To meet and access Medicare benefits under the Better Access initiative, patients must have either;

• a mental health treatment plan, or
• a psychiatrist assessment and management plan.

The patient must also have a valid referral. Valid referrals include;

• a referral for eligible allied health services by either a general practitioner (GP) or prescribed medical practitioner (PMP) at the general practice the patient is enrolled in for MyMedicare, or
• the patient's usual medical practitioner.
• direct referrals from psychiatrists or paediatricians are also accepted.

MBS benefits are available to patients who have a diagnosed mental disorder with at least moderate care needs. Examples of this may include conditions such as depression and anxiety. A general practitioner (GP), or if relevant, a psychiatrist or paediatrician can decide if a patient is eligible for support under the Better Access initiative

Patients may access telehealth services via video or telephone for the preparation of a mental health treatment plan if they receive the service from a general practitioner (GP) or prescribed medical practitioner (PMP) at their MyMedicare registered practice or their usual medical practitioner and either;

• have had at least one face-to-face appointment in the past 12 months with their usual GP or PMP, or
• they meet one of the exemptions to the clinical relationship rule (AskMBS advisory – Established clinical relationship requirement – Clarification of exemptions, as published by the Australian Government, Department of Health, Disability and Aging)

For more information relating to telehealth:

• Better Access Telehealth frequently asked questions, published by the Australian Government, Department of Health, Disability and Aging.
• Medicare Benefits Schedule - Note AN.1.1

Mental Health Treatment Plan review items: 2712, 92114, 92126, 277, 92120, and 92132

Ongoing Mental Health Consultation items: 2713, 92115, 92127, 279, 92121 and 92133.

GPs and PMPs are now to use time-tiered professional (general attendance) items to review, refer and/or provide ongoing mental health consultation for a patient’s mental health.

Please reference the flowchart below:

No.

Patients can choose to see their usual medical practitioner irrespective of their existing MyMedicare registered status. Patients may choose to seek mental health support through a separate provider for many reasons; therefore these changes will not impact the ability for patients to continue to do this.

Noting that a patient’s usual medical practitioner is someone who has;

• provided the majority of services to the person in the past 12 months, or
• is likely to provide the majority of services to the person in the following 12 months.
• This includes other GPs and PMPs who are employed at the patient’s usual medical practice.

Example:

If a patient is registered with a MyMedicare practice but prefers to see a GP at another clinic for their mental health care, such as a Doctors in Secondary Schools (DiSS) GP, they are still free to do so. The upcoming changes do not restrict patients from accessing care from their preferred practitioner.

Patients with no prior history of a mental health disorder:

A patient who has no prior history of a mental health disorder can access up to an initial 6 sessions to a clinical psychologist through a MHTP as referred by their usual GP or PMP.

Upon review of the MHTP by the patient's usual GP or PMP, the patient may access up to an additional 10 services annually.

Patients who are clinically diagnosed with a mental health disorder:

A patient who has a clinically diagnosed mental health disorder can access up to 10 individual services and an additional 10 group therapy mental health treatment services per calendar year (1 January to 31 December).

For more information:

• Better Access changes − patient / practitioner journey
• Better Access fact sheet – professionals

• Better Access Mental Health MBS User Guide (Please see page 8)