Question: I have seen a patient today with a GPMP + TCA done by a previous GP of this practice. The main diagnosis is Depression and referrals to a Psychiatrist and Psychologist. This GP billed a TCA. I know psychologist counts as a health care ally but can I bill a TCA just arranging psychology and psychiatry referrals?
Answer:
Please, ask as many questions as often as you need. It is always a pleasure to be of assistance.
Primarily, GPMP and TCA are designed for chronic conditions of the body. The psychologists are included in the EPC referral to assist others on the team. e.g. a patient with heart disease has depression and finds it hard to deal with the aftermath of a heart attack. A psychologist would be a good resource on the team to deal with that issue.
In other words, I think GPMP and TCA should not be used for mental health conditions alone. It is not outright wrong by the Medicare rules. It just does not seem to be fitting the purpose of this service. The GP Mental Health Plan is designed to manage a single mental health issue.
On another note, the psychologists are not happy to be referred under the EPC referral. They prefer a Mental Health Plan referral. It is understandable. The Medicare rebate under EPC is significantly lower than under the Mental Health Plan.