SERVICES

80147

80147 - Additional Information

Item Start Date:
01-Nov-2022
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2024

Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible occupational therapist 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 90 minutes duration

Fee: $34.55 Benefit: 85% = $29.40

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

Category 8 - MISCELLANEOUS SERVICES

80148

80148 - Additional Information

Item Start Date:
01-Nov-2022
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2024

Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible occupational therapist 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 occupational therapist; and

(e)  the service is at least 90 minutes duration

Fee: $34.55 Benefit: 85% = $29.40

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

Category 8 - MISCELLANEOUS SERVICES

80150

80150 - Additional Information

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

Focussed psychological strategies health service provided to a patient in consulting rooms by an eligible social worker 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 social worker 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 20 minutes but less than 50 minutes duration

Fee: $70.95 Benefit: 85% = $60.35

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

Category 8 - MISCELLANEOUS SERVICES

80152

80152 - Additional Information

Item Start Date:
01-Nov-2022
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2024

Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible occupational therapist 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 120 minutes duration

Fee: $47.10 Benefit: 85% = $40.05

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

Category 8 - MISCELLANEOUS SERVICES

80153

80153 - Additional Information

Item Start Date:
01-Nov-2022
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2024

Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible occupational therapist 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 occupational therapist; and

(e)  the service is at least 120 minutes duration

Fee: $47.10 Benefit: 85% = $40.05

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

Category 8 - MISCELLANEOUS SERVICES

80160

80160 - Additional Information

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

Focussed psychological strategies health service provided to a patient in consulting rooms by an eligible social worker 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 social worker 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: $100.20 Benefit: 85% = $85.20

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

Category 8 - MISCELLANEOUS SERVICES

80165

80165 - Additional Information

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

Focussed psychological strategies health service provided to a patient at a place other than consulting rooms by an eligible social worker 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 social worker 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: $129.10 Benefit: 85% = $109.75

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

Category 8 - MISCELLANEOUS SERVICES

80170

80170 - Additional Information

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

Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible social worker if:

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

(b)  the service is provided in person; and

(c)  the service is at least 60 minutes duration

Fee: $25.40 Benefit: 85% = $21.60

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

Category 8 - MISCELLANEOUS SERVICES

80171

80171 - Additional Information

Item Start Date:
01-Nov-2017
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2024

Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible social worker 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 social worker; and

(e)  the service is at least 60 minutes duration

Fee: $25.40 Benefit: 85% = $21.60

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

Category 8 - MISCELLANEOUS SERVICES

80172

80172 - Additional Information

Item Start Date:
01-Nov-2022
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2024

Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible social worker 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 90 minutes duration

Fee: $34.55 Benefit: 85% = $29.40

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

Category 8 - MISCELLANEOUS SERVICES

80173

80173 - Additional Information

Item Start Date:
01-Nov-2022
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2024

Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible social worker 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 social worker; and

(e)  the service is at least 90 minutes duration

Fee: $34.55 Benefit: 85% = $29.40

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

Category 8 - MISCELLANEOUS SERVICES

80174

80174 - Additional Information

Item Start Date:
01-Nov-2022
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2024

Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible social worker 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 120 minutes duration

Fee: $47.10 Benefit: 85% = $40.05

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

Category 8 - MISCELLANEOUS SERVICES

80175

80175 - Additional Information

Item Start Date:
01-Nov-2022
Description Updated:
01-Mar-2024
Schedule Fee Updated:
01-Jul-2024

Focussed psychological strategies health service provided to a patient as part of a group of 4 to 10 patients by an eligible social worker 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 social worker; and

(e)  the service is at least 120 minutes duration

Fee: $47.10 Benefit: 85% = $40.05

(See para 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

91187

91187 - 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 phone 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.0.78, MN.6.3, MN.7.4 of explanatory notes to this Category)

Category 8 - MISCELLANEOUS SERVICES

91188

91188 - 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 phone 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.0.78, 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 8 - MISCELLANEOUS SERVICES

91168

91168 - Additional Information

Item Start Date:
01-Mar-2023
Description Updated:
01-Mar-2023
Schedule Fee Updated:
01-Jul-2024

Telehealth attendance for a psychological therapy health service provided by an eligible clinical psychologist to a person other than the patient, if:

(a)    the service is part of the patient’s treatment;

(b)    the patient has been referred to the eligible clinical psychologist by a referring practitioner; and

(c)    the service lasts at least 30 minutes but less than 50 minutes

Fee: $113.65 Benefit: 85% = $96.65

(See para AN.0.78, MN.6.3, MN.7.5 of explanatory notes to this Category)

Category 8 - MISCELLANEOUS SERVICES

91171

91171 - Additional Information

Item Start Date:
01-Mar-2023
Description Updated:
01-Mar-2023
Schedule Fee Updated:
01-Jul-2024

Telehealth attendance for a psychological therapy health service provided by an eligible clinical psychologist to a person other than the patient, if:

(a)     the service is part of the patient’s treatment;

(b)    the patient has been referred to the eligible clinical psychologist by a referring practitioner; and

(c)     the service lasts at least 50 minutes

Fee: $166.85 Benefit: 85% = $141.85

(See para AN.0.78, MN.6.3, MN.7.5 of explanatory notes to this Category)

Category 1 - PROFESSIONAL ATTENDANCES

91818

91818 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
21-Jul-2021
Schedule Fee Updated:
01-Jul-2024

Telehealth attendance by a general practitioner, 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: $105.65 Benefit: 100% = $105.65

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

Category 1 - PROFESSIONAL ATTENDANCES

91819

91819 - Additional Information

Item Start Date:
13-Mar-2020
Description Updated:
21-Jul-2021
Schedule Fee Updated:
01-Jul-2024

Telehealth attendance by a general practitioner, 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: $151.20 Benefit: 100% = $151.20

(See para AN.0.78, MN.6.3, MN.7.4 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-Jul-2024

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: $84.55 Benefit: 100% = $84.55

(See para AN.0.78, MN.6.3, MN.7.4 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-Jul-2024

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: $121.00 Benefit: 100% = $121.00

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

Category 8 - MISCELLANEOUS SERVICES

91181

91181 - 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 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)

Category 8 - MISCELLANEOUS SERVICES

91182

91182 - 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 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)

Category 8 - MISCELLANEOUS SERVICES

91198

91198 - Additional Information

Item Start Date:
01-Mar-2023
Description Updated:
01-Mar-2023
Schedule Fee Updated:
01-Jul-2024

Phone attendance for a psychological therapy health service provided by an eligible clinical psychologist to a person other than the patient, if:

(a)     the service is part of the patient’s treatment;

(b)    the patient has been referred to the eligible clinical psychologist by a referring practitioner; and

(c)     the service lasts at least 30 minutes but less than 50 minutes

Fee: $113.65 Benefit: 85% = $96.65

(See para AN.0.78, MN.6.3, MN.7.5 of explanatory notes to this Category)

Category 8 - MISCELLANEOUS SERVICES

91199

91199 - Additional Information

Item Start Date:
01-Mar-2023
Description Updated:
01-Mar-2023
Schedule Fee Updated:
01-Jul-2024

Phone attendance for a psychological therapy health service provided by an eligible clinical psychologist to a person other than the patient, if:

(a)     the service is part of the patient’s treatment;

(b)    the patient has been referred to the eligible clinical psychologist by a referring practitioner; and

(c)     the service lasts at least 50 minutes

Fee: $166.85 Benefit: 85% = $141.85

(See para AN.0.78, MN.6.3, MN.7.5 of explanatory notes to this Category)

Category 8 - MISCELLANEOUS SERVICES

91185

91185 - 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 phone 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.0.78, MN.6.3, MN.7.4 of explanatory notes to this Category)

Category 8 - MISCELLANEOUS SERVICES

91186

91186 - 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 phone 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.0.78, MN.6.3, MN.7.4 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