Assessment services (psychology) Medicare item

A Medicare item is available from 1 July 2008 for psychologists to assist the referring medical practitioner in the diagnosis of a child under the age of 13 years and/or the development of the child's PDD treatment plan.

Assessment services for children with autism or any other PDD - psychologist PDD assessment item 82000

Psychologists planning to deliver these items must read the full description of the items, together with explanatory notes, in the Medicare Benefits Schedule - Allied Health Services - 1 November 2009

The final details of this item are subject to the passing of relevant legislation.

Referral requirements	A referral must be made by a consultant psychiatrist or paediatrician from an eligible Medicare service. A psychologist can provide the PDD assessment item to a child where: the child has previously been provided with any Medicare service covering items 296 to 370 (excepting item 359) inclusive, as provided by an eligible consultant psychiatrist; or the child has previously been provided with any Medicare service covering items 110 to 131 inclusive, as provided by an eligible consultant paediatrician. Referring psychiatrists and paediatricians are not required to use a specific form to refer children for these services. The referral may be a letter or note to the psychologist signed and dated by the referring medical practitioner. The psychologist must be in receipt of the referral at the initial consultation and must retain the referral for 24 months from the date a service was rendered for Medicare Australia auditing purposes.
Eligible children	Children must be aged under 13 years to be eligible to receive the PDD assessment item and must be referred according to the referral requirements outlined above. If there is any doubt about a child’s eligibility to receive the assessment services, Medicare Australia will be able to confirm whether the relevant psychiatric or paediatric Medicare service has been claimed (phone 132 150). The conditions classified as PDD for the purposes of these services are informed by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-TR).
Services to be provided	Assessment to assist the referring medical practitioner with their diagnosis of the child; or Assessment for the purpose of contributing to the child’s pervasive developmental disorder (PDD) treatment plan, developed by the referring medical practitioner The service must be of at least 50 minutes in duration.
Number of services	Medicare rebates are available for up to four allied health assessment services in total per eligible child. The four services may consist of any combination of services from eligible psychologists, speech pathologists or occupational therapists. It is the responsibility of the referring medical practitioner to allocate these services in keeping with the child’s individual needs.
Eligibility to provide item	This item can only be claimed by psychologists who are registered with Medicare Australia. Eligibility is open to all psychologists fully registered with the Psychologists Registration Board in the State or Territory in which they are practising, based on self-assessment of competency to deliver assessment services to children with autism or any other PDD. Provisionally registered psychologists are not eligible to provide services. A list of identified psychology practitioners with training and experience in autism and other pervasive developmental disorders will be available from the APS website to assist referring paediatricians, psychiatrists and other health practitioners. Inclusion on the list of identified practitioners is voluntary and is NOT an eligibility requirement to provide services under the Medicare initiative. Eligibility criteria for inclusion on the list are as follows: Postgraduate professional psychology degree with a component of developmental psychology including assessment and treatment of autism or pervasive developmental disorders (PDD); or Acquired proficiency through training and workshops on the assessment and treatment of autism and PDD, equivalent to two days training; or Attendance at an APS two-day workshop on the assessment and treatment of autism and PDD.
Reporting requirements	A written report must be provided to the referring consultant psychiatrist or paediatrician by the psychologist after providing the PDD assessment service(s) to the child.
Schedule fee and rebate	See How to bill for services provided.