Medicare & mental health descriptions
In 2006 the Federal Government introduced the ‘Better Access to Mental Health Care’ initiative, under which General Practitioners, Paediatricians and Psychiatrists could refer to suitably qualified and experienced allied health professionals for the provision of ‘Focussed Psychological Strategies’. Accredited Mental Health Social Workers who have been issued a Medicare Provider Number, can receive referrals from the above listed Medical Practitioners. Accredited Mental Health Social Workers are able to provide ‘Focussed Psychological Strategies’ to eligible people with a diagnosed mental disorder under the Better Access initiative.
Depending on the health care needs of the 'client', the client may receive a maximum initial course of 'treatment' of six services.
Please note the Accredited Mental Health Social Worker must provide a report to the referring Medical Practitioner following the initial six sessions, or upon completion of the treatment, which could be upon the conclusion of less than six sessions. The referring Medical Practitioner should review the client, following receipt of this report. If it is determined that the client requires further allied mental health services, the client will need to obtain a new referral for additional sessions. The client may receive a further four sessions, to a maximum of ten individual sessions per calendar year. Individuals may also be referred for up to 10 group services per calendar year, in addition to the individual allied mental health services provided. The Accredited Mental Health Social Worker's report should include (as outlined by the Medical Benefits Scheme Explanatory Notes) information about the assessment/s carried out, treatment provided and recommendations for the ongoing and future management of the client's disorder.
Click here to view the Medicare Quick reference information about the program.
The Medicare Allied Health and Dental Care initiative (previously known as ‘Enhanced Primary Care’) commenced in July 2004 to provide Medicare rebates for allied health services delivered for the management of chronic disease. Accredited Mental Health Social Workers are eligible to provide these services under the category ‘mental health worker’.
The Medicare items can only be provided to people with chronic conditions and complex care needs who are being managed by a GP. The GP is required to develop a GP Management Plan and a written Team Care Arrangements in conjunction with at least two other allied health professionals and then provide referrals to those allied health services the team believes would most benefit the patient/client. A person with a complex and/or chronic medical illness can claim up to 5 visits (in total) to relevant allied health professionals within a calendar year.
To access the Chronic Disease Management Program Quick Reference Guide please click here.
From 1 November 2019, a suite of new Eating Disorder items are being introduced to support a model of best practice evidence based care for patients with anorexia nervosa and other eligible patients with eating disorders. These changes are relevant for medical practitioners (including a GP a psychiatrist or paediatrician), and eligible Accredited Mental Health Social Workers, Clinical Psychologists and Psychologists, Occupational Therapists and Dietitians.
To access the Eating Disorders Reference Guide please click here.
The Non Directive Pregnancy Support Counselling initiative commenced on 1 November 2006 to assist women who are concerned about a pregnancy. These services can be provided by eligible GPs, psychologists, accredited social workers (including accredited mental health social workers) and mental health nurses on referral from a GP.
Health professionals providing this service under Medicare must have completed mandatory training in non-directive pregnancy support counselling. A social worker can complete this training if they are a CPD accredited member of the AASW.
The Australian Psychological Society provides web-based Non Directive Pregnancy Support Counselling training, which takes approximately 3 hours to complete. The content of this training, as outlined by the Government for all professional groups eligible to offer this service, covers non-directive counselling techniques, knowledge and skills in the areas of pregnancy related concerns, and pregnancy related information on all options and services available through Government and non-Government agencies. Upon successful completion of the training, the social worker may apply to Medicare Australia for a Medicare Provider Number. This Provider Number can only be used for Non Directive Pregnancy Support Counselling provision (unless the social worker is also an Accredited Mental Health Social Worker).
For enquiries about applying for a Medicare Provider Number, please contact Medicare on 132 150 and firstname.lastname@example.org. You can apply for the Medicare Provider Number online here.
ATAPS is part of the Better Outcomes in Mental Health Care (BOiMHC) initiative introduced by the Australian Government in 2001. ATAPS enables GPs to refer their patients to allied health professionals who deliver Focussed Psychological Strategies. Allied health professionals are defined to include psychologists, social workers, mental health nurses, occupational therapists and Aboriginal and Torres Strait Islander health workers with specific mental health qualifications. As a social worker to be eligible to provide services through ATAPS, you must demonstrate that you have met the requirements for Accreditation as a Mental Health Social Worker.
In addition to the core funding (allocated by the Department of Health) for Focussed Psychological Strategies, the ATAPS program includes components for Child and Family Mental Health, Suicide Prevention and Perinatal Services.
ATAPS services are provided by Medicare Locals (ML) or prior to this GP Networks. In 2014, the Federal Government announced that as of 30 June 2015, MLs will be closed and replaced by what is called a Primary Health Network (PHN). There will be a one year transition period, in which Primary Health Networks will assume the service delivery roles of the previous Medicare Local. Post June 2016, PHN will have made arrangements for the services to delivered by other organisations locally.
MLs were and PHNs are independent entities. Accredited Mental Health Social Workers should contact their local PHN to develop a working relation and to discuss possible referral opportunities. Please note PHN are only temporary frontline service providers!
This section will be updated when more information is known.
The below documents refer to ATAPS and the provision of these services through Medicare Locals. Given that as of 30 June 2015, Medicare Locals will be replaced by Primary Health Networks - these documents will likely be updated by the Government. When any further information has been announced, this section of the website will be updated accordingly.