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Frequently Asked Questions (FAQs) for Accredited Mental Health Social Workers

Medicare provider enquiries (Medicare program)
Medicare's contact page for health professionals can be accessed here.
Phone: 132 150
Email: medicare.prov@humanservices.gov.au
Post: Medicare, GPO Box 9822, [Your capital city]

Useful links for Accredited Mental Heath Social Workers

The Department of Human Services

The Fundamentals for all health professionals participating in the Medicare Program: http://medicareaust.com/MBS/NewHealthProfessionals/Welcome/index.html

Information on referral pathways for allied health professionals: http://medicareaust.com/MBS/PrimaryCareItems/Module2/index.html

Information about Medicare Provider Numbers: https://www.humanservices.gov.au/health-professionals/services/medicare/medicare-provider-number-health-professionals

The Department of Health

MBS Online: http://www.health.gov.au/mbsonline

Access to mental health professionals through Medicare (Better Access initiative): http://www.health.gov.au/mentalhealth-betteraccess

Frequently Asked Questions

Who can use the MPN issued to me by Medicare Australia?

Your MPN is used to identify you and your practice location when processing claims. Your MPN cannot be used to claim services provided by other health professionals. Under the Health Insurance Act 1973 you are legally responsible for services billed to Medicare under your MPN or in your name and you are responsible for paying back any Medicare benefits in the event that an incorrect benefit was claimed.

Which Item Numbers can I use?

Please see the Medicare Benefits Schedule (MBS) for item numbers and descriptors. The AASWs summary of the MBS and item numbers for Social Workers can also be accessed here. AMHSWs with MPNs can utilise the listed item numbers unless otherwise specified. Please contact the Medicare Provider Number Hotline for further enquiries on 132 150.

If my AASW membership and/or AMHSW status lapse or are not renewed, what are the implications if I hold a MPN?

To remain eligible for an MPN, a social worker must remain a current AASW member and AMHSW. Should one or both of these lapse or you choose to resign your membership/accreditation, you will no longer meet the requirements for an MPN and Medicare will be notified.

If my AASW membership and AMHSW status has lapsed or has not been renewed, how is this reinstated?

Please complete the Application for reinstatement of Accredited Mental Health Social Worker (AMHSW) status. You will need to be a current AASW member and meet all of the criteria outlined in this form in order to reinstate your AMHSW status.

What should I do if I am unable to continue with practicing as a social worker for a period of eg 6-12 months?

Please contact Membership and the Mental Health team to discuss on (03) 9320 1077 or email mental.health@aasw.asn.au.

How are fees set?

Please see the Medicare Benefits Schedule (MBS). The AASWs summary of the MBS and item numbers for Social Workers can also be accessed here. Please contact the Medicare Provider Number Hotline for further enquiries on 132 150.

What is the referral process?

A GP, Psychiatrist or Paediatrician may refer clients to an AMHSW. Referring practitioners are not required to use a specific form to refer patients for these services. The referral may be in the form of a letter, or note to an eligible allied mental health professional signed and dated by the referring practitioner. A referral must be received by the AMHSW prior to the first session.

On completion of the initial course of six treatments, the allied mental health professional must provide a written report to the referring medical practitioner, which includes information on assessments carried out, treatment provided, and recommendations on future management of the client’s disorder. A written report must also be provided to the referring medical practitioner at the completion of any subsequent course(s) of treatment provided. Following receipt of this report, the referring practitioner will consider the need for further treatment, before referring the patient for further allied health services.

Please see the Medicare Benefits Schedule for further information regarding referrals.

Who can refer?

GPs, Psychiatrists and Paediatricians may refer clients to an AMHSW.

What constitutes a valid referral?

A valid referral must be made via:
• a GP following the formulation of a Mental Health Treatment Plan or
• a Psychiatrist or Paediatrician, who following an assessment or diagnosis, may refer directly for allied health mental health services.

Referrals do not need to be addressed to a particular social worker by name or specialty. As such, a referral addressed to a business name would be considered valid where the social worker from that clinic has the appropriate discipline to treat the condition for which the patient is being referred and is registered with Medicare to provide the services.

If a referral for services notates the discipline as a profession other than social work (such as psychology), the GP (or referring professional) should be contacted to confirm the profession of the treating professional; the referring professional would then need to raise a new referral for services by the social worker.

How do clients claim the rebate?

There are a number of ways to claim the Medicare rebate:
• Provide a tax invoice to the client who will pay you. The client can then take the receipted invoice to Medicare to claim the rebate back. If you are charging over the rebate then the client would need to pay the gap to you as well.
• Bulk billing – You will need to register with Medicare for bulk billing. Medicare have forms that need to be completed. You can also register to have the payment electronically transferred to your bank account.
• Provide a tax invoice to the client, the client would then take the unpaid account to Medicare. Medicare will then assign the rebate to you as the practitioner but give it to the client to pay you. If you are charging over the rebate then the client would need to pay the gap to you as well.

For further information on claiming the Medicare rebate, Medicare can be contacted on 132 150.

Can services under Medicare be provided over the telephone?

Services under Medicare are specified as ‘professional attendance’ and therefore require face to face attendance for a Medicare benefit to apply. Other methods of service delivery, such as over the telephone, internet or via video link are not allowable under the Medicare Benefits Schedule (MBS) social worker items.

The federal government has recently announced the introduction of a new Medicare rebate for online videoconferencing consultations with Accredited Mental Health Social Workers. From November 1, people in rural and regional Australia will be able to claim a Medicare rebate for online videoconferencing consultations with psychologists, AMHSWers and other health professionals. Please visit our Medicare telehealth items webpage for further information.

Can I do ‘home visits’?

Where a professional attendance at a patient’s home is necessary to achieve therapeutic outcomes the attendance may be provided under Medicare Benefits Schedule items where the descriptor states “Professional attendance at a place other than consulting rooms”. However, where the item descriptor states, “Professional attendance at consulting rooms”, it is compulsory for the service to be performed at the social worker’s consulting rooms.

Will I be audited? What is the process?

Each year, Department of Health (Health) conducts health provider compliance audits and reviews in accordance with the legislation to ensure the correct services were provided, that the provider, patient and service were all eligible for benefits, and that the service provided meets the item requirements. If you have been chosen to participate in an audit Health will notify you by mail about this. Health may request that you provide copies of documents relating to specific claims. Further information can be found here.

Additionally, each year the AASW conducts a CPD audit on a random selection of AMHSWs where all aspects of the CPD records will be reviewed. AMHSWs who are selected to participate in the CPD audit, will be notified in writing via email and mail. For further information about the CPD Audit please contact the Mental Health Team on (03) 9320 1077 or email mental.health@aasw.asn.au.

What are the approved Focused Psychological Strategies?

Focused Psychological Strategies (as listed in the Medicare Benefits Schedule) are:
1. Psycho-education (including motivational interviewing)
2. Cognitive-behavioural therapy including:
• Behavioural interventions
• Behaviour modification
• Exposure techniques
• Activity scheduling
• Cognitive interventions
• Cognitive therapy
3. Relaxation strategies
• Progressive muscle relaxation
• Controlled breathing
4. Skills training
• Problem solving skills and training
• Anger management
• Social skills training
• Communication training
• Stress management
• Parent management training
5. Interpersonal therapy (especially for depression)
6. Narrative therapy (for Aboriginal and Torres Strait Islander people)

For further information regarding this please review the Department of Health's website.

AASW - Australian Association of Social Workers