Referral under Better Access to Mental Health (Psychologist and eligible OT’s only)

Referral

• Services provided under the “focussed psychological strategies – allied mental health items” are only eligible for a rebate if a referral is provided from one of the professionals below;
  1. GP or Medical practitioner managing the patient under a GP Mental Health Treatment Plan (GP items 2700, 2701, 2715, 2717 or medical practitioner items 272, 276, 281, 282);
  2. Medical practitioner managing the patient under a referred psychiatrist assessment and management plan
  3. Psychiatrist or Paediatrician from an eligible psychiatrist or paediatric service.
• Each referral is only valid for up to 6 sessions in one referral or the number of sessions stated by the referrer.
• Medicare benefits are available for up to 10 individual and/or 10 group psychological therapy services and/or focussed psychological strategies services per patient per calendar year. The referral must state the number of sessions that the client is being referred for. An additional 10 sessions are currently available with a GP referral under a new COVID-19 item number.
• When patients have used all of their referred services they will need to obtain a new referral from the referring practitioner if they are eligible for further services. A new referral does not necessarily require a review of the GP Mental Health Treatment Plan. It is the parent’s responsibility to ensure an initial or new referral is obtained prior to the next appointment.
• Referring practitioners are not required to use a specific form to refer patients for these services. The referral may be a letter or note to an eligible allied mental health professional signed and dated by the referring practitioner.
• The allied mental health professional must be in receipt of the referral at the first allied mental health consultation. It is required that the allied health professional retain the referral for 24 months from the date the service was rendered (for the Department of Human Services auditing purposes).
• If a patient has not used all of their psychological therapy services and/or focussed psychological strategies services under a referral in a calendar year, it is not necessary to obtain a new referral for the “unused” services. However, any “unused” services received from 1 January in the following year under that referral will count as part of the total of 10 services for which the patient is eligible in that calendar year.

Session Type

• Services provided under a Mental Health Care Plan referral must be solely for the provision of Focused Psychological Strategies to treat the diagnosed mental health condition. They cannot be used for academic intervention or for occupational therapy sessions to treat coordination or writing concerns. Sessions cannot be used for psychometric assessments, but may be used for a mental health assessment if requested by the referring doctor.
• The client must be present. Parent only sessions now are eligible for one session only, which uses up one of the 10 rebated sessions under the plan.
• A client may be eligible for a rebate for a group treatment if the referring doctor has indicated this on the referral. The group must have between 6 and 10 participants and be targeted treatment for the client’s mental health condition.

Payment

• Payment is required at the time of the appointment in alignment with the PosAbility Payment Procedures.
• Clients must pay in full at the time of the appointment. Medicare claims may be processed at the time of payment through the Hicaps machine with correct referral details and the client’s Medicare card. Alternatively, a receipt may be provided for the client to claim the rebate.
• Patients need to decide if they will use Medicare or their private health insurance ancillary cover to pay for these services. Patients cannot use their private health insurance ancillary cover to ‘top up’ the Medicare rebate paid for the services.