Lantern Psychology | Medicare

Medicare rebates

Under the Better Access to mental health scheme, clients who have a Mental Health Care Treatment Plan (MHCTP) and a referral to a psychologist from their GP, are eligible for rebates for up to 10 psychology sessions a calendar year through Medicare.

The rebate for a service provided by a clinical psychologist is currently $136.35 and for a registered psychologist, it is $92.90.

Information about MHCP eligibility can be found here.

Medicare rebates at Lantern

At Lantern Psychology, our goal is to make sure our processes are as stress-free as possible. To this end, we take your Medicare card details in the online registration process before the first session and process the rebates for you as soon as you have paid for each session. Rebates can usually be found in your bank account the next day.

For GPs: What is a valid referral?

A Mental Health Treatment Plan is not a referral and alone is not sufficient for the psychologist to provide a service unless it contains the following information:

  • date
  • patient’s name, date of birth and address
  • diagnosis / problem
  • request for services and number of sessions
  • referring practitioner’s Medicare Provider Number
  • practitioner’s signature
  • a statement about whether the patient has a GPMHTP, shared care plan or a psychiatrist assessment and management plan.

Source: Services Australia

According to the Medicare Benefits Schedule, “The referral may be in the form of a letter, or note to an eligible allied health professional signed and dated by the referring practitioner. The allied health professional must be in receipt of the referral at the first consultation.”

Information on this for GPs and psychiatrists can be found on this website.

Note: a referral is valid for the number of sessions identified on the referral and does not expire.

For GPs: MHCP facts

WHAT ARE THE GP MENTAL HEALTH TREATMENT MEDICARE ITEMS?

GP Mental Health Treatment Medicare items are:

    • MBS items 2700, 2701, 2715 or 2717 – Preparation of a GP Mental Health Treatment Plan (effective from 1 November 2011);
    • MBS item 2712 – Review of a GP Mental Health Treatment Plan; and
    • MBS item 2713 – GP Mental Health Treatment Consultation.

Please note: GPs do not have to complete another GP Mental Health Treatment Plan using one of the new items (2700, 2701, 2715 or 2717) if they are already managing a patient’s care needs using one of the former GP Mental Health Treatment Plan items (items 2702 and 2710) and this plan is still appropriate to the patient’s needs.

REVIEW OF MENTAL HEALTH CARE PLAN

When should a Review of a GP Mental Health Treatment Plan be done?

Patients with a GP Mental Health Treatment Plan should have at least one formal review (MBS item 2712). As a general rule, a formal review should occur four weeks to six months after the completion of a GP Mental Health Treatment Plan. If a further review is required, this can occur three months after the first review. Most patients should not need more than two formal reviews in a 12 month period.

Unless exceptional circumstances exist, a Review of a GP Mental Health Treatment Plan should not be done within three months of a previous claim for the same item (MBS item 2712) or within four weeks following a claim for a GP Mental Health Treatment Plan item (MBS items 2700, 2701, 2715 or 2717).

It is also expected that MBS item 2712 would generally not be claimed within four weeks of a claim for a referred psychiatrist assessment and management plan (MBS item 291).

It is not necessary to complete a review using MBS item 2712 in order to refer a patient for further allied mental health services.

Source:  https://www1.health.gov.au/internet/main/publishing.nsf/Content/pacd-gp-mental-health-care-pdf-qa#4_1

Mental Health Care Plan Facts

There is much confusion around the number of sessions provided under a MHCTP and when a new referral can be obtained. Information is outlined below.

Obtaining a MHCP

To get a MHCP, the patient must be assessed by their GP. This usually requires a double appointment, so if you would like to be assessed for a GPMHCP, let the GP’S receptionist know this when you book the appointment.

You also need a referral letter to the psychologist you will go and see, so be sure to let the GP know who you would like this address to. The GP will then either send the referral letter to the psychologist or give it to you to give to the psychologist. The referral letter must pre-date the first session with the psychologist.

Number of sessions

Under a MHCTP, patients are eligible for up to 10 subsidised sessions a calendar year (from January to December). However, each referral is only valid for up to 6 sessions. This means, if a client would like more sessions after the first six, they need to return to their GP to get another referral.

After the first six are used, the psychologist must write a letter to the GP requesting a review and a new referral, if required. The patient then must attend an appointment in which a review is carried out and then bring documentation to the psychologist on their next appointment.

New referrals in a new calendar year

There is a lot of confusion regarding the commencement of a new calendar year and when patients can obtain a new referral (for six more sessions) if they have used all 10 sessions from the previous year. Some GPs believe the patient cannot be provided with a new referral in a new calendar year until the first MHCP is a year old. This is incorrect. The patient is entitled to 10 sessions per calendar year and this can be under an existing MHCP.

If your doctor is asking you to wait until the anniversary of your previous year’s MHCP in order to provide a new referral and six more sessions in a new calendar year, show them this link: AMA website: MHCP’s Clarified.

More detailed information for GPs concerning this process is available on the MBS Online website here.