Changes to Medicare Benefits Schedule (MBS) mental health items from 1 November 2025 – Non-VR GPs (‘prescribed medical practitioners’)

Changes to Medicare Benefits Schedule (MBS) mental health items from 1 November 2025 – Non-VR GPs (‘prescribed medical practitioners’)

Advocacy > Advocacy resources > Changes to MBS mental health items from 1 November 2025 – Non-VR GPs
Last updated 17 November 2025

Disclaimer

As per the RACGP Statement on Medicare interpretation and compliance: As with all specialist medical colleges, the RACGP has no legal authority to interpret MBS rules and regulations. There is no guarantee that Medicare will consider the use of an MBS item number appropriate, even if the RACGP does. It is the responsibility of the treating practitioner to ensure that any service billed to Medicare meets the item descriptor in the MBS and any eligibility requirements in full. You should maintain appropriate patient notes to demonstrate how you meet the descriptor of any Medicare service billed. Any further enquiries relating exclusively to interpretation of the MBS can be emailed to askmbs@health.gov.au.

FAQs

  • Review of a mental health plan – items 277 (F2F), 92120 (video) and 92132 (phone) 
  • Mental health consultation >20 mins – items 279 (F2F), 92121 (video) and 92133 (phone) 

MBS items for the preparation of a Mental Health Treatment Plan (MHTP) remain in place. For non-VR general practitioners (GPs) these are: 

  • F2F – 272 (20-40 mins, without MH training), 276 (>40 mins, without MH training), 281 (20-40 mins, with MH training), 282 (>40 mins, with MH training) 
  • Video – 92118 (20-40 mins, without MH training), 92119 (>40 mins, without MH training), 92122 (20-40 mins, with MH training), 92123 (>40 mins, with MH training) 

These items are included in this MBS guide developed by the RACGP for non-VR GPs/prescribed medical practitioners (PMPs). Note: This guide was developed for PMPs working in Aboriginal and Torres Strait Islander health, but the item numbers included are also relevant to PMPs working outside of this sector. 

From 1 November 2025, MHTP preparation, referrals for psychological therapy services or focussed psychological strategies (FPS) services, and reviews of a patient’s MHTP can be provided by either: 

  • a GP or PMP at the general practice in which the patient is enrolled in MyMedicare OR 
  • regardless of whether the patient is enrolled in MyMedicare, by the patient’s usual medical practitioner. A patient’s usual medical practitioner is a GP or PMP: 

(a) who has provided the majority of services to the person in the past 12 months; or 

(b) who is likely to provide the majority of services to the person in the following 12    months; or 

(c) who is located at a medical practice that: 

(i) has provided the majority of services to the person in the past 12 months; or 

(ii) is likely to provide the majority of services to the person in the next 12 months. 

The Department of Health, Disability and Ageing (DoHDA) recognises patients can choose to see their usual medical practitioner irrespective of their existing MyMedicare registered status. This enables people to structure their physical and mental health care requirements in line with personal preference, which can commonly look like seeing a different medical practitioner for mental health support needs for a wide variety of reasons.  

Patients will continue to have discretion to determine their usual medical practitioner for the purposes of their mental health support needs. For example, if a patient is registered with a MyMedicare practice but wishes to see a GP at another practice as they consider them to be their ‘usual medical practitioner’ for their mental health support needs, there is nothing precluding the patient from doing so because of the changes coming in to effect under Better Access from 1 November 2025. 

It is a legislative requirement that GPs and PMPs can only provide telehealth services for new MHTPs if they are the patient’s MyMedicare registered practice or usual medical practitioner and have an established clinical relationship with the patient. This means the patient must have had at least one face-to-face visit in the past 12 months with their GP or PMP at their usual medical practice, or meet an specific exemption category.

More information on telehealth requirements is available at MBS Telehealth Services on MBS Online. 

Flexibility has been retained and built into the Services Australia system for the Better Access initiative to allow patients to be able to see different referring practitioners for review and further referrals for mental health treatment services under usual medical practitioner requirements. 

GPs and PMPs should check a patient’s eligibility and be aware they have obligations to ensure all rules, conditions and eligibility requirements outlined in legislation are met for a Medicare benefit to be payable. As MBS claims are often under scrutiny and DoHDA does undertake regular post-payment auditing, all GPs and PMPs providing Better Access services should ensure they keep adequate and contemporaneous records, including documenting the date, time and people who attended. This also includes GPs and PMPs noting the patient has advised them they are their usual medical practitioner if the GP has not seen that patient in the previous 12 months.  

MyMedicare and usual medical practitioner requirements only apply to MHTPs, the review of a MHTP and referrals for mental health treatment services. With the removal of MHTP review and mental health consultation items, which includes item 279, it is expected that GPs and PMPs can undertake these services using time-tiered professional (general) attendance items. GPs and PMPs will need to meet the requirements of the general attendance services to provide a general mental health consultation. However, DoHDA encourages continuity of care to support better patient outcomes.

In addition, please note that FPS services are available to any patient from any eligible GP and eligible PMP who has the appropriate training recognised by the General Practice Mental Health Standards Collaboration (GPMHSC). This has not changed and those GP and PMP MBS items are not linked to a patient’s MyMedicare practice or their usual medical practitioner. 

You can use the following time-tiered general attendance items: 
  • F2F – 52 (<5 mins), 53 (5-25 mins), 54 (25-45 mins), 57 (45-60 mins), 151 (>60 mins) 
  • Phone – 91892 (<6 mins), 91893 (>6 mins), 91903 (25-45 mins – MyMedicare linked patients only), 91913 (45-60 mins – MyMedicare linked patients only) 
These items are included in the RACGP’s MBS guide for PMPs. The guide also lists additional consultation items for PMPs in rural and regional areas.  
As noted in question 2, if general attendance items are being used for referrals for psychological therapy services or FPS services, and reviews of a patient’s MHTP, you must meet the ‘MyMedicare’ or ‘usual medical practitioner’ criteria. 
 
  • Longer phone items (91903 and 91913) are for MyMedicare enrolled patients only. You cannot bill these items unless your practice is registered for MyMedicare and the patient is enrolled in the scheme. 
  • Videoconference items for the preparation of a MHTP (92118, 92119, 92122, 92123) can only be billed if: 
  1. the patient is receiving the service from their MyMedicare registered practice or usual medical practitioner and
  1. if the patient is not enrolled in MyMedicare, you meet the established clinical relationship requirement (12-month relationship rule) for MBS telehealth services. This means the patient has received at least one face-to-face MBS service from you or another health professional at your practice in the 12 months prior to the telehealth service being provided. There was previously an exemption to the 12-month rule in place for mental health telehealth items, but this is being removed for mental health planning items on 1 November 2025. The exemption will remain in place for FPS items. 
  • Other exemptions to the 12-month rule are listed here. 
  1. the patient is receiving the service from their MyMedicare registered practice OR 
  1. you meet the established clinical relationship requirement (12-month relationship rule) for MBS telehealth services. 
If you don’t meet the criteria (eg the 12-month relationship rule), no MBS benefit is payable, and you won’t be able to bill the item. If you still wish to provide the service to the patient, they must forgo their benefit and pay completely privately for the service. 

 

Yes. FPS services remain available to any patient through an eligible GP/PMP who has completed recognised training by the GPMHSC. 

Time-tiered general attendance items can be used, including items for longer consultations (>40 mins). See question 6 for details. 

As with all MBS items, you must ensure you meet all the requirements of the relevant item descriptor before claiming. 

Yes. There are no changes to referral requirements for FPS services. 
Yes. However, while any practitioner who has completed the required training can provide FPS services, you must meet the ‘MyMedicare’ or ‘usual medical practitioner’ criteria to prepare a MHTP (see question 2).
The tripled incentive can be claimed when billing the following standard time-tiered attendance items for mental health care: 
  • F2F – 53 (5-25 mins), 54 (25-45 mins), 57 (45-60 mins), 151 (>60 mins) 
  • Video – 91803 (5-25 mins) 
  • Phone – 91893 (>6 mins) 
Tripled incentives are also claimable for the following telehealth items, but only when the patient is enrolled in MyMedicare: 
  • Phone – 91903 (25-45 mins), 91913 (45-60 mins) 
The original single incentives can be claimed for all other ‘unreferred services’ including but not limited to chronic condition management items, Better Access mental health items, health assessments, minor procedures etc. 
As with all MBS items, GPs and PMPs should ensure they maintain adequate and contemporaneous records and this includes articulating in their notes when they undertake a review of a MHTP when using the time-tiered professional (general) attendance items. 
No. The same changes are being applied to corresponding MBS GP items for mental health care.

Better Access services allow eligible health professionals to deliver up to two services per calendar year to family or carers of the patient. 

These Better Access services can be provided to a person other than the patient, where: 

  • the patient has been referred for Better Access services for allied health professionals delivering these services 
  • the treating or referring practitioner determines it is clinically appropriate 
  • the patient consents for the service to be provided to the person as part of their treatment 
  • the service is part of the patient’s treatment 
  • the patient isn’t in attendance. 
The relevant item numbers for non-VR GPs are: 

In addition to an eligible patient having a mental health diagnosis and a MHTP, a patient must have a valid referral to receive Better Access mental health treatment services.

Mental health treatment services are generally provided in two courses of treatment per year (if required). Depending on the patient’s needs and following the initial course of individual treatment (involving up to six services on the initial referral), patients can return to their GP or PMP who will undertake a review of a patient’s MHTP and assess if their patient needs further treatment. These limits do not apply to group therapy services. Up to 10 group therapy services can be specified in a single referral. Patients may also receive a referral for a course of individual mental health treatment services and group therapy mental health treatment services at the same time.

When referring a patient for mental health treatment services under Better Access, services should be utilised for patients who require at least a moderate level of support. If a patient does require mental health treatment services under the Better Access initiative, GPs and PMPs should refer to explanatory note AN.15.6 which outlines the requirements when referring patients to MBS supported allied health services. In addition to the referral requirements set out in AN.15.6, the following must be included on the referral for patients to received mental health treatment services:

  • the patient’s name, date of birth and address
  • the patient’s symptoms or diagnosis
  • a list of any current medications
  • the number of services the patient is being referred for
  • a statement about whether the patient has had a MHTP or a Psychiatrist Assessment and Management Plan prepared.

Specifying the number of services allowed per course of treatment ensures the allied health professional is managing the patient’s allocation within the annual limit, maintaining eligibility for Medicare benefits.

Further information on referral requirements for Better Access treatment services can be found at explanatory note MN.6.3.

There is nothing precluding a patient from having both a GPCCMP and a MHTP, provided they meet the relevant eligibility requirements for each plan. Whether either plan is clinically appropriate for an eligible patient remains at the clinical discretion of the relevant GP or PMP.
Where both plans are in place, the patient would be eligible for the full allocation of referred allied health services under both plans. Currently, these allocations are:
  • five individual allied health CCM services in a calendar year (10 for First Nations patients), and for patients with type 2 diabetes that are assessed as being appropriate for group services, up to eight group dietetics, diabetes education or exercise physiology services per calendar year
  • 10 individual and 10 group therapy mental health treatment (Better Access) services in a calendar year.

For CCM a separate referral is required for each type of allied health service (eg separate referrals are required for physiotherapy and dietetics). Separate referrals are also required for CCM and Better Access services.

In addition to the referral requirements outlined in AN.15.6, under Better Access, the referring practitioner must include the patient’s symptoms or diagnosis; a list of any current medications; the number of services the patient is being referred for; and a statement about whether the patient has had a MHTP or a psychiatrist assessment and management plan. The treatment provided by the allied health professional must be consistent with the range of acceptable strategies that has been approved for use be eligible health professionals utilising psychological therapy services and focussed psychological strategies.

MyMedicare is intended to improve continuity of care by encouraging patients to formalise their relationship with a regular GP. It also provides greater visibility of this relationship throughout the health system. 

Whether MyMedicare linked incentives go to the practice or patient depends on the particular incentive. For example, the Bulk Billing Practice Incentive Program (BBPIP) payment is split evenly between the practice and GP, while the General Practice in Aged Care Incentive (GPACI) has separate payments for the GP and practice. If patients access MyMedicare linked MBS items (eg longer phone consultation items), this revenue would be split as per the practice’s existing arrangements for MBS revenue. 

The RACGP is aware that some practices have had difficulty with MyMedicare where the practice operates across multiple sites, as patients can only register with a single physical practice location. This can cause patients to be ineligible for some MyMedicare linked MBS items where they have their consultation at a practice location they aren’t registered at. The RACGP is raising this issue with government and continuing to explore policy reforms which would resolve this issue.

The RACGP is represented on DoHDA’s Better Access Industry Liaison Group, which has been consulted on the implementation of the Better Access redesign. This includes legislative amendments and sector-wide communications. 

The RACGP wrote to the Minister for Health when these changes were announced, outlining our concerns around the piecemeal approach to mental health funding reform being taken by the government and highlighting the potential cut to mental health funding for GPs. Our letter called for funding reforms through increases to long consultation items, increased rebates for mental health items and decoupling FPS items from the Better Access scheme.

While the changes are intended to support continuity of care, we are concerned that the ‘usual GP/medical practitioner’ criteria and removal of the 12-month relationship rule exemption for mental health telehealth items will restrict access to vital services. We wrote to Minster Bulter requesting that these changes be postponed until after the review of MBS time-tiered items. This delay would have allowed for further consultation with GPs for recommendations from the time-tiered items review to be factored into these changes. Unfortunately, these concerns have not been heeded by government. 

We also expressed our disappointment to the Minister regarding the removal of the exemption to the 12-month relationship rule for mental health, as previous DoHDA fact sheets had stated this would be permanent. MyMedicare registration will provide an alternative pathway to access telehealth services from 1 November, however we appreciate many patients are not yet enrolled and there are various reasons why practices have not yet registered. 

The RACGP will continue to prioritise improving the accessibility of mental healthcare in general practice in its advocacy and hold government to account where it fails to do so. We are continuing to advocate for increased rebates for mental health items and longer consultations.

To support members throughout the changes, the RACGP has run a series of webinars on the reforms. The webinar specific to the mental health changes is available here.