November 2025 MBS Better Access Changes for GPs MyMedicare MHTPs and Psychiatry Referrals

The November 2025 Better Access changes will make one practical question much more common in general practice: “Is this patient linked to us through MyMedicare, and what does that mean for the mental health item I’m about to claim?”

For GPs, the change is not just a billing update. It affects how Mental Health Treatment Plans are initiated, how reviews are documented, and when a psychiatry referral sits outside the MyMedicare-linked pathway. The policy direction is clear: support continuity with a patient’s usual general practice, reduce duplication, and make the MBS item structure easier to use.

This article is an informational guide only. Practices should confirm final claiming rules, item descriptors, exemptions, and transitional arrangements through MBS Online, Services Australia, and their usual Medicare advisory channels before changing workflows.

The changes will affect everyday mental health workflows in general practice.

MyMedicare linkage changes how MHTPs fit into usual care

MyMedicare is designed to formalise the relationship between a patient and their usual general practice. Registration links the patient to a nominated practice, and in some cases a preferred GP. It does not replace clinical judgement, and it does not stop a patient from seeking care elsewhere. Its purpose is to support continuity, especially for care that benefits from longitudinal knowledge.

Mental Health Treatment Plans sit squarely in that category.

From the November 2025 Better Access changes, the policy intent is that MHTPs should be more closely connected to the patient’s registered practice. That means practices will need to treat MyMedicare status as part of the pre-claiming check for relevant Better Access mental health services.

For GPs, the practical implications are:

• Check whether the patient is registered with MyMedicare.

• Confirm whether the patient is linked to the practice providing the MHTP-related service.

• Make sure reception, nursing, and GP workflows can identify registration status before the consultation is billed.

• Document the clinical reason for the plan, not just the administrative eligibility.

• Have a process for patients who are eligible but not yet registered.

  
  

The key point is that MyMedicare linkage is about continuity, not gatekeeping clinical care. If a patient presents with mental health concerns, the consultation still needs appropriate assessment, risk review, safety planning where needed, and a clear next step. The Medicare item selected may depend on linkage rules, but the clinical responsibility remains.

For example, a patient who has been seeing the same practice for years may not yet be registered with MyMedicare. In that case, the consultation could include a discussion about registration, why it matters for ongoing mental health care, and how it supports access to the correct MBS-funded pathway. Practices should avoid leaving this until after the consultation, when billing problems are harder to fix.

A useful internal question is:

If this patient returns in four weeks, will the next GP be able to understand the plan, the referral pathway, the risk history, and the intended review point?

That is the continuity test the reforms are trying to support.

MHTPs remain clinical plans, not just referral documents

The Better Access framework has sometimes been treated as a referral mechanism for subsidised psychology sessions. The November 2025 changes are a reminder that an MHTP is meant to be a structured clinical plan.

A sound MHTP should still include:

• assessment of the presenting mental health concern

• relevant history, including previous treatment and risk factors

• goals agreed with the patient

• treatment options discussed

• referrals to eligible mental health professionals where appropriate

• crisis and safety considerations

• review timing

• communication back to the GP or practice

  
  

The MyMedicare linkage does not change those clinical components. It changes the administrative setting in which the plan is created and claimed.

This matters because mental health care often crosses several parts of the system. A patient may see a GP, psychologist, psychiatrist, emergency department, social worker, or community service. The MHTP can act as the anchor point, but only if it is current, visible, and reviewed in a meaningful way.

Practices may need to adjust templates so they capture both clinical and administrative information. A template that only asks for symptoms, diagnosis, and referral details may no longer be enough. Consider adding fields for:

• MyMedicare registration checked

• linked practice confirmed

• preferred GP recorded where relevant

• planned review timeframe

• communication preferences

• consent for information sharing

• psychiatrist involvement, if already in place

  
  

This keeps the record useful for both patient care and Medicare compliance.

A useful MHTP records the clinical plan as well as the pathway for follow-up.

MBS item simplification reduces some billing complexity

One of the main aims of the November 2025 MBS Better Access changes for GPs is to simplify the item structure. The current mental health item set has been criticised for being hard to apply consistently, especially when different items exist for preparation, review, consultation length, practitioner category, and training status.

A key change is the removal of dedicated MHTP review items. For GPs, this means the familiar review-specific pathway, including the GP MHTP review item commonly known as item `2712`, is expected to be removed from the simplified structure. Equivalent review-specific items for other eligible medical practitioners may also be affected, depending on the final item descriptors.

The clinical task does not disappear. Patients still need review. What changes is the billing pathway and the item architecture.

That distinction is critical.

A review of an MHTP should still consider whether:

• symptoms have improved, worsened, or changed

• the diagnosis or formulation needs updating

• the referral remains appropriate

• the patient has attended referred services

• medication, risk, or safety plans need adjustment

• further sessions are clinically indicated and available under the rules

• communication has been received from the allied mental health professional

• a higher level of care is needed

  
  

The simplified item structure should reduce the need to choose between multiple mental health-specific review items. In practice, GPs may need to use the relevant general attendance or updated mental health item that matches the service provided, once the final rules are confirmed.

The change should also reduce billing errors that arise when a consultation includes both mental health review and broader care. For example, a patient may attend for worsening anxiety, a medication review, sleep disturbance, and a work certificate. Under a simpler structure, the focus can shift back to documenting the service actually provided, rather than trying to force the consultation into a narrow review item.

A simple before-and-after view may help.

Before the change	From the simplified approach
Separate review-specific MHTP items created extra claiming decisions.	Fewer mental health review-specific items should make item selection clearer.
Reviews were often tied to a distinct item number.	The clinical review remains, but billing may use a broader or updated item structure.
Practices needed detailed recall rules around plan and review items.	Practices still need recalls, but templates can focus more on care progress and risk.
Billing errors could occur when review and general care overlapped.	Documentation should better reflect the actual consultation.

The safest preparation step is to separate two concepts in practice training:

Clinical review

The GP assesses progress, risk, treatment response, and next steps.

MBS item selection

The GP or billing team selects the correct item under the new descriptors.

Keeping those concepts separate helps prevent the mistaken belief that removing a review item means removing the need to review the patient.

Psychiatry referrals have important exemptions

The psychiatry exemption is one of the areas most likely to cause confusion. GPs need to distinguish between an MHTP used for Better Access allied mental health services and a referral to a psychiatrist for specialist medical assessment or management.

A patient does not need a GP Mental Health Treatment Plan before being referred to a psychiatrist. GPs can refer directly to psychiatrists when specialist assessment, diagnosis, medication advice, risk management, or shared care is clinically appropriate.

That principle remains important under the MyMedicare-linked changes.

The MyMedicare linkage requirements for MHTPs should not be read as a barrier to psychiatry referral. If a patient needs specialist psychiatric input, the GP should make the referral according to the usual referral rules and clinical urgency. The referral should clearly state the reason for referral, relevant history, current medications, risk concerns, and what type of input is being requested.

Common psychiatry referral scenarios include:

• diagnostic clarification for complex mood, psychotic, trauma-related, or neurodevelopmental presentations

• advice on medication after poor response or adverse effects

• assessment of risk that exceeds the scope of routine GP management

• shared care for complex or chronic mental illness

• assessment where hospital, community mental health, or private psychiatric care may be needed

  
  

The exemption also matters for patients who present outside their usual practice. A GP seeing a patient in an urgent or interim setting should not delay a clinically necessary psychiatry referral simply because the patient’s MyMedicare linkage is elsewhere or not yet confirmed.

That said, the exemption should not be used to bypass the MHTP requirements when the actual purpose is access to subsidised allied mental health sessions under Better Access. If the patient needs psychology, counselling, or other eligible allied mental health services through the GP MHTP pathway, the MyMedicare and item rules still need to be considered.

A clear way to frame the decision is:

• If the patient needs a GP-led Better Access MHTP, check MyMedicare linkage and the relevant MBS rules.

• If the patient needs a psychiatrist referral, use the specialist referral pathway and document the clinical reason.

• If the patient needs both, manage each pathway separately and explain how they connect.

  
  

Psychiatry referral pathways should remain available when specialist input is clinically needed.

The changes aim to improve continuity and reduce administrative drag

The Better Access changes are trying to solve two related problems.

The first is fragmented care. Mental health treatment often suffers when patients move between providers without a clear anchor point. MyMedicare linkage encourages the MHTP to sit with the practice that knows the patient best. That should make it easier to maintain recall systems, receive reports, adjust treatment, and notice when someone has dropped out of care.

The second problem is administrative burden. A complicated item structure can pull attention away from the consultation itself. When GPs must navigate several similar items, each with different rules, the risk of errors increases. Patients may also receive inconsistent information depending on which team member they speak to.

Simplifying items and linking MHTPs to usual care should help practices build cleaner workflows.

A sensible preparation plan could include the following.

Update front-desk and triage scripts

Reception teams do not need to explain the whole MBS system. They do need a safe, simple way to identify whether a patient booking for a mental health plan is registered with MyMedicare and linked to the practice.

For example, the booking process can include a neutral check:

• “Are you registered with MyMedicare at this practice?”

• “If not, we can give you information about registration before your appointment.”

• “If your concern is urgent, please let us know so the clinical team can advise the safest option.”

  
  

Adjust appointment templates

Mental health plan appointments often need longer booking slots. The new rules make it even more important to select the right appointment type before the patient arrives.

Templates should make room for:

• MHTP preparation

• mental health review after removal of dedicated review items

• psychiatry referral

• urgent mental health assessment

• mixed mental health and general care consultations

  
  

Train GPs on the difference between care rules and claiming rules

A GP may provide good clinical care but still select the wrong item. The reverse is also true: a correctly selected item does not prove the care was adequate.

Training should cover both sides. Use case examples, such as:

• an existing patient registered with the practice who needs a new MHTP

• a patient registered elsewhere who asks for a Better Access referral

• a patient in crisis who needs urgent psychiatry input

• a patient returning after psychology sessions who needs progress review

• a patient who has not yet registered with MyMedicare but is eligible

  
  

Review recall and correspondence systems

If the MHTP sits with the usual practice, the practice needs to know whether treatment is progressing. Recalls should not only track item timing. They should track clinical milestones.

Useful recall triggers include:

• review after initial psychology sessions

• medication follow-up

• risk review after acute deterioration

• non-attendance after referral

• psychiatrist report received

• psychologist report received

• care plan update needed

  
  

Create a short internal billing guide

A one-page practice guide can reduce confusion. It should name the changed items, explain the removed MHTP review items, outline MyMedicare checks, and describe psychiatry exemptions. Keep it updated as MBS Online guidance changes.

Small workflow changes can help practices prepare before November 2025.

What GPs should do before November 2025

The practices that manage this transition well will not wait until the first rejected claim or confused patient query. The work can start early and stay practical.

Before November 2025, GPs and practice teams should:

• identify which current MHTP and review item workflows will change

• update mental health plan templates

• add MyMedicare status checks to booking and billing processes

• train reception teams on simple patient messaging

• clarify how psychiatry referrals are handled

• review recall systems for mental health follow-up

• check final item descriptors once published

• document decisions clearly during the transition period

  
  

The main shift is cultural as much as administrative. MHTPs are being pulled closer to the patient’s usual practice, while the item structure is being made less complex. Psychiatry referrals remain a separate and important clinical pathway, with exemptions that protect access to specialist care when it is needed.

For GPs, the safest approach is to keep three questions in mind at each relevant consultation:

1. Is this a GP-led Better Access MHTP service?

2. Is the patient linked through MyMedicare in the way the item requires?

3. Does the patient need psychiatry input instead of, or as well as, an MHTP?

   
   

Answer those clearly, document the reasoning, and the November 2025 changes become easier to manage. The goal is not just cleaner billing. It is better continuity for patients whose mental health care depends on steady follow-up, clear communication, and a GP who can hold the thread over time.