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

I, Paul McBride, delegate of the Minister for Health, make the following determination.

Dated   6 August 2020 

 

 

 

 

 

 

Paul McBride

First Assistant Secretary

Medical Benefits Division

Health Financing Group

Department of Health

 

 

 

Contents

1  Name 

2 Commencement

3  Authority

4  Cessation

5  Definitions

6  Treatment of relevant services

7  Application of items in this instrument

8  Applications of items in Group A41

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

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

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

1  Name

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

2 Commencement

(1)   Each provision of this instrument specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms. 

Commencement information

Column 1

Column 2

Column 3

Provisions

Commencement

Date/Details

1.  The whole of this instrument

7 August 2020

 

Note:         This table relates only to the provisions of this instrument as originally made. It will not be   amended to deal with any later amendments of this instrument.

(2)   Any information in column 3 of the table is not part of this instrument. Information may be inserted in this column, or information in it may be edited, in any published version of this instrument.

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 30 September 2020.

(b)   this instrument ceases as if revoked on 31 March 2021.

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 initial treatment service means a service to which any of the following applies:

(a)  items 2721, 2723, 2725, 2727 in the general medical services table;

(b)  items 283, 285, 286, 287, 371 and 372 in the Other Medical Practitioner Determination;

(c)  items in Groups M6 and M7 of the Allied Health Services Determination.

(d)  items 91166, 91167, 91169, 91170, 91172, 91173, 91175, 91176, 91181 to 91188, 91818, 91819, 91820, 91821, 91842, 91843, 91844, 91845, of the COVID-19 Determination;

(e)  items 2729 and 2731 of the Health Insurance (Section 3C General Medical Services - General Practitioner Telehealth Services) Determination 2018.

better access subsequent treatment service means a service to which an item in a Schedule of this instrument applies.

person with a mental health disorder subject to COVID-19 public health orders means any who person has been:

(a)      required to isolate between 1 July 2020 and before 31 March 2021 due to being diagnosed with COVID-19; or

(b)      compelled by law at any time after 1 July 2020, to remain quarantined for 14 days or more as a result of being in contact with a person diagnosed with COVID-19; or

(c)      compelled by law at any time after 1 July 2020 to remain in quarantine for 14 days or more after arriving from outside Australia or from another State or Territory; or

(d)      compelled by a public health law of any State or Territory, to remain isolated at home (subject to lawful exemptions or hospitalisation) for a continuous period of 28 days or more between 1 July 2020 and
1 March 2021.

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.

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.

patient’s usual medical practitioner has the meaning given by section 8 of the COVID-19 Determination.

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.

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

(1)      An item in this instrument only applies to a service if all of the following apply:

(a)      the service is provided to a person who, in that calendar year, has received 10 better access initial treatment services;

(b)      following the provision of the last better access initial treatment service in the calendar year, the person:

(i)       had a professional service by a medical practitioner working in general practice, a psychiatrist or a paediatrician (the ‘reviewing practitioner’) to assess the effectiveness of treatment and the appropriateness of further treatment; and

(ii)     the reviewing practitioner determined it was clinically appropriate for the person to access better access subsequent treatment services; and

(iii)   the reviewing practitioner modifies the person’s GP mental health treatment plan, shared care plan, psychiatrist assessment and management plan, or where no such document exists otherwise makes a written record, to record that the reviewing practitioner recommends the person have an additional number of better access subsequent treatment services.

(2)      An item in this instrument does not apply if a person has received 10 better access subsequent treatment services.

8  Applications of items in Group A41

(1)      Items 93300 to 93311 apply to a service which is clinically indicated under a GP mental health treatment plan or a psychiatrist assessment and management plan.

(2)      Items 93300 to 93311 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.

(4)      Items 93301, 93302, 93304, 93305, 93307, 93308,  93310 or 93311 do not apply to a service unless the service is performed by the patient’s usual medical practitioner.

(5)      Subsection 8(4) does not apply to a service provided to:

(a)      a person who is under the age of 12 months; or

(b)      a person who is experiencing homelessness; or

(c)      a person who is in a COVID-19 impacted area; or

(d)      a person who receives the service from a medical practitioner located at an Aboriginal Medical Service or an Aboriginal Community Controlled Health Service.

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

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

Schedule 1—Services 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:

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and

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

112.50

93303

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

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and

(c)  the service lasts at least 40 minutes

161.00

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:

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and

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

90.00

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:

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and

(c)  the service lasts at least 40 minutes

128.80

 

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:

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who:

(i) determines the person is responding to mental health treatment, or may respond to additional mental health treatment; or

(ii) determines it appropriate for the person to access additional mental health treatment services ; or

(iii) 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

102.85

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:

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who:

(i) determines the person is responding to mental health treatment, or may respond to additional mental health treatment; or

(ii) determines it appropriate for the person to access additional mental health treatment services; or

(iii) 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

151.05

 

 

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:

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who:

(i) determines the person is responding to mental health treatment, or may respond to additional mental health treatment; or

(ii) determines it appropriate for the person to access additional mental health treatment services; or

(iii) 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

72.90

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:

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who:

(i) determines the person is responding to mental health treatment, or may respond to additional mental health treatment; or

(ii) determines it appropriate for the person to access additional mental health treatment services; or

(iii) 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

102.85

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:

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who:

(i) determines the person is responding to mental health treatment, or may respond to additional mental health treatment; or

(ii) determines it appropriate for the person to access additional mental health treatment services; or

(iii) 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

64.20

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:

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b) the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who:

(i) determines the person is responding to mental health treatment, or may respond to additional mental health treatment; or

(ii) determines it appropriate for the person to access additional mental health treatment services; or

(iii) 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

90.70

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:

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who:

(i) determines the person is responding to mental health treatment, or may respond to additional mental health treatment; or

(ii) determines it appropriate for the person to access additional mental health treatment services; or

(iii) 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

64.20

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:

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who:

(i) determines the person is responding to mental health treatment, or may respond to additional mental health treatment; or

(ii) determines it appropriate for the person to access additional mental health treatment services; or

(iii) 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

90.70

 


Schedule 2—Services 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:

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and

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

112.50

93302

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

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and

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

112.50

93304

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

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and

(c)  the service lasts at least 40 minutes

161.00

93305

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

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and

(c)  the service lasts at least 40 minutes

161.00

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:

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and

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

90.00

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:

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and

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

90.00

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:

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and

(c)  the service lasts at least 40 minutes

128.80

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:

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the practitioner is registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service; and

(c)  the service lasts at least 40 minutes

128.80

 

Group M25 – Additional psychological therapy services

Item

Service

Fee($)

93331

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

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who:

(i) determines the person is responding to mental health treatment, or may respond to additional mental health treatment; or

(ii) determines it appropriate for the person to access additional mental health treatment services; or

(iii) 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

102.85

93332

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

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who:

(i) determines the person is responding to mental health treatment, or may respond to additional mental health treatment; or

(ii) determines it appropriate for the person to access additional mental health treatment services; or

(iii) 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

102.85

93334

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

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who:

(i) determines the person is responding to mental health treatment, or may respond to additional mental health treatment; or

(ii) determines it appropriate for the person to access additional mental health treatment services; or

(iii) 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

151.05

93335

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

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who:

(i) determines the person is responding to mental health treatment, or may respond to additional mental health treatment; or

(ii) determines it appropriate for the person to access additional mental health treatment services; or

(iii) 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

151.05

 

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:

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who:

(i) determines the person is responding to mental health treatment, or may respond to additional mental health treatment; or

(ii) determines it appropriate for the person to access additional mental health treatment services; or

(iii) 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

72.90

93352

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

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who:

(i) determines the person is responding to mental health treatment, or may respond to additional mental health treatment; or

(ii) determines it appropriate for the person to access additional mental health treatment services; or

(iii) 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

72.90

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:

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who:

(i) determines the person is responding to mental health treatment, or may respond to additional mental health treatment; or

(ii) determines it appropriate for the person to access additional mental health treatment services; or

(iii) 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

102.85

93355

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

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who:

(i) determines the person is responding to mental health treatment, or may respond to additional mental health treatment; or

(ii) determines it appropriate for the person to access additional mental health treatment services; or

(iii) 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

102.85

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:

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who:

(i) determines the person is responding to mental health treatment, or may respond to additional mental health treatment; or

(ii) determines it appropriate for the person to access additional mental health treatment services; or

(iii) 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

64.20

93358

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

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who:

(i) determines the person is responding to mental health treatment, or may respond to additional mental health treatment; or

(ii) determines it appropriate for the person to access additional mental health treatment services; or

(iii) 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

64.20

93360

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

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who:

(i) determines the person is responding to mental health treatment, or may respond to additional mental health treatment; or

(ii) determines it appropriate for the person to access additional mental health treatment services; or

(iii) 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

90.70

93361

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

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders ; and

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who:

(i) determines the person is responding to mental health treatment, or may respond to additional mental health treatment; or

(ii) determines it appropriate for the person to access additional mental health treatment services; or

(iii) 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

90.70

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:

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who:

(i) determines the person is responding to mental health treatment, or may respond to additional mental health treatment; or

(ii) determines it appropriate for the person to access additional mental health treatment services; or

(iii) 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

64.20

93364

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

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who:

(i) determines the person is responding to mental health treatment, or may respond to additional mental health treatment; or

(ii) determines it appropriate for the person to access additional mental health treatment services; or

(iii) 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

64.20

93366

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

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who:

(i) determines the person is responding to mental health treatment, or may respond to additional mental health treatment; or

(ii) determines it appropriate for the person to access additional mental health treatment services; or

(iii) 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

90.70

93367

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

(a)  the person is a person with a mental health disorder subject to COVID-19 public health orders; and

(b)  the person is referred by a medical practitioner working in general practice, a psychiatrist or a paediatrician who:

(i) determines the person is responding to mental health treatment, or may respond to additional mental health treatment; or

(ii) determines it appropriate for the person to access additional mental health treatment services; or

(iii) 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

90.70