PY 2020/0716
Answer
No
Context
Question: For case conferences involving psychiatrists and allied health personnel (item 855 to 866) can the conference include the treating psychiatrist, another psychiatrist known to the patient, and then allied health or mental health nurses who treat the patient in an ambulatory setting, or does the patient’s GP need to be involved as the second doctor? If so, can that GP be included via teleconference/video conference?
Relevant legislative provisions
Health Insurance (General Medical Services Table) Regulations (No.2) 2020
Other Relevant Materials
N/A
Case law
N/A
Departmental interpretation
mbsonline.gov.au (accessed 3 July 2020)
AN.0.62
For the purposes of items 855 to 866, a multidisciplinary team requires the involvement of a minimum of three formal care providers from different disciplines, each of whom provides a different kind of care or service to the patient, and one of whom must be the patient’s usual medical practitioner. The consultant psychiatrist and the medical practitioner are counted toward the minimum of three.“
AND
“The minimum three care providers must be present for the whole of the case conference. All participants must be in communication with each other throughout the conference, either face to face, by telephone or by video link, or a combination of these.”
Detailed Reasoning
Each of the psychiatry case conference descriptions reinforces the requirement for ‘different disciplines’ to be involved. Item 855 for example provides:
| 855 | Attendance by a consultant physician in the practice of the consultant physician’s specialty of psychiatry, as a member of a multidisciplinary case conference team of at least 2 other formal care providers of different disciplines, to organise and coordinate a community case conference of at least 15 minutes but less than 30 minutes, with the multidisciplinary case conference team | 145.60 |
Relevant information regarding the make up of the case conference team and who the different providers can be is found in Regulation 1.1.5. Below are the relevant sections:
“(1) In this Schedule, a multidisciplinary case conference team for a patient:
(a) includes a medical practitioner; and
(b) either:
(i) for items 735 to 758, 825 to 828, 855 to 858, 6029 to 6042 and 6064 to 6075—includes at least 2 other members; …and
(c) may also include a family member of the patient.
(2) For the members mentioned in paragraph (b):
(a) each member must provide a different kind of care or service to the patient; and
(b) each member must not be an unpaid carer of the patient; and
(c) one member may be another medical practitioner.
Example: Other members may be allied health professionals, home and community service providers and care organisers, including the following: What follows is a long list of allied health and other health care workers, which you can access at this link.
Pulling the above information together, key points are:
- A minimum of 3 providers from the list (refer above link) are required and one of them is you (the psychiatrist)
- One of the other 2 may be another medical practitioner but because of the clear requirement for the 3 participants to be from different disciplines, a second psychiatrist cannot be counted as 1 of the remaining 2
- Unpaid carers cannot be counted towards the remaining 2
- The patient’s GP may be included (as another medical practitioner) but it is not a legal requirement (though obviously a good idea if it can be arranged)
- All participants (including the GP if included) must be in continuous contact throughout the conference which does not need to be face to face. Telephone, video or any combination is acceptable as per the departmental interpretation copied above.
Examples and other relevant information
N/A
Who this applies to
Psychiatrists claiming the case conference items
When this applies
Since the items were introduced.