Restrictions or requirements
Referrals
• A GP must refer you to a paediatrician or psychiatrist for an MBS benefit to be paid.
• A paediatrician or psychiatrist must refer you to an allied health professional for an MBS benefit to be paid.
• When referring patients to allied health assessment services to assist in making a diagnosis, any of the following relevant items must be used:
- Paediatrician – standard attendance items 110 to 131 or telehealth items 91824, 91825, 91826 or 91836.
- Psychiatrist – standard attendance items 296 to 308, 310, 312, 314, 316, 318 or 319 to 349, or telehealth items 91827, 91828, 91829, 91830, 91831, 91837, 91838, 91839,
• Allied health providers can refer to another allied health professional for an assessment however, the referring paediatrician or psychiatrist must agree.
Assessment services
• Up to 8 allied health assessment services are available per lifetime. Up to four of these services can be provided to the patient on the same day.
• A report must be prepared for the referring paediatrician or psychiatrist after the final allied health assessment.
• The assessment services are to assist the referring paediatrician or psychiatrist with their diagnosis.
• Assessment services where the psychologist makes the diagnosis, or the diagnosis is not confirmed by the referring paediatrician or psychiatrist, are not claimable through Medicare.
Patients 25 and over
• GPs can use general time-based appointments to initially assess and refer patients to psychiatrists to undertake a comprehensive assessment and diagnosis.
• Psychiatrists can undertake assessment or diagnosis during an appointment. There are several initial or time-based Medicare items available for this.
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