Information sourced from Medicare Updated February 2013
Information on the GP Mental Health items is available:
• at www.health.gov.au (A-Z Index’ link enter as key words ‘Mental Health Care – GP Medicare
Items, Q & A 111031’) click and scroll down to this title
• Explanatory Notes of the Medicare Benefits Schedule book, and
• By calling Medicare Australia on 132 150 (for GPs) or 132 011 (for patients).
GP Mental Health Items
• Item 2715 Preparation of a GP MH Treatment Plan (GP completed MH Skills Training) 20 – 39
Minute Consultation; Item 2717 Preparation of a GP MH Treatment Plan (GP completed MH Skills
Training) 40 minutes plus consultation
• Item 2700 Preparation of a GP MH Treatment Plan (GP NOT completed MH Skills Training) 20 – 39
Minute consultation; Item 2701 Preparation of a GP MH Treatment Plan (GP NOT completed MH
Skills Training) 40 minutes plus consultation
Item 2712 Review of a GP Mental Health Treatment Plan
• Item 2713 GP Mental Health Care Consultation
The items provide a structured framework for GPs to undertake early intervention, assessment and management of patients with mental disorders , as well as providing referral pathways for psychological care
AND would generally be provided by the patient’s usual doctor to patients living in the community
Item Description
2715/
2700
2717 /
2701
Preparation of a GP
Mental Health
Treatment Plan
Time
20 – 39 minutes
40 Minutes plus
Claiming Restrictions
Once in a twelve month period, with provision for exceptional circumstances.
2712 Review of a GP Mental
Health Care Plan
Not timed Twice in a twelve month period, with provision for exceptional circumstances. Not less than 4 wks from claiming 2710/2702 OR 3 months from claiming 2712
At least 20 mins No restrictions 2713 GP Mental Health Care
Consultation
All MH Items consultations must be rendered by the GP .
A specialist mental health nurse, allied health practitioner or Aboriginal Health Worker with appropriate mental health qualifications and training may provide general assistance to GPs (not intended that assistance replace requirement for service to be rendered by the GP).
Only provide GP Mental Health items where you reasonably expect you will
be the patient's 'usual GP'
have an ongoing role in the management of the patient and their mental disorder.
• Chronic psychotic disorders
• Schizophrenia
• Phobic disorders
• Adjustment disorder
• Depression
• Conduct disorder
• Post Traumatic Stress Disorder
• Panic disorder
• Drug use disorders
• Acute psychotic disorders
• Bipolar disorder
• Generalised anxiety disorder
• Unexplained somatic complaints
• Sexual disorders
• Bereavement disorders
• Eating disorders
• Alcohol use disorders
• Mixed anxiety and depression
• Dissociative (conversion) disorder
• Sleep problems
• Enuresis (non-organic)
• Mental disorder, not otherwise specified
• Neurasthenia
• Hyperkinetic (attention deficit) disorder
• Obsessive Compulsive Disorder
Dementia, delirium, tobacco use disorder and mental retardation are not regarded as mental disorders for the purposes of the GP Mental Health Care items.
(2715/2717 and 2700/ 2701) involves both assessing the patient and preparing the GP Mental Health Care Plan document .
Assessment
Must include:
• recording the patient’s agreement for the service;
• taking relevant history (biological, psychological, social)
• conducting a mental state examination;
• assessing associated risk and any co-morbidity;
• making a diagnosis and/or formulation;
• administering an outcome measurement tool, except where it is considered clinically inappropriate. (Choice of tools at GP discretion)
Plan
Must include:
• discussing the assessment with the patient, including formulation and/or diagnosis ;
• identifying and discussing referral and treatment options with the patient
• agreeing goals with the patient
• provision of psycho-education
• a plan for crisis intervention and/or for relapse prevention, if appropriate
• arrangements for referrals, treatment, support services, review and follow-up
• documentation in patient’s GP Mental Health Care Plan .
Assessment & Plan can take one or two consultations. Separate visits are only billed once with a
2715/2717 and 2700/ 2701
Where the patient has a carer, consider having the carer present for the assessment and preparation of the GP Mental Health Treatment Plan or components thereof (subject to patient agreement).
GPs should ensure that:
• the steps involved have been explained
• a copy of Plan is offered to the patient
• a copy of Plan is added to the patient’s records.
Does this patient already have a GP Mental Health Treatment Plan completed within the previous
12 months?
Contact Medicare Australia ph.132 152
If yes, the GP can:
- ask the patient for a copy of the GP Mental Health Treatment Plan
- or, with patient's permission, attempt to obtain a copy of the Plan from previous GP;
- or, with patient's permission, contact allied mental health professional providing referred services
Then consider if existing plan is still appropriate for the patient. If necessary, the GP Mental Health
Care Plan may be reviewed using MBS item 2712 (Review of a GP Mental Health Care Plan).
Review - a systematic review of the patient’s progress against their GP Mental Health Treatment Plan
Patients with 2715/2717 and 2700/ 2701 should have at least one formal review (item 2712).
Usually four weeks to six months after the completion of a Plan (2715/2717 and 2700/ 2701)
Further review if required, three months or more after first review.
Generally not be claimed within four weeks of a claim for a referred psychiatrist assessment and management plan (item 291).
Don’t need to claim a 2712 to provide a repeat referral for psychological services but should review plan as part of decision.
Must include:
• record of patient’s agreement for the service ;
• reviewing the patient’s progress against the goals outlined in GP Mental Health Treatment Plan
• modifying the Plan, if required
• ongoing psycho-education
• plan for crisis intervention and/or for relapse prevention, if appropriate
• re-administration of the outcome measurement tool used in the assessment stage,
• a personal attendance by the GP with the patient.
GPs should ensure that:
• steps involved have been explained to the patient
• a copy of the reviewed Plan is offered to the patient
• a copy of the reviewed Plan is added to the patient’s records.
MH Consultation (2713):
This item is for the ongoing management of patients with a mental disorder. Surgery consultations, of at least
20 minutes duration , where primary treating problem is related to a mental disorder.
Can be used with or without has a Mental Health Treatment Plan.
Must include:
• relevant history and patient’s presenting problem(s) (if not previously documented;
• providing treatment, advice and/or referral for other services or treatment;
• documenting the outcomes of the consultation in the patient’s
Referring Patients:
Via Better Access (Medicare Pathway)
Eligible patients may be referred for up to 10 individual services and 12 group services of psychological services per calendar year . Until the end of December 2012, eligible patients may be referred for an additional
6 services in exceptional circumstances)
Exceptional circumstances apply where there has been a significant change in the patient’s clinical condition or care circumstances that requires further therapy.
Both the patient’s GP Mental Health Treatment Plan and referral should be annotated to briefly indicate the reason why the service involved was required
Exceptional circumstances do not apply to group services.
Referring Patients:
Via ATAPS or (Better Outcomes Pathway)
If the patient is on a health care card they may be referred for no cost individual services via the Division