MENTAL HEALTH CARE PLAN (MHCP) REFERRALS
INITIAL MHCP (ITEM 2715/2717):
- Can only be billed once per calendar year per patient
- Cannot be billed again within 3 months of the last review or plan
REVIEW OF MHCP (ITEM 2712):
- May be claimed once every 3 months, but not within 4 weeks of the original MHCP
REFERRAL LIMITS:
- A maximum of 10 individual psychological sessions per calendar year can be accessed under Medicare
- Initial referral can cover up to 6 sessions, with further 4 sessions requiring a review and additional referral
IMPORTANT MBS ITEMS FOR REFERENCE:
2715, 2717 (Develop Plan)
2712 (Review Plan)
272, 276, 281–282, 2700–2701 (Assessment + Treatment)
92112–92113, 92116–92119, 92122–92123 (Telehealth Equivalents)
SEE FULL TABLE BELOW
ALWAYS CHECK MBS ONLINE FOR CURRENT ITEM NUMBER USAGE
GP Frequently Asked Questions
HOW LONG IS A MHCP VALID FOR?
MHCP referrals are valid for 2 years from the referral date.
Referrals cover the number of sessions specified and do not expire at the end of the calendar year. Any unused sessions can be carried over into the next year.
HOW MANY INDIVIDUAL THERAPY SESSIONS ARE COVERED UNDER A MHCP?
Patients can receive up to 10 therapy sessions per calendar year:
- Initial Referral: 6 sessions
- Review Referral: Up to 4 more if clinically justified
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CASE EXAMPLE – STEVE’S MHCP:
February 2024:
Steve begins therapy under a MHCP referred by his GP, Dr. Smith, to manage his anxiety. He starts with 6 sessions.
April 2024:
Steve attends therapy with Clinical Psychologist, Julijana. Over the following months, Steve works on managing his anxiety and begins to feel more in control of his symptoms.
July 2024:
As Steve’s 6 initial sessions come to an end, Julijana writes to Dr. Smith, updating him on Steve’s progress. While Steve has made significant strides, Julijana suggests 4 additional sessions to further consolidate his progress. Dr. Smith agrees, and the referral is extended.
December 2024:
By December, Steve feels much better and has made significant improvements in managing his anxiety. He no longer feels the need for further therapy at this stage. Julijana writes to Dr. Smith to confirm this, summarising Steve’s positive progress.
January 2025:
As the new year begins, Steve is automatically eligible for 10 new sessions under his MHCP, should he need them.
HOW MANY GROUP THERAPY SESSIONS ARE INCLUDED UNDER A MHCP?
Patients can access up to 10 group therapy sessions annually in addition to their individual therapy allocation.
WHEN IS A MHCP REVIEW REQUIRED?
A review is necessary if:
- The patient’s mental health status changes significantly.
- The MHCP is expiring and an updated treatment plan is required.
Reviews can be scheduled:
- First review: No sooner than 60 days after the initial plan.
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Subsequent reviews: At least 90 days apart.
HOW DOES PRE-EMPTIVE HEALTHCARE HANDLE REFERRALS?
At Pre-Emptive Healthcare, we use a structured triage system to connect patients with the most appropriate clinician. Our Clinic Director and Practice Manager review referrals to match patients with a psychologist suited to their needs.
HOW SHOULD REFERRALS BE ADDRESSED?
Under Medicare Australia, referrals are not required to be directed to a specific clinician. Even if a referral names a particular provider, the patient has the option to see any qualified clinician within the practice.
For efficient processing, we recommend that GPs address referrals to “Pre-Emptive Healthcare” rather than a specific clinician. This enables us to allocate patients based on the clinician’s expertise and the urgency.
However, if a patient prefers to see a specific clinician, they are welcome to do so. Please indicate this preference in the referral.
WHAT ARE THE FEES?
We are a private billing clinic and do not offer bulk billing. Our fees are considerably lower than the recommended rates set by the APS, with typical gap fees ranging from $100 to $140 per session.
WHERE CAN I SEND THE REFERRAL?
PSYCHOLOGICAL SCREENERS
Recent + Upcoming Changes
Starting in July 2025, a simplified GP Chronic Condition Management Plan will replace the current system. More information here.