Additional 10 MBS Mental Health Sessions During COVID-19

From 9 Oct 2020 the government has allowed a further 10 sessions per client per calendar year until 30 June 2022. There's new item numbers and a few 'simplifications' that you need to be aware of though!

Readings and Resources

  • ACPA has a really good summary of these changes 
  • Medicare's factsheet is far more detailed but somewhat convoluted.
  • Medicare's searchable MBS item detail is as cryptic as ever 

Requirements

  • These same items have been available from 7 Aug 2020 but were limited to those people affected by a lockdown such as parts of Victoria. This limitation is removed since 9 October extending these items nationwide.
  • There must be a valid GP Mental Health Care Plan in place from a GP, Psychiatrist or Paediatrician (Referrer)
  • The first 10 sessions under that MHCP for the current calendar year have to have been used.
  • The usual reporting back to the Referrer has been completed and 
  • The Referrer has assessed the client as being appropriate for receiving the additional 10 sessions. NB: The Referrer does not have to complete a 2712 review or similar, a brief note is sufficient! (yes we double checked) 
  • It is possible that these additional 10 sessions can spill over into the new year, but no more than 20 sessions are permitted in any single calendar year. 

Usage

When a client says they want to access the additional 10 sessions under Medicare the following checks and actions are needed:

  1. Check that you have a valid referral from the GP
  2. Check your previous report back to the GP has been completed (it may not have been if there were a couple of spill over sessions in 2021 beyond the 6+4 sessions in 2020)
  3. This is a superseding authorisation - if you had extra sessions waiting for the 2022 calendar year from a previous referral that had reached it's full 10 sessions this year, then there spill over sessions in 2022 should be deleted.  
  4. Create a new "MHCP +10 Covid" session Pack in PowerDiary or similar in your Practice Management System. 

Example

The Medicare rules can be difficult and confusing to understand. Here's a worked example as an adjunct.

In this example we are assuming that the client is outside of the Victorian special case rules and consider each contact from the GP to be an "authority";  that is a 2701, 2712, a hand written referral note or even theoretically a contemporaneous notation during a phone call between the Referrer and the psychologist (although we recommend this being followed up by a faxed confirmation from the GP). We also assume that the first 6 sessions are done weekly with subsequent sessions done fortnightly. NB: Authority B is superseded on 16 Oct 2020 and the unused sessions are truncated.  For this example we presume that the clinician is a registered psych doing only face to face appointments for 50mins each. 

Date Desc MBS Item Auth A Auth B Auth C Auth D Auth E Auth F Limit pa
1 Feb ‘20 GP completes a 2701 for up to 6 sx   0 of 6           0 of 10
3 Feb ‘20 Initial assessment 80110 1 of 6           1 of 10
10 Feb ‘20 Sx 1 80110 2 of 6           2 of 10
17 Feb ‘20 Sx 2 80110 3 of 6           3 of 10
24 Feb ‘20 Sx 3 80110 4 of 6           4 of 10
2 Mar ‘20 Sx 4 80110 5 of 6           5 of 10
9 Mar ‘20 Sx 5 80110 6 of 6           6 of 10
10 Mar ‘20 Psychologist completes progress report back to GP                
12 Mar ‘20 GP completes 2712 review for up to 6 sx     0 of 6          
16 Mar ‘20 Sx 6 80110   1 of 6         7 of 10
30 Mar ‘20 Sx 7 80110   2 of 6         8 of 10
13 Apr ‘20 Sx 8 80110   3 of 6         9 of 10
27 Apr ‘20 Sx 9 80110   4 of 6         10 of 10
                 
9 Oct ‘20 Additional 10 sx announced                
14 Oct ‘20 Psychologist makes client aware of need to see GP                
15 Oct ‘20 Psychologist completes progress report back to GP                
16 Oct ‘20 GP bills standard consult and writes a paper note for up to 10 sx     4 of 4 0 of 10       10 of 20
19 Oct ‘20 Sx 10 93353     1 of 10       11 of 20
2 Nov ‘20 Sx 11 93353     2 of 10       12 of 20
16 Nov ‘20 Sx 12 93353     3 of 10       13 of 20
30 Nov ‘20 Sx 13 93353     4 of 10       14 of 20
14 Dec ‘20 Sx 14 93353     5 of 10       15 of 20
28 Dec ‘20 Sx 15 93353     6 of 10       16 of 20
11 Jan ‘21 Sx 16 93353     7 of 10       1 of 20
25 Jan ‘21 Sx 17 93353     8 of 10       2 of 20
8 Feb ‘21 Sx 18 93353     9 of 10       3 of 20
22 Feb ‘21 Sx 19 93353     10 of 10       4 of 20
23 Feb ‘21 Psychologist completes progress report back to GP                
25 Feb ‘21 GP completes 2712 review for up to 6 sx         0 of 6      
8 Mar ‘21 Sx 20 80110       1 of 6     5 of 20
22 Mar ‘21 Sx 21 80110       2 of 6     6 of 20
5 Apr ‘21 Sx 22 80110       3 of 6     7 of 20
19 Apr ‘21 Sx 23 80110       4 of 6     8 of 20
3 May ‘21 Sx 24 80110       5 of 6     9 of 20
17 May ‘21 Sx 24 80110       6 of 6     10 of 20
18 May ‘21 Psychologist completes progress report back to GP                
20 May ‘21 GP completes 2712 review for up to 6 sx - NB: if the referral is > 4sx then we will refer back for the additional 10 rather than doing the 5 and 6th session.            0 of 6    
31 May ‘21 Sx 25 80110         1 of 6   11 of 20
14 Jun '21 Sx 26 80110         2 of 6   12 of 20
28 Jun '21 Sx 27 80110         3 of 6   13 of 20
12 Jul '21 Sx 28 80110         4 of 6   14 of 20
13 Jul '21 Psychologist completes progress report back to GP requesting an additional 10 sx                
14 Jul '21 GP bills standard consult and writes a paper note for up to 10 sx           4 of 4 0 of 10  
26 Jul '21 Sx 29 93353           1 of 10 15 of 20
9 Aug '21 Sx 30 93353           2 of 10 16 of 20
23 Aug '21 Sx 31 93353           3 of 10 17 of 20
6 Sep '21 Sx 32 93353           4 of 10 18 of 20
20 Sep '21 Sx 33 93353           5 of 10 19 of 20
4 Oct '21 Sx 34 93353           6 of 10 20 of 20
...                  
10 Jan ‘22 Sx 35             7 of 10 1 of 20
24 Jan '22 Sx 36             8 of 10 2 of 20
7 Feb '22 Sx 37             9 of 10 3 of 20
21 Feb '22 Sx 38             10 of 10 4 of 20
  Psychologist completes progress report back to GP
               
etc                  
 30 Jun '22 Covid items are no longer valid                

 

 

Setup 

Ask us to help or you can add the following service items to your practice management system 

Qualification Delivery Duration Item Number
Clinical Psychologist F2F 30-50 mins 93330
Clinical Psychologist Videoconference 30-50 mins 93331
Clinical Psychologist Phone 30-50 mins 93332
Clinical Psychologist F2F 50 mins + 93333
Clinical Psychologist Videoconference 50 mins + 93334
Clinical Psychologist Phone 50 mins + 93335
Psychologist F2F 30-50 mins 93350
Psychologist Videoconference 30-50 mins 93351
Psychologist Phone 30-50 mins 93352
Psychologist F2F 50 mins + 93353
Psychologist Videoconference 50 mins + 93354
Psychologist Phone 50 mins + 93355

 

Resources 

See file attached designed to help GPs to get across this material or you're welcome to use the link below and/or QR code which works on most faxes: 

https://clinicalpsychology.zendesk.com/hc/en-gb/article_attachments/900005916906/TipSheet_CovidVsBetterAccessItems.pdf

 

References

https://acpa.org.au/additional-10-mbs-mental-health-sessions-during-covid-19/

http://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/Factsheet-10MentalHealthSessions

 

 

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