Planning and management, by a practitioner, of a pregnancy if — pregnancy has progressed beyond…

Item 16590 is intended to provide for the planning and management of pregnancy that has progressed beyond 28 weeks, where the medical practitioner is intending to undertake the birth for a privately admitted patient. 

Item 16591 is for the planning and management of a pregnancy that has progressed beyond 28 weeks and the medical practitioner is providing shared antenatal care and is not intending to undertake the birth. 

Items 16590 and 16591 are to include the provision of a mental health assessment of the patient.  Both items are subject to Extended Medicare Safety Net caps and should only be claimed by a patient once per pregnancy. 

Items for the planning and management of pregnancy (16590 and 16591) and for a postnatal attendance between 4 and 8 weeks after birth (16407), include a mental health assessment of the patient, including screening for drug and alcohol use and domestic violence, to be performed by the clinician or another suitably qualified health professional on behalf of the clinician.  A mental health assessment must be offered to each patient, however, if the patient chooses not to undertake the assessment, this does not preclude a benefit being payable for these items.

It is recommended that mental health assessments associated with items 16590, 16591, and 16407 be conducted in accordance with the National Health and Medical Research Council (NHMRC) endorsed guideline: Mental Health Care in the Perinatal Period: Australian Clinical Practice Guideline – October 2017, Centre for Perinatal Excellence.

Results of the mental health assessment must be recorded in the patient’s medical record.  A record of a patient’s decision not to undergo a mental health assessment must be recorded in the patient’s clinical notes.