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 only. The 15 consultations are counted from 1 March 2024. These new items replace existing MBS items 348, 350 and 352. 
• 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 telehealth item has been introduced (equivalent to the amended item 319). 
• 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 that, from 1 March 2024:

• Items 348, 350 and 352 will be removed from the item descriptor for use with item 294, as they do not meet legislative definition of professional attendance. Their replacement MBS item numbers from will not be included on the 294 item descriptor. 
• 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 or 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.

In view of these changes, that will have an adverse impact on access to affordable care, the College will continue its discussions with DoHAC to advocate for affordable and high quality care under the MBS. 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. 

For further information, please contact policy@ranzcp.org.