Telehealth – Medicare Rebated Sessions for Remote Patients

From 1 November 2017, the Medicare ‘Better Access to Psychologists’ initiative expanded to include Telehealth (Video Conference) Consultations for Australians who are geographically isolated. This means that people who live or work remotely with an assessed mental disorder who would benefit from a structured approach to the management of their treatment needs can now gain ‘Medicare Rebates’ to cover a ‘portion of the cost’ of seeing a Psychologist via video link up for up to 7 sessions per year and 3 face to face sessions when they are formally referred by their GP under a Mental Health Care Plan. The introduction of the Telehealth Service aims to improve access to mental health services for people living or working in rural or remote locations. Whilst remote patients have always been able to access video counselling sessions via our service on a Private Basis, the government have now offered Medicare Rebates to assist patients to access support and treatment for their temporary or permanent Mental Health Challenge.

What are the eligibility requirements for patients to access Telehealth Psychological Intervention via Video Link-up?

To be eligible for Telehealth Psychological Sessions the Patient must:

Be located within an eligible area at the time of the service; that is, at the time of the Psychological Consultation the patient must be in a region classified as MMM 4 to 7 under the Modified Monash Model. See http://www.doctorconnect.gov.au/internet/otd/publishing.nsf/Content/MMM_locator
Be located at least 15 kilometres by road from the eligible Telehealth Psychologist.
Not be a patient of an emergency department or admitted to hospital at the time of the service.
Be assessed by the GP as an appropriate candidate for Video Link up Psychological Sessions.
Be assessed by the GP as having a Mental Illness or Disorder which includes one of the following:

– Alcohol use disorder

– Attention deficit disorder

– Conduct disorder

– Drug use disorder

– Panic disorder

– Psychotic disorders

– Anxiety disorders

– Bereavement disorder

– Co-occurring anxiety and depression

– Eating disorders

– Phobic disorder

– Schizophrenia

– Adjustment disorder

– Bipolar disorder

– Depression

– Obsessive compulsive disorder (OCD)

– Posttraumatic stress disorder (PTSD)

– Sexual disorders
Be eligible for Medicare Rebates.
Be able to attend 3 face to face sessions with the Psychologist over the term of the allocated annual 10 sessions (session number 4 and the remaining 9 & 10^th sessions).
Have the ability to Pre-Pay their sessions at least 48 hours prior to each booking, provide a banking receipt via email to our Receptionist and a valid Credit Card (for security purposes only).
Be older than 5 yrs old for our specific practice however Medicare advised that there are no age range limitations to access video conference psychological services.

GPs will fully assess patient suitability to receive telehealth services, and they generally consider:

The capacity of the patient to access suitable technology (e.g., access to smart phone, laptop, iPad or computer;
ability to incur data usage costs if they apply)
Form, frequency and degree of patient symptomatology
Extent of patient psychological disturbance/crisis
Potential barriers to effective use of technology (e.g., language, physical or visual impairment; computer literacy)
Quality and accessibility of social supports, particularly in the vicinity of the patient
Potential for risk of harm to self and/or others and capacity for mental health provider to manage this from a distance
The ability of the patient to travel to a face-to-face consultation in order to access more than three telehealth consultations.

How do I access Telehealth Psychological Sessions via Video Link-up (clients)?
Book a Double Consultation to see your local GP for an initial assessment to receive a Mental Health Care Plan (MHCP) under the Better Access system and if you are established as eligible, they will provide and fax a formal referral to us which entitles you to up to 10 psychological sessions per year (6+4 sessions).

For an appointment for a Video link up Psychological Sessions with one of our Highly Skilled Psychologist, you can either book via our website or contact 9450 1996 to book your appointment with one of our Friendly & Helpful Receptionists. During the call, we will need to gather a considerable amount of information to confirm your booking so please ensure you have plenty of time to provide this. Following this booking, a Welcome Email will be sent to you with a Consent Form attached that we require completed and returned before we can proceed with your first Video Link-up appointment booking.

Which forms of Video Teleconference can I use to link up to my Psychologist?
Our Psychologists use SKYPE, Facetime (for iphones only) and What’s App applications. You will need provide your mobile phone number and SKYPE/Facetime Messenger name to our Receptionist at the time of your appointment booking. You will be provided with our link up details also to reduce the risk of technological issues. Please note, whilst these video chat applications are free there ‘may’ be charges relating to your individual data used for each session.

What is the Cost of utilising Telehealth Video Conferencing sessions with a Psychologist following a Referral by your GP (MHCP)?
The full cost of a 50 minute Psychological Session via Video Link Up is $220 and needs to be paid into our account at least 48 hrs prior to your appointment. Whilst your Medicare Rebate will depend on your current threshold, it generally sits between $84.80 and $193 for patients and will be processed by our team when you provide your Medicare No. This rebate generally arrives into your bank account provided to Medicare the following day. Should you prefer us to charge your Credit Card for your session this will be processed 48 hours prior to the booked session and generally attracts a 4% surcharge.

Whilst there are no further costs from our practice, there may however be some relating to attendance to your GP if you do not have a bulk billing GP. Please note: Patients seeking a MHCP under the Better Access system will require a Double Consultation with their GP for the initial set up of a MHCP.

Are Telehealth Consultations suitable for all clients requiring Psychological Counselling?
Mental health Consultations via video conferencing may not be appropriate for all patients, particularly if there is concern that a person is at risk of doing harm to themselves or others, or if the patient does not have access to reliable or affordable broadband and/or technology required for video conferencing. The Health Department has funded the Australian Psychological Society to provide information, resources and operational advice to eligible allied health professionals on the following:

The initial assessment requirements to ensure the person and their presentation is suitable to be a recipient of telehealth mental health therapy services;
Risk management procedures for managing clients at risk of self-harm or harm to others when delivering services via video conferencing;
The principles for choosing high quality, safe technology to deliver telehealth mental health and services.

How do the telehealth Better Access items differ from the standard face-to-face Better Access (Local Mental Health Care Plan – MHCP) items?
All patients receiving psychological services under the Better Access initiative are able to receive up to 10 consultations with an eligible mental health provider per calendar year. Under the Telehealth items, patients can still receive up to 10 sessions per calendar year but only seven (7) out of the ten (10) can be provided via teleconference. The remaining consultations will need to be face-to-face. Additionally, one of the first four consultations must be conducted face-to-face. If the face-to-face consultation does not occur, the patient is not eligible for further Medicare rebates for psychological services delivered via Telehealth.

Who can provide the Better Access Telehealth services?
At South Perth Counselling Services, all our Psychologists deliver Telehealth services by Video Conference as required under the Better Access initiative. We also provide face to face psychological sessions. If you prefer an alternative Psychologist, it is recommended that you check out the APS Website to ‘Find a Psychologist’ who can provide information on who else provides these Telehealth services via Video Link-up. Your GP can also assist with locating an alternative Telehealth Psychologist.

Is a Telehealth Psychological Consultation as effective as a face-to-face consultation for the delivery of psychological services?
There is strong evidence demonstrating that psychological services provided using videoconferencing technology can be as effective as a face-to-face consultation for a variety of mental health problems. For example, the quality of the therapeutic alliance in telehealth is comparable to face-to face consultations, particularly when the provider makes adjustments to the expression of empathy, is clear about the purpose, goals and limitations of treatment, and where they take steps to optimise the visual and audio experience.

Can a patient currently undertaking extensive travel to obtain face-to-face psychological treatment under Better Access transfer to telehealth?
If the patient has a Mental Health Treatment Plan, a valid referral, access to appropriate technology and is in an eligible location, then YES they can transfer to services via Telehealth. However, their treating mental health professional may not be able to provide telehealth services. It is important to note that changing service providers may require a new referral and has implications for the therapeutic relationship. Furthermore, the ten sessions per calendar year cap on the number of claimable sessions must be maintained. Generally however, Medicare are pretty flexible in regards to changing psychological therapists by allowing one change over the course of the 10 sessions. This can be easily done by contacting your GP Practice and changing the Psychologists name on the MHCP and refaxing to your new Psychologist. Generally no further fees apply.

What equipment does the patient need for Videoconferencing?
Patients need access to a private, quiet space; a device (i.e., smartphone, iPad, computer) with a camera, microphone and speakers; and a reliable broadband internet connection. If your patient does not have the equipment required, their local medical or community clinic may have these facilities and be able to offer them to community members. Please note that patients are responsible for all costs associated with their personal data usage for the video conference consultations.

Our Psychologist, Counsellors and Team of Admin Staff at South Perth Counselling Services have an exceptional reputation within the Metro and Rural GP community and our practice provides Telehealth Services to Remote W.A patients.

Nicole Loseby (BSc Psych, BPsych, MAPS) our Resident Psychologist provides this service to remote patients across W.A. Her Provider Number is 4487935A.