Items 296–299
Psychiatrist new-patient comprehensive consultation
Professional attendance lasting more than 45 minutes by a consultant psychiatrist following referral, where the patient is either new to this psychiatrist or has not received a professional attendance from this psychiatrist in the preceding 24 months. Item billed depends on location — consulting rooms (296), hospital (297), or other location (299).
Plain-English summary. See MBS Online for the verbatim descriptor of each item.
Which item should I bill?
All variants share the same documentation requirements (below). The item number you bill is determined by the actual face-to-face duration and the location.
| Item | Time | Location | Typical use | MBS Online |
|---|---|---|---|---|
| 296 | More than 45 minutes | Consulting rooms | New patient seen in private rooms for the first comprehensive assessment. | Open |
| 297 | More than 45 minutes | Hospital | New referral or 24-month re-attendance reviewed during a hospital admission. | Open |
| 299 | More than 45 minutes | Other location (e.g. patient home) | Home visit or other community location. | Open |
Requirements to bill
Conditions imposed by the descriptor that must be met to claim any item in this family.
- 1Current referral from a medical practitioner in general practice, a participating nurse practitioner, a specialist, or another consultant physician.
- 2Attendance must last more than 45 minutes face-to-face.
- 3Patient must be new to this consultant psychiatrist OR must not have received a professional attendance from this psychiatrist in the preceding 24 months.
- 4In the preceding 24 months, no service under items 296, 297, 299, 300, 302, 304, 306, 308, 91827–91831, 91837–91839, 92437, or 92478–92483 has been provided to the patient by this psychiatrist (otherwise the standard time-banded attendance items apply, not the new-patient items).
- 5Item billed must match the actual location — 296 = consulting rooms, 297 = hospital, 299 = other location.
Your notes must show
Documentation tests — what clinical notes need to demonstrate to survive a PSR audit, regardless of which variant you bill.
- Date, start time, end time, and total face-to-face duration (>45 min).
- Location of attendance (consulting rooms / hospital / home / other) — must match the item claimed.
- Confirmation the patient is new to this psychiatrist OR no prior attendance by this psychiatrist in the preceding 24 months.
- Referral details — referrer name and profession, referral date, and validity period.
- Presenting concern, history of presenting complaint, past psychiatric history, past medical history, family history, social and developmental history.
- Mental state examination — appearance and behaviour, speech, mood and affect, thought form and content, perception, cognition, insight, judgement.
- Risk assessment — suicide, self-harm, harm to others, vulnerability, capacity.
- Diagnosis or differential — DSM-5-TR or ICD-11 framing with reasoning and rule-outs.
- Biopsychosocial formulation.
- Treatment plan — pharmacological reasoning, non-pharmacological modalities, monitoring, psychoeducation, review interval.
- Communication to the referrer (letter or summary) — best practice even where item 291 / 92435 is not claimed.
Common audit failures
Patterns the Professional Services Review scheme and Medicare audits flag.
- New-patient item billed where the patient was seen by this psychiatrist in the preceding 24 months — the standard time-banded items (300/302/304/306/308) apply instead.
- Consultation under 45 minutes — does not meet the time threshold for any item in the family.
- Item-location mismatch — billing 296 for a home visit, or 297 for a private-rooms attendance.
- No comprehensive history or MSE documented — note reads as a follow-up rather than an initial comprehensive assessment.
- No risk assessment.
- Confusion with item 291 — 291 carries the higher fee and the mandatory management-plan letter; auditors look for the letter when 291 is claimed.
Related MBS items
Diagnostic codes commonly billed under these items
ICD-10-AM diagnoses whose Medicare pathway includes this family of items. Click through to the diagnostic-code reference for differential codes and clinical context.
Dementia in Alzheimer's Disease
Organic Mental Disorders
Vascular Dementia
Organic Mental Disorders
Dementia in Other Diseases Classified Elsewhere
Organic Mental Disorders
Unspecified Dementia
Organic Mental Disorders
Organic Amnesic Syndrome Not Induced by Alcohol or Other Psychoactive Substances
Organic Mental Disorders
Delirium Not Induced by Alcohol and Other Psychoactive Substances
Organic Mental Disorders
Other Mental Disorders Due to Brain Damage and Dysfunction and to Physical Disease
Organic Mental Disorders
Personality and Behavioural Disorders Due to Brain Disease, Damage, and Dysfunction
Organic Mental Disorders
Unspecified Organic or Symptomatic Mental Disorder
Organic Mental Disorders
Mental and Behavioural Disorders Due to Alcohol Use
Substance Use Disorders
Mental and Behavioural Disorders Due to Opioid Use
Substance Use Disorders
Mental and Behavioural Disorders Due to Cannabinoid Use
Substance Use Disorders
Mental and Behavioural Disorders Due to Sedatives or Hypnotics
Substance Use Disorders
Mental and Behavioural Disorders Due to Cocaine Use
Substance Use Disorders
Mental and Behavioural Disorders Due to Other Stimulants Including Caffeine
Substance Use Disorders
Mental and Behavioural Disorders Due to Hallucinogens
Substance Use Disorders
Mental and Behavioural Disorders Due to Tobacco Use
Substance Use Disorders
Mental and Behavioural Disorders Due to Multiple Drug Use
Substance Use Disorders
Schizophrenia
Psychotic Disorders
Schizotypal Disorder
Psychotic Disorders
Persistent Delusional Disorders
Psychotic Disorders
Acute and Transient Psychotic Disorders
Psychotic Disorders
Induced Delusional Disorder
Psychotic Disorders
Schizoaffective Disorders
Psychotic Disorders
Other Nonorganic Psychotic Disorders
Psychotic Disorders
Unspecified Nonorganic Psychosis
Psychotic Disorders
Manic Episode
Mood Disorders
Bipolar Affective Disorder
Mood Disorders
Depressive Episode
Mood Disorders
Recurrent Depressive Disorder
Mood Disorders
Persistent Mood Disorders
Mood Disorders
Other Recurrent Mood Disorders — Unipolar Mania
Mood Disorders
Other Mood (Affective) Disorders
Mood Disorders
Unspecified Mood Disorder
Mood Disorders
Phobic Anxiety Disorders
Anxiety Disorders
Other Anxiety Disorders
Anxiety Disorders
Obsessive-Compulsive Disorder
Anxiety Disorders
Reaction to Severe Stress and Adjustment Disorders
Anxiety Disorders
Dissociative (Conversion) Disorders
Anxiety Disorders
Somatoform Disorders
Anxiety Disorders
Other Neurotic Disorders
Anxiety Disorders
Nonorganic Sleep Disorders
Behavioural Syndromes
Sexual Dysfunction Not Caused by Organic Disorder or Disease
Behavioural Syndromes
Mental and Behavioural Disorders Associated with the Puerperium
Behavioural Syndromes
Psychological and Behavioural Factors Associated with Disorders or Diseases Classified Elsewhere
Behavioural Syndromes
Abuse of Non-Dependence-Producing Substances
Behavioural Syndromes
Specific Personality Disorders
Personality Disorders
Mixed and Other Personality Disorders
Personality Disorders
Enduring Personality Changes Not Attributable to Brain Damage and Disease
Personality Disorders
Habit and Impulse Disorders
Personality Disorders
Gender Identity Disorders
Personality Disorders
Disorders of Sexual Preference
Personality Disorders
Psychological and Behavioural Disorders Associated with Sexual Development and Orientation
Personality Disorders
Other Disorders of Adult Personality and Behaviour
Personality Disorders
Specific Developmental Disorders of Speech and Language
Developmental Disorders
Specific Developmental Disorders of Scholastic Skills
Developmental Disorders
Specific Developmental Disorder of Motor Function
Developmental Disorders
Mixed Specific Developmental Disorders
Developmental Disorders
Other Disorders of Psychological Development
Developmental Disorders
Unspecified Disorder of Psychological Development
Developmental Disorders
Hyperkinetic Disorders / ADHD
Childhood & Adolescent Disorders
Conduct Disorders
Childhood & Adolescent Disorders
Mixed Disorders of Conduct and Emotions
Childhood & Adolescent Disorders
Emotional Disorders with Onset Specific to Childhood
Childhood & Adolescent Disorders
Disorders of Social Functioning with Onset in Childhood
Childhood & Adolescent Disorders
Tic Disorders
Childhood & Adolescent Disorders
Other Behavioural and Emotional Disorders with Onset in Childhood
Childhood & Adolescent Disorders
Templates that document these items
Note templates inside Grounded Scribe that produce documentation aligned to these MBS items.
In-depth reading in the Library
Mental Health Tribunal and Medico-Legal Report Writing: What Psychiatrists Need to Document
Psychiatrists regularly prepare reports for Mental Health Tribunals, courts, WorkCover, and insurers. This guide covers the anatomy of a defensible medico-legal report, state Mental Health Act requirements, and how structured dictation can reduce report-writing time.
Documenting Medication Changes During Psychiatric Reviews: A Structured Approach
Medication management is the backbone of psychiatric practice, yet many psychiatrists lack a consistent framework for documenting changes. This guide provides a structured approach to recording medication decisions, clinical reasoning, and monitoring plans during psychiatric reviews.
Psychiatric Consultation MBS Documentation: A Practitioner Guide
Australian psychiatrists bill from three groups of MBS attendance items: 291 (assessment-and-management-plan), the 296/297/299 new-patient comprehensive-consultation family, and the 300/302/304/306/308 duration-tier follow-up family. Each group has distinct schedule rules — 291 carries a mandatory management-plan letter and a 12-month limit; 296/297/299 require no attendance from this psychiatrist in the preceding 24 months; the 300-series shares a 50-attendances-per-calendar-year combined cap. This guide walks through documentation tests for each.
Source authority
Documentation tests on this page reference the descriptor conditions and PSR-audit patterns covered in our existing Library guides. Always confirm current rules against the official descriptor.
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