Complete details of Medicare compliance requirements for GP Mental Health Treatment Plans can be found elsewhere. The intent of this page is to highlight the common compliance mistakes that leave GP and psychologist open to problems in the case of audit.

1. GP Assesment

The GP must make a diagnosis and/or formulation. If giving a diagnosis, it must be one of the following:

If using the formulation approach, the GP must briefly describe how they suspect the patient's current functioning or mental health is being impaired. For example:

1. This patient has learning difficulties that seem to be contributing to anxiety problems and school refusal.
2. This patient may have attention deficits that are affecting his/her school work.

In some cases where the patient is a child, it may be better to refer the parents under a 2710 rather than a child. Some situations, such as child behaviour problems (unless it is conduct disorder) are not covered under Medicare. In these cases, the family could be referred to a psychologist without a 2710. Alternatively, many mothers (we say mothers because it is almost exclusively mothers who bring their children for care) will have mental health problems that either preexist or are a result of the behaviour problems (e.g., symptoms of anxiety or depression). Because best practice treatment for child behaviour problems involves working with the parent(s), not the child, a psychologist can legitimately provide skills training to the parent(s) under a 2710 with the stated aim of indirectly changing mood or anxiety status via improved parenting skills.

2. The Mental Health Care Plan What GPs need to send to psychologists

Referrals can be made in three forms:

1. a letter or a note to the psychologist that must be signed and dated.
2. via email.
3. via a telephone call. Note that verbal referrals must be followed by written confirmation of the referral by the GP.

The referral should indicate the services required under the specific government program or that a Mental Health Treatment Plan or Chronic Disease Management Plan is in place. The referral letter must show the GP's name, address and provider number and must make a specific request for the psychologist to provide the patient with psychological services.

Note that neither GP nor psychologist is Medicare compliant without a referral that includes all the above information.

3. Requirements for the Psychologist

The psychologist must provide the GP with a letter detailing the case formulation and treatment after the 6th session. At this point, the patient must return to the GP for review. If the GP considers ongoing treatment necessary, the psychologist must have a copy of a letter from the GP stating the need for continued treatment before the 7th session.