71Application of Subgroup 4 of Group A18 and Subgroup 4 of Group A19

71 Application of Subgroup 4 of Group A18 and Subgroup 4 of Group A19

(1) An item in Subgroup 4 of Group A18 or Subgroup 4 of Group A19 applies only to a service that is provided by a medical practitioner:

(a) whose name is entered in the register maintained by the Commission under regulation 3T of the Health Insurance Commission Regulations 1975; and

(b) who meets any training and skills requirements, as determined by the General Practice Mental Health Standards Collaboration, for providing services to which those Subgroups apply.

(2) An item in Subgroup 4 of Group A18 or Subgroup 4 of Group A19 does not apply to a service that:

(a) is provided to a patient who has already been provided, in the previous 12 months, with another service to which an item in either of those Subgroups applies; and

(b) is not clinically indicated.

(3) A reference in an item in Subgroup 4 of Group A18 or Subgroup 4 of Group A19 to the minimum requirements of the 3 Step Mental Health Process is a reference to the following procedures in relation to the patient concerned:

(a) at least 3 consultations related to a mental health disorder:

(i) at least 2 of which are consultations that have been planned at a previous consultation; and

(ii) each of which is of at least 20 minutes duration;

(b) assessment of the mental health disorder, including administration of an outcome measurement tool (except if considered clinically inappropriate);

(c) formulation or diagnosis or both formulation and diagnosis of the mental health disorder;

(d) supplying the patient or, if the patient agrees, the patient’s carer with:

(i) a written mental health plan; and

(ii) suitable education about the mental health disorder;

(e) at least 4 weeks, but no later than 6 months, after the consultation at which the written mental health plan was prepared:

(i) a review of the patient’s progress against the goals recorded in that plan; and

(ii) if necessary, adjustment of that plan; and

(iii) administration of the outcome measurement tool used in the assessment mentioned in paragraph (b) (except if considered clinically inappropriate).

(4) In this rule:

mental health disorder means a significant impairment of any or all of an individual’s cognitive, affective and relational abilities that:

(a) may require medical intervention; and

(b) may be a recognised, medically diagnosable illness or disorder; and

(c) is not dementia, delirium, tobacco use disorder or mental retardation.