Mental Health Care Plans & Mental Health Treatment Plans

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What is the difference between a Mental Health Treatment Plan and a Mental Health Care Plan?

Mental Health Treatment Plan and Mental Health Care Plan are often confused but are essentially the same thing. These terms can be used interchangeably to refer to a structured plan that your General Practitioner (GP), has developed to manage your presenting mental health condition. This plan will outline your mental health goals and provide information on the services and treatments that you can expect. It will also include steps to help you achieve those goals. Many government publications and clinical sources refer to and adopt a newer term, MHTP.

How much does it cost to get a MHTP?

We charge a once-off yearly amount of $55, which covers the administrative costs of communicating with your Psychologist or other Healthcare professional.

The MHTP is then Bulk Billed using the relevant time-based item #s. Other healthcare professionals associated with your service are also Bulk Billed. Of course, this applies to eligible Medicare Card and DVA card holders. You can pay privately if you do not have an eligible card to allow rebates. These are again time-based and vary. These privately billed consultations can be quoted at the time of consultation.

Time-based consultations on Medicare can be found at:

http://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/Home

If you want to ask further questions about the costs and service, call us on 1300 900 863. Alternatively, you can fill out our form on the ‘Contact Us’ page.

What is a Mental Health Treatment Plan (MHTP)?

Mental Health Treatment Plans (MHTP) are tailored strategies created for patients who are suffering from a mental health disorder.

A MHTP outlines the support, goals and actions the patient and their GP (General Practitioner) agreed on. The plan is developed with the GP to meet each patient’s specific needs. This plan can be viewed as a road map for treating and managing an individual’s mental healthcare needs.

In 2022, Medicare updated the rebates and eligibility criteria for obtaining a Mental Health Treatment Plan via your GP. With this revision, patients can now receive a Medicare rebate for each session with a mental healthcare professional.

The Medicare rebate for a mental health consultation with a GP is currently:

Item #s, 92112, 92113, 92118, 92123

A Mental Health Treatment plan allows a GP to grant up to 10 sessions with a psychologist, the rebating being $89.65, and $131.65 when you visit a clinical psychologist.

Initial Consultation Process:

During your first consultation, a nurse will spend about 20 minutes gathering your medical history. This can be done with either the patient or a designated carer/family member. This detailed history helps our GP formulate an appropriate MHTP.

Booking & Duration:
You will have two consecutive appointments: one with a nurse and then a GP. The GP consultation also lasts a minimum of 20 minutes. The two appointments will be booked together for extended consultations.

Medicare Rebate:
Our healthcare professionals, with provider numbers, base the Medicare rebate on the consultation duration.

Mental well-being is crucial. Australia’s structured approach ensures appropriate care.

What are the Benefits of getting a Mental Health Treatment Plan?

Getting a MHTP has a massive financial benefit, as opposed to seeking out mental health help privately. With a MHTP, you can receive Medicare rebates for up to ten individual therapy sessions and ten group therapy sessions each calendar year. These sessions can be with registered social workers, psychologists, occupational therapists, or other certified therapists.

An MHTP isn’t a one-size-fits-all approach. Instead, it’s tailored to your specific conditions, needs, and mental health objectives, ensuring you receive targeted and effective care.

Obtaining a MHTP from a qualified GP enhances collaboration among healthcare providers. With a clear plan in place, coordination with your psychologist, psychiatrist, or other mental health professionals becomes more straightforward.

How many Psychologist sessions am I able to achieve with a MHTP?

Mental Health Treament Plans are designed in Australia to offer up to 10 individual therapy sessions and 10 group therapy sessions per calendar year to people with mental disorders. This allowance resets each calendar year on January 1, with no chance for sessions not used to be carried over into the following year.

When do I need to see my GP to increase my sessions?

Feel free to contact your GP anytime you have questions or need clarity regarding your health. Schedule a Telehealth consultation online, and if your GP is on roster, you’ll typically get a same-day appointment.

Under the Mental Health Treament Plan, there’s a mandated consultation schedule with your GP, known as the 6-4-6 rule:

  1. Consult your GP before your first therapy session.
  2. After your initial 6 sessions, visit your GP.
  3. Following another 4 sessions, see your GP again.
  4. After another 6 sessions, consult with your GP.

How hard is it to get a Mental Health Treatment Plan?

To qualify for a Mental Health Treament Plan (MHTP), the fundamental criteria is that, in the GP’s sole judgment, the patient must be experiencing a current mental health condition or disorder. Our GPs and Nurses are seasoned in discussing and diagnosing mental health disorders. They’re optimally placed to evaluate your situation. Based on their assessment, they might recommend:

  1. A consultation with a Psychiatrist, which would necessitate a specialist referral.
  2. Consultation with a Psychologist, where an MHTP is needed to qualify for Medicare Bulk Billed consultations.
  3. Seeking guidance from a counsellor.

Mental health disorders can vary widely. They might be milder conditions like depression, anxiety, or more severe and complex disorders. It’s essential to note that your mental health should not inhibit your daily activities.

Ultimately, your GP will decide on your eligibility for an MHTP. They’ll assess your mental health, examine your symptoms, and determine if a MHTP is suited for your needs.

What are the eligibility criteria for a MHTP referral under the Medicare scheme?
MHTPs cover a wide range of mental health conditions, including but not limited to:

  • Adjustment disorders
  • Phobic disorders
  • Generalised Anxiety disorder (GAD)
  • Depression
  • Panic disorders
  • Eating disorders
  • PTSD Post Traumatic Disorder

MHTP can also cover other conditions such as post natal depression. However we recommend that you firstly consult with a GP to ascertain whether they feel you are eligible for Medicare rebated consultations. Mental Health does not neatly fit into these categories and when in doubt our Doctors will refer on to a more specialised healthcare professional to establish the best treatment plan for you. Bottomline if your mental health is affecting your daily life enjoyment of life for more than 2 weeks you should definitely seek advice from our doctors.

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FAQs on MHTP

Frequently Asked Questions
Are you able to provide a MHTP for my child?

Absolutely. You have the option to choose from a range of psychologists specialising in Child Psychology and specific childhood mental health conditions.

Out of the 10 sessions covered under the MHTP, parents can attend 2. However, your child must be present for the remaining 8 sessions.

The psychologist will guide you on the best frequency based on your child’s needs. Whether you choose to have the sessions close together or spread them throughout the year, ensure your MHTP remains updated. You will always receive the Medicare rebate for these sessions.

The 6-4-6-4 rule still applies with MHTP for children, meaning you’re required to have GP appointments after the 6th and 10th sessions. It’s crucial to always consult with your GP about Medicare entitlements.

If for any reason you’re not eligible for a Medicare-rebated session, appointments can still be made and will be charged as a private fee.

How Long Do I Need to Wait for a MHTP from the GP?

The process of obtaining a MHTP involves two steps. First is the initial consultation to gather all the details of your clinic history and assess your eligibility for Medicare rebatable referrals with a Psychologist. This can be on the same day if desired. The second part is a consultation with the GP which will take a minimum of 20 mins. This could be longer depending on your own individual case. We do not restrict a GP on time. Medicare rebates are time charged. Depending on your condition and the GP’s sub-specialty interests and experience, you will be matched with the appropriate GP for you. The appointment time could be the same day. This is best discussed with the nurse in the initial consultation. During the appointment, your GP will assess your mental health and discuss potential treatment options with you. Our GPs are specialised in mental health and are able to provide a high level of care for those suffering.

Can I have a MHTP Done Online with a Doctor or Does it have to be with the GP Face-to-Face?

At Phenix Health, we only provide online and telehealth MHTPs, making the process convenient and efficient for you.

The consultations can be through either telephone or video consultation. However, if a GP suggests it might be more beneficial to you for a face-to-face, then we are able to refer you to an appropriate GP in your area based on postcode.

For complex cases, it is best to check in with the subspecialties listed on the website to see if they may offer consultations with a best-matched Psychologist.

It’s important to note that not all medical practices may offer this service, so it’s worth checking in advance. Remember, the quality of care remains the same, whether you have your consultation online or face-to-face.

What are the steps for getting a MHTP from a GP?

The first step is to book an initial consultation through our online booking form from our website or call 1300 900 863.

You will then be booked for a virtual appointment with our nurses who will go through and take a detailed medical and family history and perhaps ask about changes to your personal life circumstances.

At the same time a GP will be booked to call you to go through a more thorough consultation to discuss your mental health concerns. After this consultation, the doctor will proceed to complete the MHTP, which will be sent to your psychologist. We are able to recommend ‘Talked’ as our preferred partner as they share similar values and service offering. They are also great at matching the most suitable Psychologist for your treatment plan.

All referrals are confidential and the passing of any information to your Psychologist or other healthcare professional will be treated with the utmost respect for your privacy and security of information.

Can I choose my own Psychologist?

Yes, you can choose your own psychologist!

A MHTP doesn’t tie you to a specific psychologist chosen by your GP and the choice of psychologist ultimately remains with you. Your GP may suggest or recommend certain psychologists based on their knowledge and experience, but you’re not obliged to choose these professionals.

You can research psychologists yourself, considering factors such as their areas of expertise, treatment approach, location, and availability. Once you’ve made your choice, you can inform your GP, who will then make the referral.

The Medicare rebate for a MHTP consultation is higher than a standard GP visit due to the additional time and complexity involved. It’s a good idea to ask about the cost when you book the appointment so you can prepare accordingly.

Will my MHTP Expire?

Typically all referrals to specialist services expire in 12 months from the date of service. However, the Medicare rebate is only available for up to ten individual and ten group therapy sessions per calendar year. If you use all these sessions and need further psychological support within the same year, you may need to discuss other funding options with your psychologist.

If you haven’t used all your sessions within the year, you’ll need a review appointment with your GP to access the remaining sessions. This review is an opportunity to assess your progress and make any necessary changes to your MHCP.

What do I do when my MHTP expires?

After 12 months if you have used all your Medicare rebateable Bulk Billed consults and still feel you need to see a Psychologist, you will need to ask your Psychologist if they can contact the GP and ask if further consultations can be provided to you under a MHTP.

This is a discussion that is undertaken between the two healthcare professionals. Of course, you are still able to continue your treatment with the Psychologist but it will be on a private paying model only.

In order for the GP to establish if you are entitled to a new MHTP they will need an additional consultation to review a new plan. Your plan may be altered to your benefit solely depending on the nature of your consultation.

Your current mental health and well-being are assessed and valued during the consultation process.

What about the costs of my Psychologist consultations?

We will refer you to the psychologist services, who are third-party consultants. We do not have influence over how much external consultants will charge.

The most appropriate match Psychologist may offer their services Bulk Billed. There may be others that will charge a ‘Gap fee’ (out-of-pocket charge). This is because the Medicare rebate may not be considered enough to cover the particular Psychologists charges.

They are entitled to charge according to their experience and speciality as they are private practice. There are other mental care services such as counsellors that may not be registered for Medicare rebates, as such these consultations will be entirely privately billed. Check the website we refer you to and speak to them directly to know the true cost before booking the service.

Can you explain the ‘Gap Fee’ a little more?

If a Psychologist advertises their service fee as $200 and the Medicare rebate for the time-based consultation is only $91.25, for example, then you will have to pay the difference of $108.75.

This works by paying the entire amount of the $200 and then the Psychologist clinic will process Medicare for which you will receive $91.25 back into your registered nominated bank account with Medicare.

If you are still unclear, please ask the administration and Billing staff to clarify this further. It can sometimes be confusing.

A purely Bulk Billed consultation by a GP or Nurse is billed at the Medicare nominated amount. This will be paid directly into the healthcare professionals account as payment in full for the services. Always discuss prior to booking whether you will be paying a gap fee or not.

What should I say to the GP in the consultation?

This appointment is about how you are feeling. It is natural and normal at first to feel nervous or perhaps embarrassed. Your GP has experience in understanding. The main reason you require this consultation is so the GP can assess your current condition, symptoms and thoughts. They will also need to know whether your situation requires an immediate plan if you are experiencing elevated thoughts, self-harm, or suicidal thoughts. The GP wants to know how this is impacting your life. Please share this to the best of your ability. If you do not feel comfortable discussing your whole story with the GP it may be best to save this until you receive an appointment with a Psychologist or counsellor.

What topics will the GP’s potential questions cover?

The GP may cover topics like your:

  • Physical health
  • Current medications you are on
  • Previous assistance
  • Family history and mental illness
  • Your environmental influences
  • Your family and cultural influences
  • Lifestyle and relationships
    our life goals and motivations
  • School, University and work stresses
  • Your emotional state

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