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Dear SPPP members,

Changes to some Medicare item numbers will begin on March 1^st. Our Section has welcomed the changes, particularly the increase in the rebate for ECT administration, destigmatising the wording of item 319 and increasing the number of rebatable interviews with family and carers. This advocacy began in 2019 with the Medicare Review into Psychiatry and although it is pretty pleasing our calls have come to fruition it has taught me how long change can take, even when it is sensible change.

There will undoubtably be questions about the changes. Feel free to contact me at michelle.atchison@sa.gov.au if needed.

And a plug for the upcoming SPPP conference with the Adult Faculty conference August 16^th to 18^th in Sydney. If anyone has suggestions for speakers or workshops, please let me know.

With regards,

Dr Michelle Atchison
Chair Bi-national Section of Private Practice Psychiatry Committee

For further details, please read on.

New Medicare Psychiatry items from 1 March 2024 (Australia)

Changes will be made to Medicare Benefits Schedule (MBS) psychiatry item numbers from 1 March 2024 to implement the changes endorsed by the MBS Review Taskforce. These changes are the result of long-term advocacy by the College to secure these positive changes for private psychiatry.  

Key changes include:

• An increase for the ECT schedule fee from $74.55 to $162.55. 
• Introduction of 5 new time-tiered items (that mirror items 300 – 308) for psychiatrists to consult with people close to patients (usually families) and increasing the number of these services available to 15 per year. These are available via face-to-face and video. Three equivalent telephone items are also available that mirror items 300 – 304. The 15 consultations are counted from 1 March 2024.
• Amendments to the wording of item 319 to allow use where the formulation of the patient’s clinical presentation indicates intensive psychotherapy is a clinically appropriate and indicated treatment, removing the requirements for specific disorders or level of functioning. A new equivalent telehealth item has also been introduced.
• Amending the item descriptors for items 291 and 293 to strengthen the intent of these items and provide further clarity to providers regarding this intention.
• Clarification that inclusion of under 12-month-old infant (with a valid referral) can be considered a patient for group therapy item 346. 

The Department of Health and Aged Care (DoHAC) has further confirmed the following, starting 1 March 2024:

• A cap of 50 consultations will apply for services used over a 12-month period for face-to-face, video (mirroring items 300 to 308) and telephone (mirroring 300 – 304) by introducing 5 new video items and 3 new telephone items. Previously video and telephone consultations were not included in this 50 cap. After 50 consultations have been used in a 12-month period, a lower patient rebate using item numbers 310 to 318 (and video and telephone equivalents) will occur. These consultations limits will be counted from 1 March 2024.

The College has reiterated its preferred position that the cap of 50 services be abolished to allow for consistent rebates for people who require longer-term psychiatric care. The College has also requested that that usage be monitored to ensure that this does not limit access to affordable services for people who may require more regular check ins via telehealth. Service caps for item 319 (and telehealth equivalent) will remain at 160 consultations per calendar year.

Factsheets detailing the changes will be made available on the Department of Health and Aged Care website.

Please contact policy@ranzcp.org for further information.

Thank you for reading.