Mental Health (Psychology and Neuropsychology)

The TAC Medical Excess may apply to these services

Mental Health services provided by a Medical Practitioner (including General Practitioners and Psychiatrists) are funded in accordance with the Medical Practitioners policy.

Policy

The TAC can fund the reasonable cost of psychology services in relation to injuries sustained in a transport accident, following the provision of a written referral from a medical practitioner, where the psychologist is registered by the Psychology Board of Australia.

Transport Accident Act 1986 reference: s.3 'medical service (b)' and s.60

Where psychology services are provided in a hospital setting, refer to the relevant policy below:

Definition

In this policy, mental health is considered a state of emotional and social wellbeing in which the individual can cope with the normal stresses of life and achieve their potential. It includes being able to work productively and contribute to community life. Mental health is not simply the absence of mental illness.

The TAC's definition of Mental Health is consistent with the National Mental Health Plan 2003-2008, which can be accessed via the Department of Health and Ageing website.

Guidelines

What psychology services can the TAC fund?

The TAC can fund the reasonable cost of psychology services where:

there is proper clinical justification
the service is likely to be effective and achieve or maintains a measurable improvement
the service promotes progress towards independence and self-management
evidence based treatment is provided as endorsed by professional bodies.

The TAC will fund a maximum time-limit of 60 minutes per consultation, except for the following circumstances where:

the administration of psychometric tests will take longer than 60 minutes. Any test results must be sent to the TAC Officer.
Eye Movement Desensitisation and Reprocessing (EMDR) therapy is being provided
it has been agreed that it is more appropriate for the client to undertake longer but less frequent sessions, e.g. for a client who travels excessive distances for treatment
services are provided by a neuropsychologist.

To expedite payment of accounts, the TAC encourages prior approval be sought by the client's treating psychologist.

Who may refer a TAC client for psychology?

In order for the TAC to consider funding psychology, a client must be initially referred by a medical practitioner.

Who can provide psychology?

Psychology services are a medical service and must be provided by a psychologist registered with the appropriate state registration board.

What outcomes will the TAC seek when considering funding for psychology treatment?

It is preferable that the treating psychologist has the knowledge and skills in the assessment and treatment of people with problems relating to post-traumatic mental health.

The TAC requires practitioners to clearly document goals, measures and outcome measures. Outcome measures are tools used to assess change in patient characteristics over time.

The treatment is expected to be of a high quality, effective and directed at positive outcomes in social, family and work and closely coordinated with the work of other health practitioners and treatments.

What documentation does the TAC require to consider initial funding of Mental Health services?

A Mental Health Treatment Plan (MHTP) (psychology or neuropsychology) is required for all new clients where treatment is requested beyond:

an initial 5 sessions of treatment, or
an initial 10 sessions for clients with a 'severe injury' and who have been discharged from hospital to facilitate the development of complex treatment goals.

All fields on the MHTP must be completed to be accepted by the TAC.

If there is a gap in treatment of greater than 6 months or if the TAC client attends a different psychology clinic, the TAC expects that a new MHTP will be completed by the psychologist and submitted to the TAC for approval.

Form downloads

The Mental Health Treatment Plan is not required from hospitals using Rehab OnLine.

What documentation does the TAC require to consider ongoing funding of Mental Health services?

Psychologists should not submit written reports or a Mental Health Treatment Review (MHTR) (psychology or neuropsychology) unless specifically requested to do so in writing by the TAC.

Treating psychologists must contact the TAC Coordinator by phone towards the completion of the approved treatment plan to discuss the client's progress and request further services if required. In some circumstances, a Mental Health Treatment Review (MHTR) may be requested.

When does the TAC require a Mental Health Treatment Review (MHTR)?

These plans may be requested from time to time by the TAC in order to obtain additional information on the treatment being provided to a client or requested for a client.

All fields on the Mental Health Treatment Review form must be completed to be accepted by the TAC.

The TAC will only fund MHTR's when they have been requested by the TAC.

Form downloads

The Mental Health Treatment Review is not required from hospitals using Rehab OnLine.

What will the TAC fund for the completion of a Mental Health Treatment Plan or Mental Health Review Plan form?

The TAC will fund a psychologist to complete a Mental Health Treatment Plan or Mental Health Treatment Review form in accordance with the TAC Fee Schedule.

Can the TAC fund psychology and neuropsychology reports?

The TAC can fund the cost of reports where:

it is agreed the MHTP and MHTR are not relevant
the report has been requested by the TAC and prior written approval has been obtained
the cost of the report is in accordance with the TAC Fee Schedule .

Can the TAC fund group consultations by a psychologist?

The TAC can fund group consultations by psychologists. Group consultations must consist of a minimum of four and a maximum of 10 clients in a group receiving continual overall supervision and treatment.

Can the TAC fund family counselling services?

Where a TAC client dies or sustains a severe injury as a result of a transport accident, the TAC can fund Family Counselling to members of his/her immediate family in accordance with the Family Counselling Limit.

MHTP and MHTR forms are not required to be completed for family counselling services.

Can the TAC fund visits by a psychologist to a private hospital?

The TAC can fund visits by a psychologist to a client who is an in-patient in a private hospital where:

the visit is specifically requested by the clients treating medial practitioner
the hospital has consented
the cost of psychology is not included in the hospital bed fee, i.e. the hospital is a TAC non arrangement hospital .

Can the TAC fund a psychologist to travel?

The TAC can fund travel time where:

prior written approval has been provided by the TAC
a medical certificate confirming that the client is medically unfit to travel, or
the need for attendance is clinically justified by the treating therapist that the treatment should be delivered in a community setting, e.g. home, school or work
the provider providing the treatment is the most appropriate according to geographic location of the client and the therapy specialty required
travel time is separately billed and is reimbursed on a time only basis at a pro rata rate.

Travel time can be claimed only for travel to and from the practitioner's practice address and the community setting, e.g. home or school. Where more than one client is visited in a single travel period, total travel costs should be apportioned equally to those clients whom services have been provided.
For example, Practice rooms are in A, patient 1 in B, patient 2 in C, patient 3 in D, travelling time is as below:

Patient	From	To	Time
1	A	B	50 minutes
2	B	C	45 minutes
3	C	D	55 minutes
Return to Rooms	D	A	1 hour 15 minutes
		Total travelling	3 hours 45 minutes

3 hours 45 minutes @ $150.00 per hour (fee as of 1 July 2010) = $562.50, therefore travel per patient, $562.50/3 = $187.50 and the travel time will average to 1 hour 15 minutes each. The average travel time and the amount charged must be clearly stated on the invoice. For the current rate, refer to the TAC Fee Schedule.

Can the TAC fund a psychologist to attend meetings?

The TAC can fund psychologist to attend meetings where:

prior written approval has been provided by the TAC, and
the need for attendance is clinically justified.

Can the TAC fund psychology services where a significant gap in a client's treatment exists?

For the purpose of this policy, a gap in treatment is when no psychology services have been sought for more than 6 months and treatment commences or resumes after this period.

The TAC can fund psychology services after a gap in treatment, however, the TAC requires a further referral from a medical practitioner and may telephone or write to a client and/or the service provider in order to:

determine if the treatment is related to the transport accident injury
determine the reason for the gap in treatment, and
obtain details of the proposed treatment plan.

Once this information is received the TAC will consider the request for funding of treatment.

What billing information does the TAC require?

The TAC requires that the actual provider of the service be identified on each account for payment. In addition, the name and address of the referring medical practitioner and date of referral should be provided on all invoices.

It is the responsibility of the registered provider to ensure that accounts submitted to the TAC are correct, regardless of who has completed the account. Where a service is payable on an hourly basis, the number of hours rather than a total fee is required for processing of accounts.

Can the TAC fund psychology services performed by a member of a client's immediate family?

Refer to the Funding Treatment by a Member of a Client's Immediate Family policy.

In relation to psychology services what will the TAC not fund?

The TAC will not fund:

treatment or services for a person other than the injured client
treatment or services provided by probationary psychologists
treatment, services or equipment where there is no published evidence in a recent peer-reviewed journal article that the treatment, service or equipment is safe and effective. Refer to the Non-Established, New or Experimental Treatment policy
treatment or services where there is no proper clinical justification
treatment or services where the cost is included in the hospital bed fee. Refer to the Hospitals - Private (Contracted) and Hospitals - Private (Arrangement) policies.
treatment or services for public hospital in-patient acute and rehabilitation episodes of care
treatment or services for a condition that existed before a transport accident or that is not a direct result of a transport accident
fees associated with non-attendance
the cost of telephone calls and telephone consultations between providers and clients, and between other providers, including hospitals
neurotherapy treatment
more than one, non-hospital consultation per day
treatment or services provided outside the Commonwealth of Australia
treatment or services provided more than 2 years prior to the request for funding except where the request for payment is made within 3 years of the transport accident. Refer to the Time Limit for the Application for Payment of Medical and Like Expenses policy.

Refer to the Mental Health Resources section of the TAC website for further information for providers about mental health recovery following a transport accident.

Forms and Brochures

Provider use only

For further information about TAC policies contact the TAC on 1300 654 329. Alternatively, e-mail policy@tac.vic.gov.au

Last Updated 28 Feb 2011