Better Access Initiative Changes: November 1, 2025
The Australian Government is implementing significant changes to the Better Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Schedule from November 1, 2025. These reforms respond to a 2022 independent evaluation that identified major equity problems in the program, including widening gaps for people from lower socioeconomic backgrounds and rural areas, along with record-high gap fees. The changes aim to improve continuity of care and reduce administrative burden for GPs while maintaining the same number of subsidised sessions. However, professional bodies have raised concerns about potential access barriers for vulnerable populations. All changes are subject to the passage of legislation.
The three core changes reshaping Better Access
The reforms centre on three interconnected changes that fundamentally alter how GPs manage mental health care under Medicare. First, Mental Health Treatment Plans and referrals must now come from either a GP at the patient’s MyMedicare registered practice or the patient’s “usual medical practitioner” regardless of MyMedicare registration. This represents a significant shift toward continuity of care, formalizing the patient-practice relationship that underpins effective mental health management.
Second, twelve specific mental health MBS items are being deleted entirely. Items 2712, 92114, 92126, 277, 92120, and 92132 covering Mental Health Treatment Plan reviews will cease, along with items 2713, 92115, 92127, 279, 92121, and 92133 for ongoing mental health consultations. These items previously paid $83.65 for reviews and consultations. In their place, GPs will use standard general attendance items based on actual time spent with patients, including access to new Level E consultation items for longer appointments. This change enables GPs to claim the tripled bulk billing incentive for Commonwealth concession card holders and children under 16—a significant financial improvement that should support more affordable mental health care for vulnerable populations.
Third, despite these structural changes, the number of subsidised sessions remains unchanged: patients continue to access 10 individual sessions and 10 group sessions per calendar year, with up to 2 family/carer participation sessions counting toward the individual allocation. The evaluation explicitly recommended maintaining these session limits, and the government has confirmed this multiple times in official documentation.
What GPs need to know about referral requirements
From November 1, 2025, Medicare benefits for Better Access services will only be payable when the Mental Health Treatment Plan, review, and referrals are undertaken by either the GP at a patient’s MyMedicare registered practice or the patient’s “usual medical practitioner.” The government defines a usual medical practitioner as someone who has provided the majority of services to the person in the past 12 months, or someone who is likely to provide the majority of services in the following 12 months. This definition extends to practices as well—the practice that has provided or will provide the majority of care can also meet this requirement.
MyMedicare registration is voluntary and free for patients. Patients registered with MyMedicare should obtain their mental health treatment plans and referrals from their MyMedicare registered practice, while patients not registered can still access Better Access from their usual GP under the alternative pathway. This flexibility was introduced after strong advocacy from the Australian Psychological Society, which argued that mandatory MyMedicare registration would create unacceptable barriers to care. However, the APS continues to express concern that even the “usual GP” requirement disadvantages young people, itinerant populations, shift workers, and rural residents—groups that already face higher rates of mental illness and lower service access.
Psychiatrists and paediatricians retain their existing ability to directly refer patients without requiring a Mental Health Treatment Plan, preserving established clinical pathways for specialist-initiated care. GPs appropriately trained in focused psychological strategies can also continue providing these services directly to their own patients without referral requirements.
MBS items retained and deleted
The government has retained all 16 Mental Health Treatment Plan preparation items, ensuring GPs can still claim for the initial assessment and plan development. Items 2715 and 2717 (for GPs with mental health skills training) and items 2700 and 2701 (for GPs without specific training) continue for face-to-face consultations of 20 to less than 40 minutes, and 40 minutes or more respectively. Telehealth equivalents (92116, 92117, 92112, 92113) also remain. Prescribed Medical Practitioners have corresponding items (272, 276, 281, 282) with their own telehealth variations. These preparation items pay $106.20 for the mid-tier item and higher rates for longer consultations, with 75% Medicare benefit ($79.65) or 100% when bulk-billed.
The deleted items—2712, 2713, and their telehealth equivalents for both GPs and Prescribed Medical Practitioners—previously provided dedicated billing for reviews and ongoing consultations at $83.65. The replacement approach uses standard general attendance items (levels A through E) based on actual consultation time. This change offers several advantages: GPs can claim higher-value items when spending more time with patients, access the tripled bulk billing incentive for vulnerable populations, and integrate physical and mental health care within single consultations without the previous complexity of co-claiming rules. The government explicitly describes this as increasing the MBS benefit for GP mental health consultations compared to the removed items.
All allied health professional items remain unchanged. Clinical psychologists retain items 80000, 80005, 80010, and 80015 for individual psychological therapy, with current rebates of $145.25 for the most common 50-minute consultation (item 80010, schedule fee $170.85). Registered psychologists, social workers, and occupational therapists continue using their focused psychological strategies items in the 80100-80175 range. Group therapy items for all allied health professionals remain available, with telehealth options restricted to Modified Monash Model 4-7 locations. The GP focused psychological strategies items (2721-2745 series) also continue without change for appropriately credentialed GPs.
Implementation timeline and transition arrangements
The November 1, 2025 implementation date applies to new referrals dated on or after that date. Referrals written before November 1, 2025 remain valid under the previous rules until all sessions specified in those referrals are completed. This transition provision means patients with existing treatment plans and referrals can continue their current care without disruption. Mental Health Treatment Plans do not expire—they remain valid until the GP determines a new plan is needed or the patient’s circumstances change significantly.
The changes are subject to the passage of legislation, which requires a disallowable instrument to be tabled in Parliament. The Department of Health is developing comprehensive guidance materials for GPs, PMPs, and patients, which will be available on the department website by November 1. A national communications campaign is planned to promote awareness among health professionals and the public. The sector has been consulted throughout the implementation process through the Better Access Industry Liaison Group, which includes the RACGP, ACRRM, allied health representatives, and consumer groups.
From November 1, 2025, MyMedicare telehealth Mental Health Treatment Plan items will no longer be exempt from established clinical relationship requirements. These items must now comply with explanatory note AN.1.1, which requires practitioners to have seen the patient face-to-face at least once in the past 12 months (or to have provided treatment to the patient on at least one occasion) to claim telehealth items. This aligns mental health telehealth with standard Medicare telehealth requirements.
Professional perspectives and ongoing concerns
The Royal Australian College of General Practitioners has expressed strong opposition to specific aspects of the changes. RACGP President Dr Nicole Higgins called the removal of item 2712 (the Mental Health Treatment Plan review item) a “slap in the face for general practice,” describing it as a missed opportunity to support affordable mental health access. The RACGP is concerned about the inability to collect meaningful data on mental health reviews once these dedicated items are removed, noting that while GPs will continue providing reviews within general consultations, the lack of specific item numbers eliminates visibility into this critical aspect of care. However, some GPs acknowledge potential benefits from the flexibility to claim time-appropriate general attendance items and access tripled bulk billing incentives.
The Australian Psychological Society has been more actively opposed, taking immediate advocacy action that successfully influenced the policy. Initially, the government proposed requiring MyMedicare registration for Better Access referrals. Following intense APS engagement with media, government, and the Department of Health in September 2025, this requirement was softened to allow referrals from “usual GPs” regardless of MyMedicare status. Despite this partial victory, the APS argues that the “usual GP” concept is fundamentally flawed because not all Australians have or can access a usual GP—particularly young people, itinerant populations, shift workers, and rural residents who already experience higher mental illness rates. The APS has called for complete removal of the review requirements and recommended allowing people to access up to three Better Access sessions without GP referral, along with streamlined case conferencing and bulk billing incentives for psychologists.
The Australian Association of Psychologists has stated that the changes “directly contravened advice from the industry” and expressed concern that GPs may be discouraged from referring patients to Better Access services in favor of newly announced federal digital services. This reflects broader anxiety within the psychology profession about the government’s mental health strategy potentially shifting away from traditional face-to-face therapeutic relationships toward lower-cost technology-enabled alternatives.
Broader policy context and supporting initiatives
These Better Access changes form part of a substantial mental health investment announced in the 2024-25 Federal Budget, totalling $588.5 million over eight years. The centrepiece is a new National Early Intervention Service providing free cognitive behavioural therapy via phone or video for people with mild mental health concerns or transient distress, without requiring diagnosis or referral. This service aims to create an alternative pathway for people who need support but may not meet the threshold for Better Access or prefer not to involve their GP.
Medicare Mental Health Centres are receiving enhanced funding to provide free community-based services for people with moderate to complex needs, including access to psychologists and psychiatrists. Primary Health Networks are receiving $71.7 million over four years to work with general practices providing free wraparound support. The Psychiatry Workforce Program continues with $40.5 million through 2025-26, supporting up to 30 full-time equivalent training posts annually for GPs and other practitioners to obtain the Certificate of Psychiatry, with focus on rural and remote areas.
Concurrent with Better Access changes, expanded bulk billing incentives commence November 1, 2025, extending eligibility to all Medicare-eligible patients rather than only concession card holders and children under 16. This adds approximately 15 million people to eligibility and includes a new Bulk Billing Practice Incentive Program providing 12.5% additional quarterly payment for eligible services, split equally between doctor and practice. The government estimates nine out of ten GP visits will be bulk-billed by 2030 under these reforms.
What the evaluation revealed about Better Access performance
The 2022 independent evaluation by the University of Melbourne—which prompted these changes—painted a mixed picture of Better Access performance since its 2006 launch. Approximately 5% of Australians received at least one session under Better Access in 2021, costing taxpayers $1.2 billion annually, with generally positive outcomes for those who accessed services. However, the evaluation identified severe equity problems that are actually worsening over time. People from lower socioeconomic backgrounds are significantly underserved despite having higher mental health needs. Regional, rural, and remote Australians miss out on services, as do aged care residents. The median out-of-pocket cost increased from $81.41 in 2022 to $92.04 in 2023, with 74.5% of treatment services involving co-payments—creating financial barriers that disproportionately affect disadvantaged populations.
The evaluation highlighted a critical “missing middle” problem: people with complex mental health needs who are too unwell for GP-based care alone but not sick enough to require hospitalization fall through gaps in the system. The evaluation found that Better Access serves some groups very well while others increasingly miss out, with gaps widening between advantaged and disadvantaged Australians. The government’s decision not to extend the temporary additional 10 COVID-19 sessions beyond December 31, 2022 was controversial but reflected evaluation findings that suggested the additional sessions primarily benefited people already well-served by Better Access rather than addressing equity gaps.
The evaluation recommended maintaining the 10-session limit while improving how those sessions are targeted to people who need them most, supporting better communication between practitioners, and reducing administrative complexity for GPs. The November 2025 changes represent the government’s response to these recommendations, though debate continues about whether they adequately address the systemic equity issues identified.
Practical guidance for claiming and documentation
GPs should use standard time-tiered consultation items (23, 36, 44, 52, or new Level E items 53, 54, 57) when reviewing Mental Health Treatment Plans or providing ongoing mental health consultations from November 1, 2025. These items offer greater flexibility and potentially higher remuneration than the previous dedicated mental health items, particularly for longer consultations. When bulk-billing Commonwealth concession card holders and children under 16, GPs can now access the tripled bulk billing incentive—a significant financial improvement that was not available for the previous mental health-specific items.
Mental Health Treatment Plan preparation continues using items 2700, 2701, 2715, or 2717 based on whether the GP has completed mental health skills training and the duration of the consultation. These items remain unchanged with current rebates of $79.65 (75% benefit) for the 20 to less than 40-minute tier, with higher rates for longer consultations and 100% benefit ($106.20) when bulk-billed. Telehealth equivalents are available via video consultation where clinically appropriate and the established relationship requirements are met.
Referrals must include the patient’s name, date of birth, address, diagnosis of a mental disorder, current medications, the number of sessions (maximum six on initial referral), and be signed and dated by the referring practitioner. From November 1, 2025, the referring practitioner must be at the patient’s MyMedicare registered practice or be the patient’s usual medical practitioner as defined by the new requirements. Referrals remain valid until the specified number of sessions are completed—they do not expire based on time. If a patient changes allied health providers, the referral remains valid for the new provider. GPs continue to determine how many sessions patients receive in each course of treatment, up to the maximum of 10 individual sessions per calendar year, typically providing up to six sessions initially with option for an additional course of up to four sessions.
Allied health professionals must provide written reports to the referring practitioner at the completion of each course of treatment, including assessments conducted, treatment provided, and recommendations for future management. This reporting requirement remains unchanged and is critical for supporting the continuity of care that underlies the November 2025 reforms.
Contact and further information
For provider enquiries about MBS items and claiming, contact Services Australia Provider Enquiry Line on 132 150 or email askMBS@health.gov.au. For patients, the Medicare General Enquiry Line is available on 132 011. Policy information is available on the Department of Health and Aged Care website at health.gov.au/Better-Access-Initiative. MBS Online at mbsonline.gov.au provides detailed item descriptors and explanatory notes for all Mental Health Treatment Plan and psychological therapy items.
The Department of Health has published comprehensive fact sheets titled “MBS changes under the Better Access initiative from 1 November 2025” available through MBS Online, and “Better Access redesign from 1 November 2025” available at health.gov.au/resources/publications. The Australian Government Response to the Better Access Evaluation provides detailed context about the policy rationale and broader mental health strategy. Guidance materials for implementing the changes are being finalized and will be available on the department website by November 1, with ongoing consultation with the sector throughout the implementation process.
Conclusion: Balancing continuity, access, and equity
The November 1, 2025 Better Access changes represent a significant policy shift attempting to balance multiple competing objectives: improving continuity of care through the MyMedicare/usual GP requirement, reducing administrative burden and improving financial viability for GPs through general attendance items and bulk billing incentives, and better targeting services to those who need them most. The retention of session limits while removing dedicated review items reflects evaluation findings that the problem is not the number of sessions but rather who accesses them and how effectively care is coordinated.
The controversy surrounding these changes reflects genuine tensions in mental health policy: continuity of care is valuable, but requiring patients to see a “usual GP” in an environment of significant GP workforce shortages may create unintended access barriers. Financial improvements for GPs through Level E items and tripled bulk billing incentives should support more affordable care, but the loss of dedicated mental health items eliminates data collection that could demonstrate general practice’s contribution to mental health outcomes. The broader mental health investment—including the National Early Intervention Service and enhanced Medicare Mental Health Centres—aims to create alternative pathways for people who cannot access or do not need GP-led Better Access services, though questions remain about whether these alternatives will adequately address equity gaps identified in the evaluation.
Medical practitioners should prepare for these changes by familiarizing themselves with the new referral requirements, ensuring patients understand the MyMedicare/usual GP pathway, and adjusting claiming practices to use general attendance items for mental health reviews and consultations. The transition provisions protect existing patients, but new referrals from November 1 must comply with the updated requirements. Monitoring how these changes affect patient access—particularly for vulnerable populations—will be critical as implementation proceeds.