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Determinations/Health as amended, taking into account amendments up to Health Insurance Legislation Amendment (Section 3C General Medical Services – Cease GP Mental Health Treatment Plan Phone Services) Determination 2021
Administered by: Health
Registered 02 Sep 2021
Start Date 07 Aug 2021
To be ceased 30 Jun 2022
Ceased by Self Ceasing
Table of contents.

Commonwealth Coat of Arms of Australia

Health Insurance (Section 3C General Medical – Expansion of GP and Allied Health Mental Health Services) Determination 2020

made under subsection 3C(1) of the

Health Insurance Act 1973

Compilation No. 9

Compilation date:                              7 August 2021

Includes amendments up to:            F2021L01079

Registered:                                         2 September 2021

About this compilation

This compilation

This is a compilation of the Health Insurance (Section 3C General Medical – Expansion of GP and Allied Health Mental Health Services) Determination 2020 that shows the text of the law as amended and in force on 7 August 2021 (the compilation date).

The notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of provisions of the compiled law.

Uncommenced amendments

The effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the Legislation Register (www.legislation.gov.au). The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. For more information on any uncommenced amendments, see the series page on the Legislation Register for the compiled law.

Application, saving and transitional provisions for provisions and amendments

If the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.

Editorial changes

For more information about any editorial changes made in this compilation, see the endnotes.

Modifications

If the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. For more information on any modifications, see the series page on the Legislation Register for the compiled law.

Self‑repealing provisions

If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.

  

  

  


Contents

1............ Name............................................................................................................................. 1

3............ Authority....................................................................................................................... 1

4............ Cessation....................................................................................................................... 1

5............ Definitions..................................................................................................................... 1

6............ Treatment of relevant services....................................................................................... 3

7............ Application of items in this instrument.......................................................................... 3

8............ Applications of items in Group A41............................................................................. 4

9............ Effect of election to claim private health insurance for an allied health service.............. 4

10.......... Application of items in Group A42............................................................................... 4

11.......... Fee in relation to the first patient during each attendance at a residential aged care facility       5

Schedule 1—Services and fees—face‑to‑face psychological therapy and focussed psychological strategies                                                             7

Schedule 2—Services and fees—telehealth and phone psychological therapy and focussed psychological strategies                                               19

Schedule 3—Services and fees—initial psychological therapy and focussed psychological strategies                                                                                    30

Schedule 4—Services and fees—initial focussed psychological strategies                                                                                                                                                   35

Endnote 1—About the endnotes                                                                                                      38

Endnote 2—Abbreviation key                                                                                                          39

Endnote 3—Legislation history                                                                                                       40

Endnote 4—Amendment history                                                                                                     42


1  Name

       This instrument is the Health Insurance (Section 3C General Medical – Expansion of GP and Allied Health Mental Health Services) Determination 2020.

3  Authority

This instrument is made under subsection 3C(1) of the Health Insurance Act 1973.

4  Cessation

Unless earlier revoked:

(a)  Schedule 2 of this instrument ceases as if revoked on 31 December 2021.

(b) this instrument ceases as if revoked on 30 June 2022.

5  Definitions

             (1)  In this Determination:

Act means the Health Insurance Act 1973.

admitted patient means a patient who is receiving a service that is provided:

(a)  as part of an episode of hospital treatment; or

(b)  as part of an episode of hospital‑substitute treatment in respect of which the person to whom the treatment is provided chooses to receive a benefit from a private health insurer.

Allied Health Services Determination means the Health Insurance (Allied Health Services) Determination 2014.

better access subsequent treatment service means a service to which an item in Schedule 1 or 2 (excluding Group A42) of this instrument applies.

care recipient has the meaning given by the general medical services table.

course of treatment, for items 93375, 93376, 93381, 93382, 93383, 93384, 93385 and 93386, has the meaning giving by paragraph 4(1)(a) of the definition in the Allied Health Services Determination.

COVID‑19 Determination means the Health Insurance (Section 3C General Medical Services ‑ COVID‑19 Telehealth and Telephone Attendances) Determination 2020.

eligible clinical psychologist has the meaning given by section 4 of the Allied Health Services Determination.

eligible occupational therapist has the meaning given by section 4 of the Allied Health Services Determination.

eligible psychologist has the meaning given by section 4 of the Allied Health Services Determination.

focussed psychological strategies means any of the following mental health care management strategies, each of which has been derived from evidence‑based psychological therapies:

(a)   psycho‑education;

(b)   cognitive‑behavioural therapy which involves cognitive or behavioural interventions;

(c)   relaxation strategies;

(d)   skills training;

(e)   interpersonal therapy;

(f)   eye movement desensitisation and reprocessing;

(g)   narrative therapy (for Aboriginal and Torres Strait Islander people).

GP mental health treatment plan means a service to which any of the following applies:

(a) items 2700, 2701, 2715 or 2717 of the general medical services table;

(b) items 272, 276, 281 or 282 of the Other Medical Practitioner Determination;

(c) items 92112, 92113, 92116, 92117, 92118, 92119, 92122, 92123, 92124, 92125, 92128, 92129, 92130, 92131, 92134 or 92135 of the COVID 19 Determination;

(d) items 93400 to 93407 and 93431 to 93438 of this Determination.

Other Medical Practitioner Determination means the Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Determination 2018.

mental disorder means a significant impairment of any or all of an individual’s cognitive, affective and relational abilities that:

(a)   may require medical intervention; and

(b)   may be a recognised, medically diagnosable illness or disorder; and

(c)   is not dementia, delirium, tobacco use disorder or mental retardation.

person who is experiencing homelessness has the meaning given by section 5 of the COVID‑19 Determination.

person who is in a COVID‑19 impacted area has the meaning given by section 5 of the COVID‑19 Determination.

preparation of a GP mental health treatment plan has the meaning given by the general medical services table.

phone attendance means a professional attendance by telephone where the health practitioner:

(a)   has the capacity to provide the full service through this means safely and in accordance with professional standards; and

(b)   is satisfied that it is clinically appropriate to provide the service to the patient; and

(c)   maintains an audio link with the patient.

psychiatrist assessment and management plan means a psychiatrist assessment and management plan made under item 92435 or 92475 in this instrument or item 291 of the general medical services table.

relevant provisions means all provisions, relating to professional services or to medical services, of the Act and regulations made under the Act, and the National Health Act 1953 and regulations under that Act.

shared care plan has the meaning given by section 9B of the Allied Health Services Determination.

telehealth attendance means a professional attendance by video conference where the rendering health practitioner:

(a)   has the capacity to provide the full service through this means safely and in accordance with relevant professional standards; and

(b)   is satisfied that it is clinically appropriate to provide the service to the patient; and

(c)   maintains a visual and audio link with the patient; and

(d)   is satisfied that the software and hardware used to deliver the service meets the applicable laws for security and privacy.

Note: The following terms are defined in subsection 3(1) of the Act:

·      general medical services table

·      item

·      medical practitioner

·      Chief Executive Medicare

·      professional service

6  Treatment of relevant services

For subsection 3C(1) of the Act, a relevant health service, provided in accordance with this instrument and as a clinically relevant health service, is to be treated, for the relevant provisions, as if:

(a)          it were both a professional service and a medical service; and

(b)          there were an item in the general medical services table that:

(i)          related to the health service; and

(ii)          specified in respect of the health service a fee in relation to each State, being the fee specified in the Schedule in relation to the service.

7  Application of items in this instrument

An item in Group A41, M25 or M26 of this instrument does not apply if a person has received 10 better access subsequent treatment services for that calendar year.

8  Applications of items in Group A41

(2)  Items 93300 to 93311 and 93287, 93288, 93291 and 93292 apply to a service which is provided by a medical practitioner:

(a)   whose name is entered in the register maintained by the Chief Executive Medicare under section 33 of the Human Services (Medicare) Regulations 2017; and

(b)   who is identified in the register as a medical practitioner who can provide services to which Subgroup 2 of Group A20 of the general medical services table applies or items 283, 285, 286, 287, 371 and 372 of the Other Medical Practitioner Determination applies; and

(c)   who meets any training and skills requirements, as determined by the General Practice Mental Health Standards Collaboration for providing services to which Subgroup 2 of Group A20 of the general medical services table applies or items 283, 285, 286, 287, 371 and 372 of the Other Medical Practitioner Determination applies.

(3) Items 93302, 93305, 93308, 93311, 93332, 93335, 93352, 93355,  93358, 93361, 93364 or 93367 do not apply to a service if:

(a)   the patient elects to be treated in person, and it is safe and appropriate for the service to be performed in person at consulting rooms; or

(b)   the rendering health provider and the patient have the capacity to undertake an attendance by telehealth.

9  Effect of election to claim private health insurance for an allied health service

An item in Group M25, M26, M27 and M28 in a Schedule to this instrument do not apply to a service if a private health insurance benefit has been claimed for the service.

10  Application of items in Group A42

General application of items

(1)  Items 93400, 93401, 93402, 93403, 93421, 93431, 93432, 93433, 93434 and 93451 apply only in the course of personal attendance by a single medical practitioner on a single patient.

(2)  Items in Subgroup 1, 2, 3 and 4 of Group A42 apply only to a patient with a mental disorder.

Claiming restrictions for treatment plan and review items

(3)  Items 93400 to 93407 and 93431 to 93439 do not apply to a service to which items 80020, 80021, 80120, 80121, 80145, 80146, 80170 and 80171 of the Allied Health Services Determination apply.

Practitioner training

(4)  Items 93402, 93403, 93406, 93407, 93433, 93434, 93437 and 93438 apply only if the medical practitioner providing the service has successfully completed mental health skills training accredited by the General Practice Mental Health Standards Collaboration.

Note:      The General Practice Mental Health Standards Collaboration operates under the auspices of the Royal Australian College of General Practitioners.

Definition

(5)  In review items 93421, 93422 and 93423:

associated general practitioner means a general practitioner (not including a specialist or consultant physician) who, if not engaged in the same general practice as the general practitioner mentioned in that item, performs the service described in the item at the request of the patient (or the patient’s guardian).

 

(6)  In review items 93451, 93452 and 93453:

associated medical practitioner means a medical practitioner who, if not engaged in the same general practice as the medical practitioner mentioned in the item, performs the service mentioned in the item at the request of the patient (or the patient or the patient’s guardian).

11  Fee in relation to the first patient during each attendance at a residential aged care facility

(1)  For the first patient attended during one attendance by a general practitioner at one residential aged care facility on one occasion, the fee for the medical service described in whichever of items 2733, 2735, 93400, 93401, 93402, 93403, 93421, 93287 and 93288 applies is the amount listed in the item plus $67.35.

(2)  For the first patient attended during one attendance by a medical practitioner at one residential aged care facility on one occasion, the fee for the medical service described in whichever of items 941, 942, 93431, 93432, 93433, 93434, 93451, 93291 and 93292 applies is the amount listed in the item plus $48.90.


Schedule 1Services and fees—face‑to‑face psychological therapy and focussed psychological strategies

 

 

Group A41 – Additional focussed psychological strategies

 

Item

Service

Fee($)

Subgroup 1—GP additional focussed psychological strategies

93300

Professional attendance at consulting rooms by a general practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if:

(b) the service is clinically indicated under a GP mental health treatment plan or a psychiatrist assessment and management plan; and

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

113.50

93303

Professional attendance at consulting rooms by a general practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if:

(b) the service is clinically indicated under a GP mental health treatment plan or a psychiatrist assessment and management plan; and

(c)  the service lasts at least 40 minutes

162.45

93287

Professional attendance by a general practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if:

(a) the person is a care recipient in a residential aged care facility (but not as an admitted patient of a hospital); and

(b) the service is clinically indicated under a GP mental health treatment plan or a psychiatrist assessment and management plan; and

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

113.50

93288

 

Professional attendance by a general practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if:

(a) the person is a care recipient in a residential aged care facility (but not as an admitted patient of a hospital); and

(b) the service is clinically indicated under a GP mental health treatment plan or a psychiatrist assessment and management plan; and

(c)  the service lasts at least 40 minutes

162.45

Subgroup 2—Non specialist practitioner additional focussed psychological strategies

93306

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

(b) the service is clinically indicated under a GP mental health treatment plan or a psychiatrist assessment and management plan; and

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

90.80

93309

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

(b) the service is clinically indicated under a GP mental health treatment plan or a psychiatrist assessment and management plan; and

(c)  the service lasts at least 40 minutes

130.00

93291

 

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

(a) the person is a care recipient in a residential aged care facility (but not as an admitted patient of a hospital); and

(b) the service is clinically indicated under a GP mental health treatment plan or a psychiatrist assessment and management plan; and

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

90.80

93292

 

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

(a) the person is a care recipient in a residential aged care facility (but not as an admitted patient of a hospital); and

(b) the service is clinically indicated under a GP mental health treatment plan or a psychiatrist assessment and management plan; and

(c)  the service lasts at least 40 minutes

130.00

 

Group A42 – Mental health planning for care recipients of an residential aged care facility

Item

Service

Fee($)

Subgroup 1—GP mental health treatment plans for care recipients of an residential aged care facility

93400

Professional attendance by a general practitioner who has not undertaken mental health skills training, for the preparation of a GP mental health treatment plan for a patient (but not as an admitted patient of a hospital) if:

(a) the person is a care recipient in a residential aged care facility; and

(b) the service lasts at least 20 minutes, but less than 40 minutes

87.75

93401

Professional attendance by a general practitioner who has not undertaken mental health skills training, for the preparation of a GP mental health treatment plan for a patient (but not as an admitted patient of a hospital) if:

(a) the person is a care recipient in a residential aged care facility; and

(b) the service lasts at least 40 minutes

129.20

93402

Professional attendance, by a general practitioner who has undertaken mental health skills training, for the preparation of a GP mental health treatment plan for a patient (but not as an admitted patient of a hospital) if:

(a) the person is a care recipient in a residential aged care facility; and

(b) the service lasts at least 20 minutes, but less than 40 minutes

111.45

93403

Professional attendance, by a general practitioner who has undertaken mental health skills training, for the preparation of a GP mental health treatment plan for a patient (but not as an admitted patient of a hospital) if:

(a) the person is a care recipient in a residential aged care facility; and

(b) the service lasts at least 40 minutes

164.15

Subgroup 2—GP mental health treatment plan review for care recipients of an residential aged care facility

93421

Professional attendance by a general practitioner to review a GP mental health treatment plan which the general practitioner, or an associated medical practitioner has prepared, or to review a psychiatrist assessment and management plan (but not as an admitted patient of a hospital) if:

(a)  the person is a care recipient in a residential aged care facility; and

(b)  one of the following services has been provided to the patient:

(i)  a mental health treatment plan under items 93400 to 93411 or 93431 to 93442; or 

(ii) a psychiatrist assessment and management plan; and

(c)  the reviewing practitioner modifies the person’s GP mental health treatment plan or psychiatrist assessment and management plan to record that they recommend the person have an additional number of better access treatment services

87.75

Subgroup 3—Non specialist practitioner mental health treatment plans for care recipients of an residential aged care facility

93431

Professional attendance by a medical practitioner who has not undertaken mental health skills training (not including a general practitioner, specialist or a consultant physician), for the preparation of a GP mental health treatment plan for a patient (but not as an admitted patient of a hospital) if:

(a) the person is a care recipient in a residential aged care facility; and

(b)  the service lasts at least 20 minutes, but less than 40 minutes

70.25

93432

Professional attendance by a medical practitioner who has not undertaken mental health skills training (not including a general practitioner, specialist or a consultant physician), for the preparation of a GP mental health treatment plan for a patient (but not as an admitted patient of a hospital) if:

(a) the person is a care recipient in a residential aged care facility; and

(b)  the service lasts at least 40 minutes

103.40

93433

Professional attendance, by a medical practitioner who has undertaken mental health skills training (but not including a general practitioner, specialist or consultant physician), for the preparation of a GP mental health treatment plan for a patient (but not as an admitted patient of a hospital) if:

(a) the person is a care recipient in a residential aged care facility; and

(b) the service lasts at least 20 minutes, but less than 40 minutes

89.20

93434

Professional attendance, by a medical practitioner who has undertaken mental health skills training, for the preparation of a GP mental health treatment plan for a patient (but not as an admitted patient of a hospital) if:

(a) the person is a care recipient in a residential aged care facility; and

(b) the service lasts at least 40 minutes

131.35

Subgroup 4— Non specialist practitioner mental health treatment plan review for care recipients of an residential aged care facility

93451

Professional attendance by a medical practitioner to review a GP mental health treatment plan which the medical practitioner, or an associated medical practitioner has prepared, or to review a Psychiatrist Assessment and Management Plan (but not as an admitted patient of a hospital) if:

(a) the person is a care recipient in a residential aged care facility; and

(b) one of the following services has been provided to the patient:

(i) a mental health treatment plan under items 93400 to 93411 or 93431 to 93442; or

(ii) a psychiatrist assessment and management plan; and

(c) the reviewing practitioner modifies the person’s GP mental health treatment plan or psychiatrist assessment and management plan to record that they recommend the person have an additional number of better access treatment services

70.20

 

Group M25 – Additional psychological therapy services

Item

Service

Fee($)

93330

Psychological therapy health service provided to a person in consulting rooms (but not as an admitted patient of a hospital), by an eligible clinical psychologist if:

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who makes a written record of the need for additional mental health treatment services; and

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

(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e) 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

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

103.80

93333

Psychological therapy health service provided to a person in consulting rooms (but not as an admitted patient of a hospital), by an eligible clinical psychologist if:

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who makes a written record of the need for additional mental health treatment services; and

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

(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e) 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

(f)  the service is at least 50 minutes duration

152.40

93312

Psychological therapy health service provided to a person (but not as an admitted patient of a hospital), by an eligible clinical psychologist if:

(a) the person is a care recipient in a residential aged care facility; and

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who makes a written record of the need for additional mental health treatment services; and

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

(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e) 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

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

103.80

93313

Psychological therapy health service provided to a person (but not as an admitted patient of a hospital), by an eligible clinical psychologist if:

(a) the person is a care recipient in a residential aged care facility; and

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who makes a written record of the need for additional mental health treatment services; and

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

(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e) 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

(f)  the service is at least 50 minutes duration

152.40

 

Group M26 – Additional focussed psychological strategies (allied mental health)

 

Item

Service

Fee($)

Subgroup 1— Additional focussed psychological strategies (eligible psychologist, attendance 20 to 50 minutes)

93350

Focussed psychological strategies health service provided to a person in consulting rooms (but not as an admitted patient of a hospital) by an eligible psychologist if:

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who makes a written record of the need for additional mental health treatment services; and

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

(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e) 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

(f)  the service is at least 20 minutes but less than 50 minutes duration

73.55

93316

Focussed psychological strategies health service provided to a person (but not as an admitted patient of a hospital) by an eligible psychologist if:

(a) the person is a care recipient in a residential aged care facility; and

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who makes a written record of the need for additional mental health treatment services; and

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

(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e) 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

(f)  the service is at least 20 minutes but less than 50 minutes duration

73.55

Subgroup 2— Additional focussed psychological strategies (eligible psychologist, attendance at least 50 minutes)

93353

Focussed psychological strategies health service provided to a person in consulting rooms (but not as an admitted patient of a hospital), by an eligible psychologist if:

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who makes a written record of the need for additional mental health treatment services; and

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

(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e) 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

(f)  the service is at least 50 minutes duration

103.80

93319

Focussed psychological strategies health service provided to a person (but not as an admitted patient of a hospital), by an eligible psychologist if:

(a) the person is a care recipient in a residential aged care facility; and

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who makes a written record of the need for additional mental health treatment services; and

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

(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e) 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

(f)  the service is at least 50 minutes duration

103.80

Subgroup 3— Additional focussed psychological strategies (eligible occupational therapist)

93356

Focussed psychological strategies health service provided to a person in consulting rooms (but not as an admitted patient of a hospital) by an eligible occupational therapist if:

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who makes a written record of the need for additional mental health treatment services; and

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

(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e) 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

(f)  the service is at least 20 minutes but less than 50 minutes duration

64.80

93359

Focussed psychological strategies health service provided to a person in consulting rooms (but not as an admitted patient of a hospital) by an eligible occupational therapist if:

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who makes a written record of the need for additional mental health treatment services; and

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

(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e) 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

(f)  the service is at least 50 minutes duration

91.50

93322

Focussed psychological strategies health service provided to a person (but not as an admitted patient of a hospital) by an eligible occupational therapist if:

(a) the person is a care recipient in a residential aged care facility; and

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who makes a written record of the need for additional mental health treatment services; and

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

(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e) 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

(f)  the service is at least 20 minutes but less than 50 minutes duration

64.80

93323

Focussed psychological strategies health service provided to a person (but not as an admitted patient of a hospital) by an eligible occupational therapist if:

(a) the person is a care recipient in a residential aged care facility; and

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who makes a written record of the need for additional mental health treatment services; and

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

(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e) 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

(f)  the service is at least 50 minutes duration

91.50

Subgroup 4— Additional focussed psychological strategies (eligible social worker)

93362

Focussed psychological strategies health service provided to a person in consulting rooms (but not as an admitted patient of a hospital) by an eligible social worker if:

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who makes a written record of the need for additional mental health treatment services; and

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

(d)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e)  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

(f)  the service is at least 20 minutes but less than 50 minutes duration

64.80

93365

Focussed psychological strategies health service provided to a person in consulting rooms (but not as an admitted patient of a hospital) by an eligible social worker if:

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who makes a written record of the need for additional mental health treatment services; and

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

(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e) 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

(f)  the service is at least 50 minutes duration

91.50

93326

Focussed psychological strategies health service provided to a person (but not as an admitted patient of a hospital) by an eligible social worker if:

(a) the person is a care recipient in a residential aged care facility; and

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who makes a written record of the need for additional mental health treatment services; and

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

(d)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e)  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

(f)  the service is at least 20 minutes but less than 50 minutes duration

64.80

93327

Focussed psychological strategies health service provided to a person (but not as an admitted patient of a hospital) by an eligible social worker if:

(a) the person is a care recipient in a residential aged care facility; and

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who makes a written record of the need for additional mental health treatment services; and

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

(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e) 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

(f)  the service is at least 50 minutes duration

91.50

 

Schedule 2Services and fees—telehealth and phone psychological therapy and focussed psychological strategies

 

 

Group A41 – Additional focussed psychological strategies

 

Item

Service

Fee

 

Subgroup 1—GP additional focussed psychological strategies

 

93301

Telehealth attendance by a general practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if:

(b) the service is clinically indicated under a GP mental health treatment plan or a psychiatrist assessment and management plan; and

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

113.50

 

93302

Phone attendance by a general practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if:

(b) the service is clinically indicated under a GP mental health treatment plan or a psychiatrist assessment and management plan; and

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

113.50

 

93304

Telehealth attendance by a general practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if:

(b) the service is clinically indicated under a GP mental health treatment plan or a psychiatrist assessment and management plan; and

(c)  the service lasts at least 40 minutes

162.45

 

93305

Phone attendance by a general practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if:

(b) the service is clinically indicated under a GP mental health treatment plan or a psychiatrist assessment and management plan; and

(c)  the service lasts at least 40 minutes

162.45

 

Subgroup 2—Non specialist practitioner additional focussed psychological strategies

 

93307

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

(b) the service is clinically indicated under a GP mental health treatment plan or a psychiatrist assessment and management plan; and

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

90.80

 

93308

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

(b) the service is clinically indicated under a GP mental health treatment plan or a psychiatrist assessment and management plan; and

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

90.80

 

93310

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

(b) the service is clinically indicated under a GP mental health treatment plan or a psychiatrist assessment and management plan; and

(c)  the service lasts at least 40 minutes

130.00

 

93311

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

(b) the service is clinically indicated under a GP mental health treatment plan or a psychiatrist assessment and management plan; and

(c)  the service lasts at least 40 minutes

130.00

 

 

Group A42 – Mental health planning for care recipients of an residential aged care facility

Item

Service

Fee($)

Subgroup 1— GP mental health treatment plans for care recipients of an residential aged care facility

93404

Telehealth attendance by a general practitioner who has not undertaken mental health skills training, for the preparation of a GP mental health treatment plan for a patient (but not as an admitted patient of a hospital) if:

(a) the person is a care recipient in a residential aged care facility; and

(b) the service lasts at least 20 minutes but less than 40 minutes

87.75

93405

Telehealth attendance by a general practitioner who has not undertaken mental health skills training, for the preparation of a GP mental health treatment plan for a patient (but not as an admitted patient of a hospital) if:

(a) the person is a care recipient in a residential aged care facility; and

(b) the service lasts at least 40 minutes

129.20

93406

 

Telehealth attendance by a general practitioner who has undertaken mental health skills training, for the preparation of a GP mental health treatment plan for a patient (but not as an admitted patient of a hospital) if:

(a) the person is a care recipient in a residential aged care facility; and

(b) the service lasts at least 20 minutes but less than 40 minutes

111.45

93407

Telehealth attendance by a general practitioner who has undertaken mental health skills training, for the preparation of a GP mental health treatment plan for a patient (but not as an admitted patient of a hospital) if:

(a) the person is a care recipient in a residential aged care facility; and

(b) the service lasts at least 40 minutes

164.15

Subgroup 2— GP mental health treatment plan review for care recipients of an residential aged care facility

93422

 

Telehealth attendance by a general practitioner to review a GP mental health treatment plan which the general practitioner, or an associated medical practitioner has prepared, or to review a psychiatrist assessment and management plan (but not as an admitted patient of a hospital) if:

(a)   the person is a care recipient in a residential aged care facility; and

(b)   one of the following services has been provided to the patient:

(i)    a mental health treatment plan under items 93400 to 93411 or 93431 to 93442; or

(ii)   a psychiatrist assessment and management plan; and

(c)   the reviewing practitioner modifies the person’s GP mental health treatment plan or psychiatrist assessment and management plan to record that they recommend the person have an additional number of better access treatment services

87.75

93423

 

Phone attendance by a general practitioner to review a GP mental health treatment plan which the general practitioner, or an associated medical practitioner has prepared, or to review a psychiatrist assessment and management plan (but not as an admitted patient of a hospital) if:

(a)   the person is a care recipient in a residential aged care facility; and

(b)  one of the following services has been provided to the patient:

(i)    a mental health treatment plan under items 93400 to 93411 or 93431 to 93442; or

(ii)   a psychiatrist assessment and management plan; and

(c)   the reviewing practitioner modifies the person’s GP mental health treatment plan or psychiatrist assessment and management plan to record that they recommend the person have an additional number of better access treatment services

87.75

Subgroup 3— Non specialist practitioner mental health treatment plans for care recipients of an residential aged care facility

93435

Telehealth attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician), who has not undertaken mental health skills training, for the preparation of a GP mental health treatment plan for a patient (but not as an admitted patient of a hospital) if:

(a) the person is a care recipient in a residential aged care facility; and

(b) the service lasts at least 20 minutes but less than 40 minutes

70.20

 

93436

Telehealth attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician), who has not undertaken mental health skills training, for the preparation of a GP mental health treatment plan for a patient (but not as an admitted patient of a hospital) if:

(a) the person is a care recipient in a residential aged care facility; and

(b) the service lasts at least 40 minutes

103.40

 

93437

Telehealth attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician), who has undertaken mental health skills training, for the preparation of a GP mental health treatment plan for a patient (but not as an admitted patient of a hospital) if:

(a) the person is a care recipient in a residential aged care facility; and

(b) the service lasts at least 20 minutes but less than 40 minutes

89.15

 

93438

Telehealth attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician), who has undertaken mental health skills training, for the preparation of a GP mental health treatment plan for a patient (but not as an admitted patient of a hospital) if:

(a) the person is a care recipient in a residential aged care facility; and

(b) the service lasts at least 40 minutes

131.30

 

Subgroup 4— Non specialist practitioner mental health treatment plan review for care recipients of an residential aged care facility

 

93452

 

Telehealth attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician) to review a GP mental health treatment plan which the medical practitioner, or an associated medical practitioner has prepared, or to review a psychiatrist assessment and management plan (but not as an admitted patient of a hospital) if:

(a) the person is a care recipient in a residential aged care facility; and

(b) one of the following services has been provided to the patient:

(i) a mental health treatment plan under items 93400 to 93411 or 93431 to 93442; or

(ii) a psychiatrist assessment and management plan; and

(c)   the reviewing practitioner modifies the person’s GP mental health treatment plan or psychiatrist assessment and management plan to record that they recommend the person have an additional number of better access treatment services

70.20

 

93453

 

Phone attendance by a medical practitioner (not including a general practitioner, specialist or consultant physician) to review a GP mental health treatment plan which the medical practitioner, or an associated medical practitioner has prepared, or to review a psychiatrist assessment and management plan (but not as an admitted patient of a hospital) if:

(a) the person is a care recipient in a residential aged care facility; and

(b) one of the following services has been provided to the patient:

(i) a mental health treatment plan under items 93400 to 93411 or 93431 to 93442; or

(ii) a psychiatrist assessment and management plan; and

(c)   the reviewing practitioner modifies the person’s GP mental health treatment plan or psychiatrist assessment and management plan to record that they recommend the person have an additional number of better access treatment services

70.20

 

Group M25 – Additional psychological therapy services

 

Item

Service

Fee($)

 

93331

Psychological therapy health service provided by telehealth attendance by an eligible clinical psychologist if:

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who makes a written record of the need for additional mental health treatment services; and

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

(d)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e)  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

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

103.80

 

93332

Psychological therapy health service provided by phone attendance by an eligible clinical psychologist if:

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who makes a written record of the need for additional mental health treatment services; and

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

(d)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e)  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

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

103.80

 

93334

Psychological therapy health service provided by telehealth attendance by an eligible clinical psychologist if:

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who makes a written record of the need for additional mental health treatment services; and

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

(d)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e)  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

(f)  the service is at least 50 minutes duration

152.40

 

93335

Psychological therapy health service provided by phone attendance by an eligible clinical psychologist if:

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who makes a written record of the need for additional mental health treatment services; and

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

(d)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e)  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

(f)  the service is at least 50 minutes duration

152.40

 

 

 

Group M26 – Additional focussed psychological strategies (allied mental health)

 

Item

Service

Fee($)

 

Subgroup 1— Additional focussed psychological strategies (eligible psychologist, attendance 20 to 50 minutes)

 

93351

Focussed psychological strategies health service provided by telehealth attendance by an eligible psychologist if:

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who makes a written record of the need for additional mental health treatment services; and

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

(d)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e)  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

(f)  the service is at least 20 minutes but less than 50 minutes duration

73.55

 

93352

Focussed psychological strategies health service provided by phone attendance by an eligible psychologist if:

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who makes a written record of the need for additional mental health treatment services; and

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

(d)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e)  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

(f)  the service is at least 20 minutes but less than 50 minutes duration

73.55

 

Subgroup 2— Additional focussed psychological strategies (eligible psychologist, attendance at least 50 minutes)

 

93354

Focussed psychological strategies health service provided by telehealth attendance by an eligible psychologist if:

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who makes a written record of the need for additional mental health treatment services; and

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

(d)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e)  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

(f)  the service is at least 50 minutes duration

103.80

 

93355

Focussed psychological strategies health service provided by phone attendance by an eligible psychologist if:

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who makes a written record of the need for additional mental health treatment services; and

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

(d)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e)  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

(f)  the service is at least 50 minutes duration

103.80

 

Subgroup 3— Additional focussed psychological strategies (eligible occupational therapist)

 

93357

Focussed psychological strategies health service provided by telehealth attendance by an eligible occupational therapist if:

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who makes a written record of the need for additional mental health treatment services; and

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

(d)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e)  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

(f)  the service is at least 20 minutes but less than 50 minutes duration

64.80

 

93358

Focussed psychological strategies health service provided by phone attendance by an eligible occupational therapist if:

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who makes a written record of the need for additional mental health treatment services; and

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

(d)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e)  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

(f)  the service is at least 20 minutes but less than 50 minutes duration

64.80

 

93360

Focussed psychological strategies health service provided by telehealth attendance by an eligible occupational therapist if:

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who makes a written record of the need for additional mental health treatment services; and

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

(d)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e)  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

(f)  the service is at least 50 minutes in duration

91.50

 

93361

Focussed psychological strategies health service provided by phone attendance by an eligible occupational therapist if:

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who makes a written record of the need for additional mental health treatment services; and

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

(d)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e)  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

(f)  the service is at least 50 minutes in duration

91.50

 

Subgroup 4— Additional focussed psychological strategies (eligible social worker)

 

93363

Focussed psychological strategies health service provided by telehealth attendance by an eligible social worker if:

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who makes a written record of the need for additional mental health treatment services; and

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

(d)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e)  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

(f)  the service is at least 20 minutes but less than 50 minutes duration

64.80

 

93364

Focussed psychological strategies health service provided by phone attendance by an eligible social worker if:

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who makes a written record of the need for additional mental health treatment services; and

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

(d)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e)  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

(f)  the service is at least 20 minutes but less than 50 minutes duration

64.80

 

93366

Focussed psychological strategies health service provided by telehealth attendance by an eligible social worker if:

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who makes a written record of the need for additional mental health treatment services; and

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

(d)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e)  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

(f)  the service is at least 50 minutes duration

91.50

 

93367

Focussed psychological strategies health service provided by phone attendance by an eligible social worker if:

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who makes a written record of the need for additional mental health treatment services; and

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

(d)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e)  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

(f)  the service is at least 50 minutes duration

91.50

 

 

 

Schedule 3Services and fees—initial psychological therapy and focussed psychological strategies

1  Limitation on certain individual items

             (1)  This section applies to items 93375, 93376, 93381, 93382, 93383, 93384, 93385 and 93386.

             (2)  For any particular patient, an item mentioned in subsection (1) applies in a calendar year only if the service described in the item is one of the first 10 relevant services provided to the patient in the calendar year.

             (3)  In this section relevant service means a service to which any of items 2721 to 2727 of the general medical services table, or items 80000 to 80015, 80100 to 80115, 80125 to 80140, or 80150 to 80165 in the allied health services determination, or items 91166, 91167, 91169, 91170, 91172, 91173, 91175, 91176, 91181, 91182, 91183, 91184, 91185, 91186, 91187, 91188, 91818, 91819, 91820, 91821, 91842, 91843, 91844 and 91845 of the COVID‑19 Determination, or items 283 and 286 in the Other Medical Practitioner Determination apply.

2   Referrals by psychiatrists for psychological therapy and focussed psychological  strategies health services

             (1)  This section applies to items 93375, 93376, 93381, 93382, 93383, 93384, 93385 and 93386.

             (2)  The referral by a consultant physician specialising in the practice of his or her field of psychiatry must be a referral for a service to which any of items 293 to 370 of the general medical services table or items 91827, 91828, 91829, 91830, 91831, 91837, 91838, 91839, 91840, 91841, 92436, 92437, 92458, 92459, 92460, 92476, 92477, 92498, 92499 and 92500 of the COVID‑19 Determination applies.

             (3)   The referral by a specialist in the practice of his or her field of psychiatry or paediatrics must be a referral for a service to which any of items 104 to 109 of the general medical services table or items 91822, 91823, 91832 or 91833 of the COVID‑19 Determination applies.

3  Fee in relation to the first patient during each attendance at a residential aged care facility

For the first patient attended during one attendance by an allied health professional at one residential aged care facility on one occasion, the fee for the medical service described in whichever of items 93312, 93313, 93316, 93319, 93322, 93323, 93326, 93327, 93375, 93376, 93381 to 93386 applies is the amount listed in the item plus $47.45.

 

Group M27 – Initial  Psychological Therapy Services

Item

Service

Fee($)

93375

Psychological therapy health service provided to a person (but not as an admitted patient of a hospital), by an eligible clinical psychologist if:

(a) the person is a care recipient in a residential aged care facility; and

(b)  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; and

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

(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e) 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

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

103.80

93376

 

Psychological therapy health service provided to a person (but not as an admitted patient of a hospital), by an eligible clinical psychologist if:

(a) the person is a care recipient in a residential aged care facility; and

(b)  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; and

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

(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e) 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

(f)  the service is at least 50 minutes duration

152.40

Group M28 – Initial  Focussed Psychological Strategies (Allied Mental Health)

93381

 

Focussed psychological strategies health service provided to a person (but not as an admitted patient of a hospital) by an eligible psychologist if:

(a) the person is a care recipient in a residential aged care facility; and

(b)  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; and

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

(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e) 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

(f)  the service is at least 20 minutes but less than 50 minutes duration

73.55

93382

Focussed psychological strategies health service provided to a person (but not as an admitted patient of a hospital), by an eligible psychologist if:

(a) the person is a care recipient in a residential aged care facility; and

(b)  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;  and

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

(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e) 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

(f)  the service is at least 50 minutes duration

103.80

93383

Focussed psychological strategies health service provided to a person (but not as an admitted patient of a hospital) by an eligible occupational therapist if:

(a) the person is a care recipient in a residential aged care facility; and

(b)  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; and

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

(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e) 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

(f)  the service is at least 20 minutes but less than 50 minutes duration

64.80

93384

Focussed psychological strategies health service provided to a person (but not as an admitted patient of a hospital) by an eligible occupational therapist if:

(a) the person is a care recipient in a residential aged care facility; and

(b)  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; and

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

(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e) 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

(f)  the service is at least 50 minutes duration

91.50

93385

Focussed psychological strategies health service provided to a person (but not as an admitted patient of a hospital) by an eligible social worker if:

(a) the person is a care recipient in a residential aged care facility; and

(b)  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; and

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

(d)  at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e)  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

(f)  the service is at least 20 minutes but less than 50 minutes duration

64.80

93386

 Focussed psychological strategies health service provided to a person (but not as an admitted patient of a hospital) by an eligible social worker if:

(a) the person is a care recipient in a residential aged care facility; and

(b)  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;  and

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

(d) at the completion of a course of treatment, the referring medical practitioner reviews the need for a further course of treatment; and

(e) 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

(f)  the service is at least 50 minutes duration

91.50

Schedule 4Services and fees—initial focussed psychological strategies

1 Application of focussed psychological strategies items

(1)  Items 941, 942, 2733 and 2735 apply to a service which is provided by a medical practitioner:

(a)   whose name is entered in the register maintained by the Chief Executive Medicare under section 33 of the Human Services (Medicare) Regulations 2017; and

(b)   who is identified in the register as a medical practitioner who can provide services to which Subgroup 2 of Group A20 of the general medical services table applies or items 283, 285, 286, 287, 371 and 372 of the Other Medical Practitioner Determination applies; and

(c)   who meets any training and skills requirements, as determined by the General Practice Mental Health Standards Collaboration for providing services to which Subgroup 2 of Group A20 of the general medical services table applies or items 283, 285, 286, 287, 371 and 372 of the Other Medical Practitioner Determination applies.

 

(2) Items 941, 942, 2733 and 2735 do not apply to:

(a)     a service which:

(i)    is provided to a patient who, in a calendar year, has already been provided with 6 services to which any of items 941, 942, 2733 and 2735 or any of the items in Subgroup 2 of Group A20 of the general medical services table or items 283, 285, 286, 287, 371 and 372 of the Other Medical Practitioner Determination or items 91818, 91819, 91820, 91821, 91842, 91843, 91844, 91845 of the COVID‑19 Determination applies; and

(ii)   is provided before the medical practitioner managing the GP mental health treatment plan or the psychiatrist assessment and management plan has conducted a patient review and recorded in the patient’s records a recommendation that the patient have additional sessions of focussed psychological strategies in the same calendar year; or

(b)             a service which is provided to a patient who has already been provided, in the calendar year, with 10 other services to which any of items 941, 942, 2733 and 2735 or any of the items in Subgroup 2 of A20 of the general medical services table or items 283, 285, 286, 287, 371 and 372 of the Other Medical Practitioner Determination, or items 80000 to 80015, 80100 to 80115, 80125 to 80140 or 80150 to 80165, or items 91820, 91821, 91844, 91845, 91166, 91167, 91169, 91170, 91172, 91173, 91175, 91176, 91181, 91182, 91183, 91184, 91185, 91186, 91187, 91188, 91818, 91819, 91842 and 91843 of the COVID‑19 Determination apply.

 

Group A20Mental health care

Subgroup 2Focussed psychological strategies

2733

Professional attendance by a general practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if:

(a) the person is a care recipient in a residential aged care facility (but not as an admitted patient of a hospital); and

(b) the service is clinically indicated under a GP mental health treatment plan or a psychiatrist assessment and management plan; and

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

113.50

2735

Professional attendance by a general practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders if:

(a) the person is a care recipient in a residential aged care facility (but not as an admitted patient of a hospital); and

(b) the service is clinically indicated under a GP mental health treatment plan or a psychiatrist assessment and management plan; and

(c)  the service lasts at least 40 minutes

162.45

 

 

 

Group A7 – Acupuncture and Non‑Specialist Practitioner Items

Subgroup 9 – Non Specialist Practitioner mental health care

941

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

(a) the person is a care recipient in a residential aged care facility (but not as an admitted patient of a hospital); and

(b) the service is clinically indicated under a GP mental health treatment plan or a psychiatrist assessment and management plan; and

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

90.80

942

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

(a) the person is a care recipient in a residential aged care facility (but not as an admitted patient of a hospital); and

(b) the service is clinically indicated under a GP mental health treatment plan or a psychiatrist assessment and management plan; and

(c)  the service lasts at least 40 minutes

130.00

 


Endnotes

Endnote 1—About the endnotes

The endnotes provide information about this compilation and the compiled law.

The following endnotes are included in every compilation:

Endnote 1—About the endnotes

Endnote 2—Abbreviation key

Endnote 3—Legislation history

Endnote 4—Amendment history

Abbreviation key—Endnote 2

The abbreviation key sets out abbreviations that may be used in the endnotes.

Legislation history and amendment history—Endnotes 3 and 4

Amending laws are annotated in the legislation history and amendment history.

The legislation history in endnote 3 provides information about each law that has amended (or will amend) the compiled law. The information includes commencement details for amending laws and details of any application, saving or transitional provisions that are not included in this compilation.

The amendment history in endnote 4 provides information about amendments at the provision (generally section or equivalent) level. It also includes information about any provision of the compiled law that has been repealed in accordance with a provision of the law.

Editorial changes

The Legislation Act 2003 authorises First Parliamentary Counsel to make editorial and presentational changes to a compiled law in preparing a compilation of the law for registration. The changes must not change the effect of the law. Editorial changes take effect from the compilation registration date.

If the compilation includes editorial changes, the endnotes include a brief outline of the changes in general terms. Full details of any changes can be obtained from the Office of Parliamentary Counsel.

Misdescribed amendments

A misdescribed amendment is an amendment that does not accurately describe the amendment to be made. If, despite the misdescription, the amendment can be given effect as intended, the amendment is incorporated into the compiled law and the abbreviation “(md)” added to the details of the amendment included in the amendment history.

If a misdescribed amendment cannot be given effect as intended, the abbreviation “(md not incorp)” is added to the details of the amendment included in the amendment history.

 

Endnote 2—Abbreviation key

ad = added or inserted

o = order(s)

am = amended

Ord = Ordinance

amdt = amendment

orig = original

c = clause(s)

par = paragraph(s)/subparagraph(s)

C[x] = Compilation No. x

/sub‑subparagraph(s)

Ch = Chapter(s)

pres = present

def = definition(s)

prev = previous

Dict = Dictionary

(prev…) = previously

disallowed = disallowed by Parliament

Pt = Part(s)

Div = Division(s)

r = regulation(s)/rule(s)

ed = editorial change

reloc = relocated

exp = expires/expired or ceases/ceased to have

renum = renumbered

effect

rep = repealed

F = Federal Register of Legislation

rs = repealed and substituted

gaz = gazette

s = section(s)/subsection(s)

LA = Legislation Act 2003

Sch = Schedule(s)

LIA = Legislative Instruments Act 2003

Sdiv = Subdivision(s)

(md) = misdescribed amendment can be given

SLI = Select Legislative Instrument

effect

SR = Statutory Rules

(md not incorp) = misdescribed amendment

Sub‑Ch = Sub‑Chapter(s)

cannot be given effect

SubPt = Subpart(s)

mod = modified/modification

underlining = whole or part not

No. = Number(s)

commenced or to be commenced

 

Endnote 3—Legislation history

 

Name

Registration

Commencement

Application, saving and transitional provisions

Health Insurance (Section 3C General Medical – Expansion of GP and Allied Health Mental Health Services) Determination 2020

6 Aug 2020 (F2020L00996)

7 Aug 2020 (s 2(1) item 1)

 

Health Insurance Legislation Amendment (Extend Cessation Date of Temporary COVID‑19 Items) Determination 2020

21 Sept 2020 (F2020L01190)

Sch 1 (item 3): 22 Sept 2020 (s 2(1) item 2)

Health Insurance (Section 3C General Medical – Expansion of GP and Allied Health Mental Health Services) Amendment (Expand Eligible Patients) Determination 2020

8 Oct 2020 (F2020L01290)

9 Oct 2020 (s 2(1) item 1)

Health Insurance (Section 3C General Medical – Expansion of GP and Allied Health Mental Health Services) Amendment (Care Recipient in a Residential Aged Care Facility) Determination 2020

9 Dec 2020 (F2020L01548)

Sch 1 (items 1–19): 10 Dec 2020 (s 2(1) item 1)

Health Insurance (Section 3C General Medical – Expansion of GP and Allied Health Mental Health Services and Chronic Disease Management) Amendment Determination 2020

23 Dec 2020 (F2020L01704)

Sch 1 (items 1–6): 10 Dec 2020 (s 2(1) item 2)

Health Insurance Legislation Amendment (Extend Cessation Date of Temporary COVID‑19 Items) Determination 2021

19 Mar 2021 (F2021L00267)

Sch 1 (item 2): 19 Mar 2021 (s 2(1) item 1)

Health Insurance Legislation Amendment (Section 3C General Medical and Diagnostic Imaging Services – Medicare Indexation) Determination 2021

8 Apr 2021 (F2021L00426)

Sch 1 (items 357–404): 1 July 2021 (s 2(1) item 1)

Health Insurance Legislation Amendment (Section 3C General Medical Services – Medicare Indexation and Extension of Remote Service Options) Determination 2021

24 June 2021 (F2021L00822)

Sch 1 (item 2): 25 June 2021 (s 2(1) item 2)
Sch 2 (items 25–68): 1 July 2021 (s 2(1) item 3)

Health Insurance Legislation Amendment (Section 3C General Medical Services – Eating Disorder and HCH Consequential Changes) Determination 2021

29 June 2021 (F2021L00896)

Sch 3 (item 15): 30 June 2022 (s 2(1) item 4)

Health Insurance Legislation Amendment (Section 3C General Medical Services – Usual Medical Practitioner Exemption) Determination 2021

21 July 2021 (F2021L01007)

Sch 1 (items 2, 3): 21 July 2021 (s 2(1) item 1)

Health Insurance Legislation Amendment (Section 3C General Medical Services – Cease GP Mental Health Treatment Plan Phone Services) Determination 2021

6 Aug 2021 (F2021L01079)

7 Aug 2021 (s 2(1) item 1)

 

Endnote 4—Amendment history

 

Provision affected

How affected

s 2.............................................

rep LA s 48D

s 4.............................................

am F2020L01190; F2020L01290; F2021L00267; F2021L00822

s 5.............................................

am F2020L01290; F2020L01548; F2020L01704

 

ed C4

 

am F2021L00896; F2021L01007; F2021L01079

s 7.............................................

am F2020L01290; F2020L01548; F2020L01704

 

ed C4

s 8.............................................

am F2020L01548

 

ed C3

 

am F2021L01007

s 9.............................................

rs F2020L01548

s 10...........................................

ad F2020L01548

 

am F2021L01079

s 11...........................................

ad F2020L01548

 

am F2020L01704

 

rs F2021L00426

Schedule 1

 

Schedule 1................................

am F2020L01290; F2020L01548; F2021L00426

Schedule 2

 

Schedule 2................................

am F2020L01290; F2020L01548; F2021L00822; F2021L01079

 

exp 31 Dec 2021 (s 4(a))

Schedule 3

 

Schedule 3................................

ad F2020L01548

 

ed C3

 

am F2021L00426

Schedule 4

 

Schedule 4................................

ad F2020L01704

 

am F2021L00426