Psychiatrist new-patient comprehensive consultation — video telehealth

Video 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 92437 is the video-telehealth equivalent of the in-person new-patient family (296 consulting rooms, 297 hospital, 299 other location).

Plain-English summary. See MBS Online for the verbatim descriptor of each item.

Time

More than 45 minutes

Frequency

Not capped

Referral

Required

Profession

Consultant Psychiatrist

Requirements to bill

Conditions imposed by the descriptor that must be met to claim this item.

1Current referral from a medical practitioner in general practice, a participating nurse practitioner, a specialist, or another consultant physician.
2Attendance must be by videoconference (not phone) and last more than 45 minutes.
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 telehealth attendance items apply, not the new-patient item).
5A clinically appropriate audio + visual link must be used; the patient must be able to see and hear the practitioner and vice versa.

Your notes must show

Documentation tests — what clinical notes need to demonstrate to survive a PSR audit.

Date, start time, end time, and total face-to-face video duration (>45 min).
Modality — videoconference, with confirmation that audio + visual link was clinically appropriate.
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 (with explicit notation of any limitations imposed by the video modality).
Risk assessment — suicide, self-harm, harm to others, vulnerability, capacity, including how the practitioner verified safety in a telehealth context.
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.

Phone-only attendance billed as 92437 — 92437 is video only; phone attendances must use 91837–91839 (which are time-banded follow-up items, not new-patient items).
Item billed where the patient was seen by this psychiatrist in the preceding 24 months — the time-banded video items (91827–91831) apply instead.
Consultation under 45 minutes video — does not meet the time threshold.
No comprehensive history or MSE documented — note reads as a follow-up rather than an initial comprehensive assessment.
No documented adaptation to telehealth — particularly in MSE and risk assessment, where the video modality changes what can and cannot be observed.
No risk assessment.

Related MBS items

291

Psychiatrist assessment and management plan

296–299

Psychiatrist new-patient comprehensive consultation

91827–91839

Psychiatric attendance — duration-tier follow-up (telehealth)

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.

Item 92437 on MBS Online

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