Provision of Focussed Psychological Strategies

Provision of Focussed Psychological Strategies

Associated Items: 283, 285, 286, 287, 2721, 2723, 2725, 2727, 80100, 80105, 80110, 80115, 80120, 80121, 80122, 80123, 80125, 80127, 80128,  80130, 80135, 80140, 80145, 80146, 80147, 80148,  80150, 80152, 80153, 80155, 80160, 80165, 80170, 80171, 80172, 80173, 80174, 80175, 91818, 91819, 91842, 91843, 91820, 91821, 91844, 91845, 91169, 91170, 91183, 91184, 91172, 91173, 91185, 91186, 91175, 91176, 91187 , 91188

Services attracting Medicare benefits

There are 58 Medicare Benefits Schedule (MBS) items for the provision of focussed psychological strategy services to eligible patients by an eligible general practitioner (GP), eligible prescribed medical practitioner (PMP), eligible psychologist (registered), eligible occupational therapist, or eligible social worker. These consist of:

Individual focussed psychological strategies:

GP services:

• face-to-face items: 2721, 2723, 2725 and 2727
• video and phone items: 91818, 91819, 91842 and 91843

PMP services:  

• face-to-face items: 283, 285, 286 and 287
• video and phone items: 91820, 91821, 91844 and 91845

Psychologist (registered) services:

• face-to-face items: 80100, 80105, 80110 and 80115
• video and phone items: 91169, 91170, 91183 and 91184

Occupational therapist services:

• face-to-face items: 80125, 80130, 80135 and 80140
• video and phone items: 91172, 91173, 91185 and 91186

Social worker services:

• face-to-face items: 80150, 80155, 80160 and 80165
• video and phone items: 91175, 91176, 91187, and 91188

Group focussed psychological strategies:

Psychologist (registered) services:

• face-to-face items: 80120, 80122 and 80127
• video items: 80121, 80123 and 80128

Occupational therapist services:

• face-to-face items: 80145, 80147, 80152
• video items: 80146, 80148, 80153

Social worker services:

• face-to-face items: 80170, 80172, 80174
• video items: 80171, 80173, 80175

To provide these services, eligible health professionals must meet the provider eligibility requirements set out below and be registered with Services Australia.

For group focussed psychological strategies services provided via video, additional restrictions apply. Please see the group focussed psychological strategies services - telehealth (video) requirements section below for further information.

Eligible referral services

Referrals for treatment services under the Better Access initiative should be utilised for patients who require at least a moderate level of support.

For the purposes of Better Access treatment services, a Medicare benefit will be not payable unless patients meet the eligibility and referral requirements outlined in explanatory note AN.0.78 | Medicare Benefits Schedule.

Service length and type

Services provided by eligible health professionals under these items must meet the time period requirements specified within the item descriptor.

It is expected that professional attendances at places other than consulting rooms would be provided where treatment in other environments is necessary to achieve therapeutic outcomes.

A range of acceptable strategies has been approved for use by eligible health professionals utilising the focussed psychological strategies items.

These are: 

• psycho-education
• cognitive-behavioural therapy that involves cognitive or behavioural interventions
• relaxation strategies
• skills training
• interpersonal therapy
• eye movement desensitisation and reprocessing; and
• narrative therapy (for Aboriginal and Torres Strait Islander peoples).

Number of services per year

Medicare benefits are available for up to 10 individual and 10 group therapy mental health treatment services in a calendar year. The services may consist of:

• psychological therapy services delivered by eligible clinical psychologists (refer to explanatory note MN.6.2 - Provision of Psychological Therapy); and/or
• focussed psychological strategies services delivered by eligible GPs, eligible PMPs, eligible psychologists (registered), eligible social workers and eligible occupational therapists. 

Course of treatment and reporting back to the referring medical practitioner or practice

Eligible patients must be referred for focussed psychological strategies services by either a GP or PMP at the general practice in which the patient is enrolled in MyMedicare, or regardless of whether the patient is enrolled in MyMedicare, by the patient’s usual medical practitioner who is managing the patient under a Mental Health Treatment Plan. This also includes a GP or PMP who is located at a medical practice that has provided the majority of care over the previous 12 months or will be providing the majority of their care over the next 12 months. In addition, eligible patients can be referred under a Psychiatrist Assessment and Management Plan, or on direct referral from a psychiatrist or paediatrician. For additional information on Better Access referral requirements, refer to explanatory note MN.6.3 - Referral Requirements for Better Access Treatment Services. 

Focussed psychological strategies services are available to any patient from any eligible GP and eligible PMP who has the appropriate training recognised by the General Practice Mental Health Standards Collaboration. GPs and PMPs who provide focussed psychological strategies services do so as part of an arrangement for the treatment of an assessed mental disorder under a Mental Health Treatment Plan.

The treating eligible allied health professional providing the service must be in receipt of the referral at the first mental health consultation. The treating eligible allied health professional must also retain the referral for 2 years (24 months) from the date the service was rendered.

The referring practitioner can decide how many services the patient will receive in a course of treatment, within the maximum service limit for the course of treatment. The maximum service limit for each course of treatment is set out below:

• Initial course of treatment - a maximum of 6 services.
• Subsequent course of treatment - a maximum of 6 services up to the patient's cap of 10 services per calendar year (for example, if the patient received 6 services in their initial course of treatment, they could only receive 4 services in a subsequent course of treatment provided within the same calendar year).

On completion of the initial course of treatment, the treating eligible health professional providing the service must provide a written report to the referring practitioner, which includes information on:

• assessments carried out on the patient;
• treatment provided; and
• recommendations on future management of the patient's disorder (e.g. if they require a subsequent course of treatment as the initial course of individual services is only up to 6 services, with the subsequent being no more than the maximum of 10 services per calendar year), noting further treatment under the Better Access initiative should be utilised for patients who require at least a moderate level of support.

A written report must also be provided to the referring practitioner at the completion of any subsequent course(s) of treatment provided to the patient.

Group focussed psychological strategies services

In addition to individual focussed psychological strategies services, eligible patients may also claim up to 10 separate group focussed psychological strategies service MBS items within a calendar year for group therapy mental health treatment services provided by eligible allied health professionals. Group focussed psychological strategy services can be claimed for groups of 4 to 10 patients. However, the eligible allied health professional providing the service can claim these MBS items if 4 patients were due to attend and 1 patient is unable to attend, regardless of the reason.

Group focussed psychological strategies services - telehealth (video) requirements

Group therapy mental health treatment services may only be delivered via video in certain circumstances. To be eligible for group therapy mental health treatment services via video, the patient must be located in a Modified Monash Model area 4-7 at the time of the consultation, and at least 15 kilometres apart by road from the eligible allied health professional delivering the service. The patient or eligible allied health professional is not permitted to travel to an area outside the minimum 15 kilometres distance in order to claim a video consultation item.

More information about the Modified Monash Model, including a search tool to identify the classification of a specific location, is available at:

https://www.health.gov.au/topics/rural-health-workforce/classifications/mmm

Record Keeping

Eligible GPs or eligible PMPs or eligible allied health professionals providing focussed psychological strategies services must keep contemporaneous notes of the consultation including documenting the date, time and people who attended. Only clinical details recorded at the time of attendance count towards the time of the consultation. Other notes or reports added at a later time are not included. For information on what constitutes adequate and contemporaneous records, refer to explanatory note GN.15.39 - Practitioners should maintain adequate and contemporaneous records.

Professional eligibility to provide focussed psychological strategy services

Under the Better Access initiative, focussed psychological strategies services may only be provided by an eligible GP, eligible PMP, eligible psychologist (registered), eligible occupational therapist, or eligible social worker. The eligibility requirements for each profession are set out below.

A person is an eligible GP or eligible PMP in relation to the provision of focussed psychological strategies if the person:

1. is entered in the register maintained by the Chief Executive Medicare under section 33 of the Human Services (Medicare) Regulations 2017;
2. is identified in the register as a medical practitioner who can provide focussed psychological strategies services; and
3. meets the relevant training and skills requirements, as determined by the General Practice Mental Health Standards Collaboration.

A person is an eligible allied health professional in relation to the provision of a focussed psychological strategies health service if the person meets 1 of the following requirements:

1. the person holds general registration in the health profession of psychology with the Psychology Board of Australia; or
2. the person is a member of the Australian Association of Social Workers (AASW) and accredited by AASW as meeting the accreditation criteria set out in the document published by AASW titled ‘AASW Accredited Mental Health Social Worker Application Criteria’ as in force on 1 July 2022; or
3. the person:
   
   1. holds registration in the health profession of occupational therapy with the Occupational Therapy Board of Australia; and
   2. is accredited by Occupational Therapy Australia as meeting the criteria for mental health endorsement as set out in the document published by Occupational Therapy Australia titled ‘Occupational Therapy Australia Mental Health Endorsement Criteria’ as in force on 1 March 2023.

Continuing professional development for occupational therapists and social workers providing focussed psychological strategies services

In addition to meeting the relevant professional eligibility requirements, eligible occupational therapists and eligible social workers are required to have completed 10 one-hour units of focussed psychological strategies continuing professional development per year to provide focussed psychological strategies services.  A year for the purposes of these items is from 1 July to 30 June annually. Part-time allied health professionals are required to complete 10 units of focussed psychological strategies related continual professional development, the same as full-time allied health professionals.

Continual professional development units must relate to the delivery of focussed psychological strategies in any of the following areas:

a. psycho-education;

b. cognitive-behavioural therapy including;

1. behavioural interventions;
2. behaviour modification;
3. exposure techniques;
4. activity scheduling;

c. cognitive interventions including:

1. cognitive therapy;

d. relaxation strategies including;

1. progressive muscle relaxation;
2. controlled breathing;

e. skills training including;

1. problem solving skills and training;
2. anger management;
3. social skills training;
4. communication training;
5. stress management;
6. parent management training;

f. interpersonal therapy;

g. eye movement desensitisation and reprocessing;

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

i. clinical skills to undertake a full assessment of a patient in order to form a diagnosis and commence treatment planning.

Acceptable continual development activities where the content is related to focussed psychological strategies can include formal postgraduate education, workshops, seminars, lectures, journal reading, writing papers, receipt of supervision and peer consultation, and online training. There is flexibility in the continual professional activities that can be undertaken to meet individual professional needs and their practice/client base and client needs. For example, activities could also include assessment and treatment of specific disorders and client types such as youth, or different modalities and delivery such as working with groups.

A person required to complete focussed psychological strategies continuing professional development must keep written records of completion of focussed psychological strategies continuing professional development for a period of 2 years from the end of the continuing professional year to which the focussed psychological strategies continuing professional development relates.

Eligible occupational therapists and eligible social workers who register to provide focussed psychological strategies during the continual professional development year (1 July – 30 June), are obligated to undertake continual professional development on a pro-rata basis. The amount of continual professional development units will be calculated from the 1st of the month immediately succeeding the month they obtained initial registration. 

Registering with Services Australia

Advice about registering with Services Australia to provide Better Access services is available from the Services Australia provider enquiry line on 132 150. 

Further information

For further information on the Better Access Initiative, refer to explanatory note AN.0.78 – Better Access Initiative.

For further information about Medicare Benefits Schedule items, please visit the MBS online website at www.health.gov.au/mbsonline. 

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

If you are a patient seeking advice about Medicare services, patient benefits, or your Medicare claims, please contact Services Australia on the Medicare General enquiry line on 132 011.