View Related Items
Category 1 - PROFESSIONAL ATTENDANCES
AN.0.56
GP Mental Health Treatment Plans and Consultation
Associated items: 272, 276, 277, 279, 281, 282, 2700, 2701, 2712, 2713, 2715, 2717, 92112, 92113, 92114, 92115, 92116, 92117, 92118, 92119, 92120, 92121, 92122, 92123, 92126, 92127, 92132, 92133
This note provides information on the preparation and review of GP Mental Health Treatment Plans under the Better Access initiative (refer to explanatory note AN.0.78 - Better Access Initiative).
Who can provide
The GP Mental Health Treatment Plan, Review and Consultation Medicare Benefits Schedule (MBS) items are available for use in general practice by a general practitioner or prescribed medical practitioner. The term 'GP' is used in these notes as a generic reference to general practitioners able to claim these items.
Patient Eligibility
These GP services are available to patients who meet the relevant eligibility requirements (refer to explanatory note AN.0.78 - Better Access Initiative). GP Mental Health Treatment Plan and Review services can also be provided to private inpatients (including private inpatients who are residents of aged care facilities) being discharged from hospital. Where the service is provided as part of an episode of hospital treatment, the service must be claimed at the 75% MBS benefit.
Services attracting Medicare benefits
The GP Mental Health Treatment items define services for which Medicare benefits are payable where GPs undertake early intervention, assessment, and management of patients with diagnoseable mental disorders. For information on the service requirements of these items, please see the relevant headings below.
There are 16 MBS items for the preparation of a GP Mental Health Treatment Plan. These are:
For GPs providing GP Mental Health Treatment Plans who have undertaken mental health skills training recognised through the General Practice Mental Health Standards Collaboration:
- Face-to-face items: 2715 and 2717
- Telehealth items 92116 and 92117
For GPs who have not undertaken mental health skills training:
- Face-to-face items 2700 and 2701
- Telehealth items 92112 and 92113
For Prescribed Medical Practitioners providing GP Mental Health Treatment Plans who have undertaken mental health skills training recognised through the General Practice Mental Health Standards Collaboration:
- Face-to-face items 281 and 282
- Telehealth items 92122 and 92123
For Prescribed Medical Practitioners who have not undertaken mental health skills training:
- Face-to-face items 272 and 276
- Telehealth items 92118 and 92119
It is strongly recommended that GPs and Prescribed Medical Practitioners providing mental health treatment have appropriate mental health training. GP organisations support the value of appropriate mental health training for practitioners using these items.
Additionally, there are 6 items for the review of a GP Mental Health Treatment Plan or Psychiatrist Assessment and Management Plan. These are:
- GP face-to-face item: 2712
- GP telehealth items: 92114 and 92126
- Prescribed medical practitioner face-to-face item: 277
- Prescribed medical practitioner telehealth items: 92120 and 92132
There are also additional items that exist for the review of Psychiatrist Assessment and Management Plans. For further information, refer to explanatory note AN.0.30 – Consultant Psychiatrist – Referred Patient Assessment and Management Plan.
There are 6 items for GP mental health treatment consultation. These are:
- GP face-to-face item: 2713
- GP telehealth items: 92115 and 92127
- Prescribed medical practitioner face-to-face item: 279
- Prescribed medical practitioner telehealth items: 92121 and 92133
Preparation of a GP Mental Health Treatment Plan
A GP Mental Health Treatment Plan is intended to identify and document the care needs of patients with a diagnosable mental disorder to allow for a structured approach to the management of their treatment. Before proceeding with a GP Mental Health Treatment Plan service, the GP must ensure that:
- The GP Mental Health Treatment Plan preparation service and the steps involved in preparing a GP Mental Health Treatment Plan are explained to the patient and (if appropriate and with the patient's permission) to the patient's carer; and
- the patient's agreement to proceed is recorded.
The preparation of a GP Mental Health Treatment Plan involves the assessment of a patient’s mental disorder and preparation of a plan to assist the patient in managing their mental disorder. The preparation of a GP Mental Health Treatment Plan must be documented in writing, and include an assessment process consisting of:
- The administration of an outcome measurement tool (except if considered clinically inappropriate); and
- The formulation of the mental disorder, including a provisional or formal diagnosis.
An outcome measurement tool refers to a tool used to monitor changes in a patient’s health that occur in response to treatment received by the patient.
The choice of the evidence-based outcome measurement tool/s to be used is at the clinical discretion of the practitioner, however examples of appropriate outcome tools include:
- Kessler Psychological Distress Scale (K10)
- DASS 21 (Depression, Anxiety and Stress)
- Initial Assessment and Referral Decision Support Tool (IAR-DST)
GPs using such tools should be familiar with their appropriate clinical use, and if not, should seek appropriate education and training. Once a GP has completed an assessment of a patient’s mental disorder, the GP must:
- Identify and discuss referral and treatment options with the patient, including appropriate support services;
- Agree upon treatment goals with the patient and any actions the patient will take;
- Provide relevant and suitable education about the patient’s mental disorder;
- Create a plan for crisis intervention and/or for relapse prevention; and
- Make arrangements for required referrals, treatment, appropriate support services, review and follow-up.
This information must be recorded in writing in the patient's GP Mental Health Treatment Plan. Upon completion of preparation of a GP Mental Health Treatment Plan, a copy must be offered to the patient, and where relevant and if the practitioner considers it appropriate, the patient’s carer, before a GP Mental Health Treatment Plan item may be claimed. A copy of the GP Mental Health Treatment Plan must be added to the patient’s medical records.
A patient's GP Mental Health Treatment Plan should be treated as a living document for updating as required. In particular, the plan can be updated at any time to incorporate relevant information, such as feedback or advice from other health professionals on the diagnosis or treatment of the patient. A new plan should not be prepared unless clinically required, and generally not within 12 months of a previous plan, unless exceptional circumstances exist. Ongoing management can be provided through the GP Mental Health Treatment Consultation and standard consultation items, as required, and reviews of progress through the GP Mental Health Treatment Plan Review items.
Referral and Treatment Options
Once a GP Mental Health Treatment Plan has been completed and claimed on an appropriate Medicare service, a patient is eligible to access relevant treatment and referral options. Relevant treatment and referral options consist of support services, psychiatric services, and relevant services provided under the Better Access initiative (refer to explanatory note AN.0.78 - Better Access Initiative).
Reviewing a GP Mental Health Treatment Plan
The review item is a key component for assessing and managing the patient's progress once a GP Mental Health Treatment Plan has been prepared, along with ongoing management through the GP Mental Health Treatment Consultation item and/or standard consultation items. A patient's GP Mental Health Treatment Plan should be reviewed at least once.
A Medicare benefit can be claimed once the GP who prepared the patient's GP Mental Health Treatment Plan (or another GP in the same practice or in another practice where the patient has changed practices) has undertaken a systematic review of the patient's progress against the GP Mental Health Treatment Plan by completing the activities that must be included in a review. The review item can also be used where a psychiatrist has prepared a referred Psychiatrist Assessment and Management Plan (item 291 or 92435), as if that patient had a GP Mental Health Treatment Plan.
Before proceeding with any GP Mental Health Treatment review service, the GP must ensure that:
- The GP Mental Health Treatment Plan review service and the steps involved are explained to the patient and (if appropriate and with the patient's permission) to the patient's carer; and
- the patient's agreement to proceed is recorded.
The review must include:
- a review of the patient's progress against the goals outlined in the GP Mental Health Treatment Plan;
- checking, reinforcing and expanding education;
- a plan for crisis intervention and/or for relapse prevention, if appropriate and if not previously provided;
- re-administration of the outcome measurement tool used in the assessment stage, except where considered clinically inappropriate; and
- modification of the documented GP Mental Health Treatment Plan if required.
If amendments are made to the patient’s GP Mental Health Treatment Plan, a copy of the amended plan must be offered to the patient, and where relevant and appropriate, the patient’s carer, before a GP Mental Health Treatment Plan review service may be claimed. A copy of the amended plan must also be added to the patient’s medical records.
In general, most patients should not require more than two reviews in a 12-month period, with ongoing management through the GP Mental Health Treatment Consultation and standard consultation items, as required. A benefit for a GP Mental Health Treatment Plan review service will not be paid more than once in a three-month period, or within four weeks following a claim for a GP Mental Health Treatment Plan item.
Mental Health Treatment Consultation
The Mental Health Treatment Consultation items are for an extended consultation with a patient where the primary treating problem is related to a mental disorder, including for a patient being managed under a GP Mental Health Treatment Plan. This item may be used for ongoing management of a patient with a mental disorder. This item should not be used for the development of a GP Mental Health Treatment Plan.
A GP Mental Health Treatment Consultation must include:
- taking relevant history and identifying the patient's presenting problem(s) (if not previously documented);
- providing treatment, advice and/or referral for other services or treatment; and
- documenting the outcomes of the consultation in the patient's medical records and other relevant mental health plan (where applicable).
A patient may be referred from a GP Mental Health Treatment Consultation for other treatment and services. This does not include referral for Better Access services, unless the patient is being managed by the GP under a GP Mental Health Treatment Plan or under a referred Psychiatrist Assessment and Management Plan (item 291 or 92435).
Additional claiming information
The GP Mental Health Treatment Plan, Review and Consultation items cover the consultations at which the relevant items are undertaken, noting that to co-claim a mental health MBS item and another item both services must be clinically relevant and distinct services.
Where an additional consultation is undertaken, both services must be clinically relevant, and all item requirements must be met. For example, for item 2700, the duration of the service must have been at least 20 minutes. The time of the preceding consultation must not be counted towards the time of the mental health service.
Where separate consultations are undertaken in conjunction with mental health consultations, the patient's invoice or Medicare voucher (assignment of benefit form) for the separate consultation should be annotated (e.g. separate consultation clinically required/indicated).
A benefit is not claimable, and an account should not be rendered, until all components of the relevant item have been provided.
All consultations conducted as part of the GP Mental Health Treatment items must be rendered by a GP or prescribed medical practitioner. A specialist mental health nurse, other allied health practitioner, Aboriginal and Torres Strait Islander health practitioner or Aboriginal Health Worker with appropriate mental health qualifications and training may provide general assistance to GPs in provision of mental health care.
Further information
For further information on the Better Access Initiative, refer to explanatory note AN.0.78 - Better Access Initiative.
For further information about Medicare Benefits Schedule items, please visit the MBS online website at www.health.gov.au/mbsonline.
Further information is available for providers from the Services Australia provider enquiry line on 132 150.
If you are a patient seeking advice about Medicare services, patient benefits, or your Medicare claims, please contact Services Australia on the Medicare General enquiry line on 132 011.
Related Items: 272 276 277 279 281 282 2700 2701 2712 2713 2715 2717 92112 92113 92114 92115 92116 92117 92118 92119 92120 92121 92122 92123 92126 92127 92132 92133
Related Items
Category 1 - PROFESSIONAL ATTENDANCES
2700 - Additional Information
Professional attendance by a general practitioner (including a general practitioner who has not undertaken mental health skills training) of at least 20 minutes but less than 40 minutes in duration for the preparation of a GP mental health treatment plan for a patient
Fee: $81.70 Benefit: 75% = $61.30 100% = $81.70
(See para AN.0.56, AN.0.78 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
2701 - Additional Information
Professional attendance by a general practitioner (including a general practitioner who has not undertaken mental health skills training) of at least 40 minutes in duration for the preparation of a GP mental health treatment plan for a patient
Fee: $120.25 Benefit: 75% = $90.20 100% = $120.25
(See para AN.0.56, AN.0.78 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
2712 - Additional Information
Professional attendance by a general practitioner to review a GP mental health treatment plan which he or she, or an associated general practitioner has prepared, or to review a Psychiatrist Assessment and Management Plan
Fee: $81.70 Benefit: 75% = $61.30 100% = $81.70
(See para AN.0.56, AN.0.78 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
2713 - Additional Information
Professional attendance by a general practitioner in relation to a mental disorder and of at least 20 minutes in duration, involving taking relevant history and identifying the presenting problem (to the extent not previously recorded), providing treatment and advice and, if appropriate, referral for other services or treatments, and documenting the outcomes of the consultation
Fee: $81.70 Benefit: 100% = $81.70
(See para AN.0.56, AN.0.78 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
2715 - Additional Information
Professional attendance by a general practitioner (including a general practitioner who has undertaken mental health skills training of at least 20 minutes but less than 40 minutes in duration for the preparation of a GP mental health treatment plan for a patient
Fee: $103.70 Benefit: 75% = $77.80 100% = $103.70
(See para AN.0.56, AN.0.78 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
2717 - Additional Information
Professional attendance by a general practitioner (including a general practitioner who has undertaken mental health skills training) of at least 40 minutes in duration for the preparation of a GP mental health treatment plan for a patient
Fee: $152.80 Benefit: 75% = $114.60 100% = $152.80
(See para AN.0.56, AN.0.78 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
272 - Additional Information
Professional attendance by a prescribed medical practitioner (who has not undertaken mental health skills training), lasting at least 20 minutes but less than 40 minutes, for the preparation of a GP mental health treatment plan for a patient
Fee: $65.35 Benefit: 75% = $49.05 100% = $65.35
(See para AN.0.56, AN.0.78, AN.7.1, AN.7.22 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
276 - Additional Information
Professional attendance by a prescribed medical practitioner (who has not undertaken mental health skills training), lasting at least 40 minutes, for the preparation of a GP mental health treatment plan for a patient
Fee: $96.20 Benefit: 75% = $72.15 100% = $96.20
(See para AN.0.56, AN.0.78, AN.7.1, AN.7.22 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
277 - Additional Information
Professional attendance by a prescribed medical practitioner to:
(a) review a GP mental health treatment plan which a medical practitioner, or an associated medical practitioner, has prepared; or
(b) to review a Psychiatrist Assessment and Management Plan
Fee: $65.35 Benefit: 75% = $49.05 100% = $65.35
(See para AN.0.56, AN.0.78, AN.7.1, AN.7.22 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
279 - Additional Information
Professional attendance by a prescribed medical practitioner, in relation to a mental disorder, lasting at least 20 minutes and involving:
(a) taking relevant history and identifying the presenting problem (to the extent not previously recorded); and
(b) providing treatment and advice; and
(c) if appropriate, referral for other services or treatments; and
(d) documenting the outcomes of the consultation
Fee: $65.35 Benefit: 75% = $49.05 100% = $65.35
(See para AN.0.56, AN.0.78, AN.7.1, AN.7.22 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
281 - Additional Information
Professional attendance by a prescribed medical practitioner (who has undertaken mental health skills training), lasting at least 20 minutes but less than 40 minutes, for the preparation of a GP mental health treatment plan for a patient
Fee: $82.95 Benefit: 75% = $62.25 100% = $82.95
(See para AN.0.56, AN.0.78, AN.7.1, AN.7.22 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
282 - Additional Information
Professional attendance by a prescribed medical practitioner (who has undertaken mental health skills training), lasting at least 40 minutes, for the preparation of a GP mental health treatment plan for a patient
Fee: $122.25 Benefit: 75% = $91.70 100% = $122.25
(See para AN.0.56, AN.0.78, AN.7.1, AN.7.22 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
92126 - Additional Information
Phone attendance by a general practitioner to review a GP mental health treatment plan which the general practitioner, or an associated general practitioner has prepared, or to review a Psychiatrist Assessment and Management Plan.
Fee: $81.70 Benefit: 100% = $81.70
(See para AN.0.56, AN.0.78 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
92127 - Additional Information
Phone attendance by a general practitioner in relation to a mental disorder and of at least 20 minutes in duration, involving taking relevant history and identifying the presenting problem (to the extent not previously recorded), providing treatment and advice and, if appropriate, referral for other services or treatments, and documenting the outcomes of the consultation.
Fee: $81.70 Benefit: 100% = $81.70
(See para AN.0.56, AN.0.78 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
92132 - Additional Information
Phone attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician), to review a GP mental health treatment plan which he or she, or an associated medical practitioner has prepared, or to review a psychiatrist assessment and management plan
Fee: $65.35 Benefit: 100% = $65.35
(See para AN.0.56, AN.0.78, AN.7.22 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
92133 - Additional Information
Phone attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician) in relation to a mental disorder and of at least 20 minutes in duration, involving taking relevant history and identifying the presenting problem (to the extent not previously recorded), providing treatment and advice and, if appropriate, referral for other services or treatments, and documenting the outcomes of the consultation
Fee: $65.35 Benefit: 100% = $65.35
(See para AN.0.56, AN.0.78, AN.7.22 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
92112 - Additional Information
Telehealth attendance, by a general practitioner who has not undertaken mental health skills training (and not including a specialist or consultant physician), of at least 20 minutes but less than 40 minutes in duration for the preparation of a GP mental health treatment plan for a patient.
Fee: $81.70 Benefit: 100% = $81.70
(See para AN.0.56, AN.0.78 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
92113 - Additional Information
Telehealth attendance, by a general practitioner who has not undertaken mental health skills training (and not including a specialist or consultant physician), of at least 40 minutes in duration for the preparation of a GP mental health treatment plan for a patient.
Fee: $120.25 Benefit: 100% = $120.25
(See para AN.0.56, AN.0.78 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
92114 - Additional Information
Telehealth attendance by a general practitioner to review a GP mental health treatment plan which the general practitioner, or an associated general practitioner has prepared, or to review a Psychiatrist Assessment and Management Plan.
Fee: $81.70 Benefit: 100% = $81.70
(See para AN.0.56, AN.0.78 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
92115 - Additional Information
Telehealth attendance by a general practitioner in relation to a mental disorder and of at least 20 minutes in duration, involving taking relevant history and identifying the presenting problem (to the extent not previously recorded), providing treatment and advice and, if appropriate, referral for other services or treatments, and documenting the outcomes of the consultation.
Fee: $81.70 Benefit: 100% = $81.70
(See para AN.0.56 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
92116 - Additional Information
Telehealth attendance, by a general practitioner who has undertaken mental health skills training, of at least 20 minutes but less than 40 minutes in duration for the preparation of a GP mental health treatment plan for a patient.
Fee: $103.70 Benefit: 100% = $103.70
(See para AN.0.56, AN.0.78 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
92117 - Additional Information
Telehealth attendance, by a general practitioner who has undertaken mental health skills training, of at least 40 minutes in duration for the preparation of a GP mental health treatment plan for a patient.
Fee: $152.80 Benefit: 100% = $152.80
(See para AN.0.56, AN.0.78 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
92118 - Additional Information
Telehealth attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician), who has not undertaken mental health skills training, of at least 20 minutes but less than 40 minutes in duration for the preparation of a GP mental health treatment plan for a patient
Fee: $65.35 Benefit: 100% = $65.35
(See para AN.0.56, AN.0.78, AN.7.22 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
92119 - Additional Information
Telehealth attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician), who has not undertaken mental health skills training, of at least 40 minutes in duration for the preparation of a GP mental health treatment plan for a patient
Fee: $96.20 Benefit: 100% = $96.20
(See para AN.0.56, AN.0.78, AN.7.22 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
92120 - Additional Information
Telehealth attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician), to review a GP mental health treatment plan which he or she, or an associated medical practitioner has prepared, or to review a psychiatrist assessment and management plan
Fee: $65.35 Benefit: 100% = $65.35
(See para AN.0.56, AN.0.78, AN.7.22 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
92121 - Additional Information
Telehealth attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician), in relation to a mental disorder and of at least 20 minutes in duration, involving taking relevant history and identifying the presenting problem (to the extent not previously recorded), providing treatment and advice and, if appropriate, referral for other services or treatments, and documenting the outcomes of the consultation
Fee: $65.35 Benefit: 100% = $65.35
(See para AN.0.56, AN.0.78, AN.7.22 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
92122 - Additional Information
Telehealth attendance by a medical practitioner, (not including a general practitioner, specialist or consultant physician), who has undertaken mental health skills training, of at least 20 minutes but less than 40 minutes in duration for the preparation of a GP mental health treatment plan for a patient
Fee: $82.95 Benefit: 100% = $82.95
(See para AN.0.56, AN.0.78, AN.7.22 of explanatory notes to this Category)
Category 1 - PROFESSIONAL ATTENDANCES
92123 - Additional Information
Telehealth attendance by a medical practitioner, (not including a general practitioner, specialist or consultant physician), who has undertaken mental health skills training, of at least 40 minutes in duration for the preparation of a GP mental health treatment plan for a patient
Fee: $122.25 Benefit: 100% = $122.25
(See para AN.0.56, AN.0.78, AN.7.22 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