Medicare Benefits Schedule - Note MN.8.4

Eligible allied health professionals

Items 81000, 81005, 81010, 93026 and 93029 can only be claimed for services provided by psychologists, social workers and mental health nurses who meet the following specific eligibility requirements, and are registered with Services Australia.

To be eligible to provide services using MBS items 81000, 93026 and 93029, a psychologist must hold general registration in the health profession of psychology under the applicable law in force in the state or territory in which the service is provided and be certified by the Australian Psychological Society as appropriately trained in non-directive pregnancy counselling.

To be eligible to provide services using MBS items 81005, 93026 and 93029, a social worker must be a 'Member' of the Australian Association of Social Workers (AASW), be certified by AASW either as meeting the standards for mental health set out in the document published by AASW titled ‘Practice Standards for Mental Health Social Workers 2014’ as in force on 25 September 2014 and certified by AASW as appropriately trained in non-directive pregnancy counselling.

To be eligible to provide services using MBS items 81010, 93026 and 93029, a mental health nurse must be a 'Credentialled Mental Health Nurse' as certified by the Australian College of Mental Health Nurses, and be appropriately trained in non-directive pregnancy counselling.

For this health service, a person is appropriately trained in non-directive pregnancy counselling if the person has undergone training based on the key criteria contained in the document published by the Department titled ‘Key criteria for non-directive pregnancy counselling training provided to GPs and allied health professionals in relation to the Medicare non-directive pregnancy support counselling items’, as in force on 1 November 2006.

Registering with Services Australia

Advice about registering with Services Australia to provide non-directive pregnancy support counselling services using items 81000 – 81010, 93026 and 93029 is available from Services Australia provider inquiry line on 132 150.

Further information

Additional information can be found on the Department of Health and Aged Care and Services Australia website by searching 'allied health'. 

Further information is also available for providers from the Services Australia provider inquiry line on 132 150.

Related Items: 81000 81005 81010 93026 93029

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Non directive pregnancy support counselling health service provided to a person, who is currently pregnant or who has been pregnant in the preceding 12 months by an eligible psychologist, eligible social worker or eligible mental health nurse as a phone attendance if:

(a)    the person is concerned about a current pregnancy or a pregnancy that occurred in the 12 months preceding the provision of the first service; and

(b)    the person is referred by a medical practitioner who is not a specialist or consultant physician; and

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

(d)    the eligible psychologist, eligible social worker or eligible mental health nurse does not have a direct pecuniary interest in a health service that has as its primary purpose the provision of services for pregnancy termination; and

(e)     the service is at least 30 minutes duration;

to a maximum of 3 services (including services to which items 81000, 81005, 81010 in the Allied Health Determination, item 4001 of the general medical services table and item 93026, 92136 and 92138 apply) for each pregnancy.

The service may be used to address any pregnancy related issues for which non directive counselling is appropriate

Fee: $80.50 Benefit: 85% = $68.45

(See para MN.8.1, MN.8.2, MN.8.3, MN.8.4 of explanatory notes to this Category)

Provision of a non-directive pregnancy support counselling service to a person who is currently pregnant or who has been pregnant in the preceding 12 months, by an eligible psychologist, where the patient is referred to the psychologist by a medical practitioner (including a general practitioner, but not a specialist or consultant physician), and lasting at least 30 minutes. The service may be used to address any pregnancy related issues for which non-directive counselling is appropriate.

This service may be provided by a psychologist who is registered with Medicare Australia as meeting the credentialling requirements for provision of this service.  It may not be provided by a psychologist who has a direct pecuniary interest in a health service that has as its primary purpose the provision of services for pregnancy termination.

To a maximum of three non-directive pregnancy support counselling services per patient, per pregnancy from any of the following items -81000, 81005, 81010 and 4001

Fee: $80.50 Benefit: 85% = $68.45

(See para MN.8.1, MN.8.2, MN.8.3, MN.8.4 of explanatory notes to this Category)

Provision of a non-directive pregnancy support counselling service to a person who is currently pregnant or who has been pregnant in the preceding 12 months, by an eligible social worker, where the patient is referred to the social worker by a medical practitioner (including a general practitioner, but not a specialist or consultant physician), and lasting at least 30 minutes. The service may be used to address any pregnancy related issues for which non-directive counselling is appropriate.

This service may be provided by a social worker who is registered with Medicare Australia as meeting the credentialling requirements for provision of this service.  It may not be provided by a social worker who has a direct pecuniary interest in a health service that has as its primary purpose the provision of services for pregnancy termination.

To a maximum of three non-directive pregnancy support counselling services per patient, per pregnancy from any of the following items -81000, 81005, 81010 and 4001

Fee: $80.50 Benefit: 85% = $68.45

(See para MN.8.1, MN.8.2, MN.8.3, MN.8.4 of explanatory notes to this Category)

Provision of a non-directive pregnancy support counselling service to a person who is currently pregnant or who has been pregnant in the preceding 12 months, by an eligible mental health nurse, where the patient is referred to the mental health nurse by a medical practitioner (including a general practitioner, but not a specialist or consultant physician), and lasting at least 30 minutes. The service may be used to address any pregnancy related issues for which non-directive counselling is appropriate.

This service may be provided by a mental health nurse who is registered with Medicare Australia as meeting the credentialling requirements for provision of this service.  It may not be provided by a mental health nurse who has a direct pecuniary interest in a health service that has as its primary purpose the provision of services for pregnancy termination.

To a maximum of three non-directive pregnancy support counselling services per patient, per pregnancy from any of the following items - 81000, 81005, 81010 and 4001

Fee: $80.50 Benefit: 85% = $68.45

(See para MN.8.1, MN.8.2, MN.8.3, MN.8.4 of explanatory notes to this Category)

Non directive pregnancy support counselling health service provided to a person who is currently pregnant or who has been pregnant in the preceding 12 months by an eligible psychologist, eligible social worker or eligible mental health nurse as a telehealth attendance if:

(a) the person is concerned about a current pregnancy or a pregnancy that occurred in the 12 months preceding the provision of the first service; and

(b) the person is referred by a medical practitioner who is not a specialist or consultant physician; and

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

(d) the eligible psychologist, eligible social worker or eligible mental health nurse does not have a direct pecuniary interest in a health service that has as its primary purpose the provision of services for pregnancy termination; and

(e) the service is at least 30 minutes duration;

to a maximum of 3 services (including services to which items 81000, 81005, 81010 in the Allied Health Determination, item 4001 of the general medical services table and item 93029, 92136 and 92138 apply) for each pregnancy.

The service may be used to address any pregnancy related issues for which non directive counselling is appropriate

Fee: $80.50 Benefit: 85% = $68.45

(See para MN.8.1, MN.8.2, MN.8.3, MN.8.4 of explanatory notes to this Category)