Mental Health Care Plans, Referrals & The New Year – Let’s try and make it a little less confusing!
Often there is confusion in the new calendar year about the requirements under Medicare for managing clients on a GP Mental Health Treatment Plan (MHTP).
We frequently receive queries around this time of year about whether the GP needs to prepare a new MHTP or provide a new referral when an existing client is going to continue to receive psychological services in 2018.
Check out the video below where Clinical Psychologist, Dr Danielle McCarthy, clears the air about what is and isn’t needed in the new year in order to receive psychological services. .
Danielle McCarthy: People often come in with a referral from their GP who has referred them to see us. In one referral, they can receive up to 6 sessions. So their GP can refer up to 6 sessions under one referral letter. That’s why after those 6 sessions you’re asked to go back to see your GP (if you still require ongoing psychological treatment), as we need a new referral to approve additional sessions.
In a calendar year you can receive up to 10 sessions. A calendar year runs from January through to December. It doesn’t matter whether your MHTP was made in June, or August, or January – it doesn’t matter. You can receive up to 10 sessions between January to December. Say you come and see us in February and you have 6 sessions, then your psychologist sends you back to your GP to get a new referral letter. At this stage often the second referral approves 4 sessions because that adds up to 10. You then come back and use those 4 additional sessions and that might take you through to August. If you still continue treatment at this stage you can use your private health to assist with funding your session/s as you will no longer be able to receive a Medicare rebate.
Now where it gets confusing is say you come and see us in November (to begin treatment) and you use 3 sessions from November through to December and then we close for Christmas and we reopen in January. At this time, you do not need a new referral letter. You’ve only used 3 sessions. However, now it’s a new year, you can receive up to 10 sessions. So you’ve used 3 this year and then next year rolls around, you’ve got 3 more sessions (6 in total) before you need to go back and see your GP.
It gets slightly more tricky now as you’ve actually only had 3 in the new calendar year. So we can actually ask for approval for an additional 6 sessions if we think you need it. So we would ask you to see your GP and get a new referral letter approving up to another 6 sessions. After you’ve used those 6, you would have had 9 in total in the new calendar year (as you had 3 at the beginning). You actually still have another 1 session you can potentially access. So crazy as it may seem, you would need to go back to see your GP to get approval for that final session. Hopefully that’s making sense. So 10 per calendar year but each referral from your GP can only approve up to 6 sessions at a time.