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The Better Access initiative and the role of GPs

The Better Access initiative (introduced by the Federal Government in 2006) aims to improve health outcomes by providing targeted treatment of people with a clinically diagnosed mental disorder.


How does the Better Access initiative work?

The Better Access initiative allows eligible people with an assessed mental disorder to access rebated mental health services for which they can receive a rebate. At the time of publication, each person is entitled to access up to 10 individual services and up to 10 group services per calendar year.

Patients can access more than 10 individual services and/or more than 10 group services, but they can receive rebates for only the first 10 individual services and only the first 10 group services within a calendar year are eligible for rebates.

For up to date information, visit the Department of Health (DoH) website on https://www.health.gov.au/initiatives-and-programs/better-access-initiative?utm_source=health.gov.au&utm_medium=callout-auto-custom&utm_campaign=digital_transformation.


Eligibility for rebated services

Patients with an assessed mental disorder are eligible to access services under the Better Access initiative sessions when they are referred to an approved provider via one of the following:
  • a GP managing the patient under a General Practice Mental Health Treatment Plan (GPMHTP)
  • a referred psychiatrist assessment and management plan, or
  • a psychiatrist or paediatrician.
One of the above professionals would then refer the patient to an approved provider for the rebated sessions.


Approved providers

Approved providers are:
  • GPs who are registered as a provider of Focussed Psychological Strategies (FPS)
  • psychologists
  • appropriately trained and accredited social workers and occupational therapists.
Useful resources
Department of Health. Better Access initiative. Available at: https://www.health.gov.au/initiatives-and-programs/better-access-initiative?utm_source=health.gov.au&utm_medium=callout-auto-custom&utm_campaign=digital_transformation
Services Australia. Better Access initiative - supporting mental health care. Available at: https://www.servicesaustralia.gov.au/better-access-initiative-supporting-mental-health-care


Mental disorders applicable under the Better Access initiative

At the time of publication, the following mental disorders are eligible for treatment under the Better Access initiative, as per the International classification of diseases, 10th revision (ICD-10).
  • acute psychotic disorders
  • enuresis
  • adjustment disorder
  • generalised anxiety
  • alcohol-use disorders
  • hyperkinetic (attention deficit) disorders
  • bereavement disorders
  • mental disorder, not otherwise specified
  • bipolar disorder
  • mixed anxiety and depression
  • chronic psychotic disorders
  • neurasthenia
  • conduct disorder
  • panic disorder
  • depression
  • phobic disorders
  • dissociative (conversion) disorder
  • sexual disorders
  • drug-use disorders
  • sleep problems
  • eating disorders
  • unexplained somatic complaints.

As the ICD-11 may be adopted during the 2026–28 triennium, there may be variation to the above list of mental disorders applicable under the Better Access initiative.
 

‘Mental disorder, not otherwise specified’

The condition listed above as ‘Mental disorder, not otherwise specified’ covers any mental disorder that does not meet the description of any of the other mental disorders in the ICD-10. Similar to the ‘not otherwise specified’ codes in the Diagnostic and statistical manual of mental disorders, it allows for atypical cases. For a patient to be diagnosed with this condition, they must have mental health symptoms that reach the threshold for clinical significance but do not fall neatly into one of the disorder categories.

However, the MBS online notes indicate that organic mental disorders (i.e., those due to brain damage) are excluded under ‘Mental disorder, otherwise not specified’.


Mental disorders not applicable under the Better Access initiative

In addition to organic mental disorders, the following disorders are not applicable under the Better Access initiative:
  • delirium
  • dementia
  • mental retardation
  • tobacco-use disorders.
Although not applicable under the Better Access initiative, GPs can address these disorders if the patient presents with an applicable mental disorder has comorbidity with one or more of these disorders (e.g., when a patient has dementia and generalised anxiety).
Useful resources
International Classification of Diseases 10th edition (ICD-10). Available at: https://icd.who.int/browse10/2019/en
International Classification of Diseases 11th edition (ICD-11). Available at: https://icd.who.int/browse11/l-m/en


The role of the GPMHSC and GPs in the Better Access initiative

The GPMHSC sets and monitors the training standards for GPs that allow them to deliver services during GP consultations that correspond to mental health MBS item numbers.

Table 1 sets out services and the corresponding MBS item numbers that GPs can claim based on their mental health training.
Table 1. GPs’ eligibility to provide mental health MBS items
Mental Health Training Services MBS item numbers MBS Rebate
None Preparation of a patient’s GP MHTP 2700, 2701 Minimum MBS rebate
Level 1: MHST Preparation of a patient’s GP MHTP 2715, 2717 Maximum [higher schedule] MBS rebate
Level 2: FPS ST Registered to provide FPS interventions to patients for their mental health conditions as identified in the patient’s GP MHTP 2721– 2727 MBS rebates apply for up to 10 individual FPS sessions and 10 group sessions per person per calendar year
 
Useful resource
Department of Health. MBS Online. Available at: http://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/Home
GPMHSC Mental health MBS item number descriptors and rebates. Available at: https:///www.gpmhsc.org.au/gp-resources/mbs-descriptors-and-rebates