291 Assessment
A 291 Assessment is a comprehensive psychiatric assessment conducted by a consultant psychiatrist following an appropriate referral. It includes a detailed review of your mental health, relevant history and current concerns, with a written diagnostic assessment and management plan provided to your referring practitioner where Medicare requirements are met.
Comprehensive assessment
Your psychiatrist reviews your current concerns, psychiatric history, symptoms, treatment history and relevant personal circumstances as part of a detailed initial psychiatric assessment.
Referral and review
A 291 Assessment requires an appropriate referral from a GP or participating nurse practitioner. Your psychiatrist reviews the referral alongside information gathered during the consultation.
Diagnostic assessment
The assessment considers your presentation and available clinical information to determine an appropriate psychiatric diagnosis where sufficient information is available.
Medicare requirements
Item 291 has specific Medicare requirements relating to the assessment, referral, duration and written management plan. Eligibility for a Medicare rebate depends on meeting the applicable requirements.
What happens during a 291 Assessment?
A 291 Assessment gives your referring GP access to a detailed specialist psychiatric opinion. During the appointment, the consultant psychiatrist undertakes a mental state examination and comprehensive diagnostic assessment, with an appropriate outcome tool used where clinically appropriate. Where Item 291 requirements are met, a written 12-month management plan is provided to the referring practitioner.
Comprehensive psychiatric assessment
Mental state examination
Diagnostic assessment
Appropriate outcome tools where indicated
12-month management plan
Written report for your referrer
What does a Medicare Psychiatrist Assessment involve?
The purpose of a Medicare 291 Assessment is to provide specialist psychiatric expertise that can inform ongoing care by the referring practitioner.
The psychiatrist will:
Review the referral
Relevant information provided by the referring GP or participating nurse practitioner is considered alongside the patient's presentation.
Complete the assessment
The psychiatrist undertakes the required psychiatric assessment, including a mental state examination and comprehensive diagnostic assessment.
Develop recommendations
A management plan is prepared based on the patient's diagnosis and relevant biological, psychological and social factors.
Report to the referrer
A written report containing the comprehensive diagnostic assessment and 12-month management plan is provided to the referring practitioner within two weeks of the assessment. Where clinically appropriate, the diagnosis and plan may also be explained to the patient and a copy provided.
What happens during a 291 Assessment?
A 291 Assessment follows a structured process designed to provide your referring GP or participating nurse practitioner with specialist psychiatric input. The assessment includes a mental state examination and comprehensive diagnostic assessment, followed by a written management plan where the psychiatrist determines that ongoing care can appropriately remain with the referring practitioner.
1. Referral
A GP or participating nurse practitioner refers you to a consultant psychiatrist for assessment or management.
2. Assessment
Your psychiatrist reviews your concerns, relevant history and current presentation, including a mental state examination.
3. Diagnostic review
A comprehensive diagnostic assessment is undertaken, with an appropriate outcome tool used where clinically indicated.
4. Management plan
A written 12-month management plan is prepared for your referring practitioner, covering relevant biopsychosocial factors and ongoing care recommendations.
Understanding your 291 Assessment
A 291 Assessment is intended to provide your GP with a detailed psychiatric assessment and practical recommendations for ongoing management. Your psychiatrist considers your presenting concerns alongside relevant psychiatric, medical, psychological and social history. The consultation includes a mental state examination and comprehensive diagnostic assessment, with an appropriate outcome tool used where clinically appropriate.
The assessment is designed for circumstances where the psychiatrist determines that your ongoing care can appropriately be managed by the referring GP or participating nurse practitioner without ongoing management by the psychiatrist. This makes the written report an important part of the service, rather than simply a record of the consultation.
What is included in the written report?
The psychiatrist provides the referring practitioner with a written report containing the comprehensive diagnostic assessment and a 12-month management plan. The plan considers relevant biopsychosocial factors and may include recommendations relating to psychological treatment, medication, monitoring, further assessment, longer-term goals or escalation of treatment where clinically appropriate.
The report must be provided to the referring practitioner within two weeks of the assessment. Where clinically appropriate, the psychiatrist may also explain the assessment and management plan to the patient and provide a copy.
Face-to-Face Appointments
Face-to-face 291 Assessments are available at our practice, allowing your psychiatrist to complete a detailed assessment in a private consultation setting.
Telehealth Appointments
Telehealth 291 Assessments may be available where clinically appropriate, providing access to a consultant psychiatrist without attending the practice in person.
Frequently asked questions
What is a 291 Assessment?
A 291 Assessment is a specialist psychiatric assessment under Medicare involving a comprehensive diagnostic assessment and a written 12-month management plan for the referring GP or participating nurse practitioner.
Do I need a GP referral for a Medicare 291 Assessment?
Yes. Item 291 requires a referral from a medical practitioner in general practice, including a GP, or a participating nurse practitioner.
How long does a 291 Assessment take?
The Medicare Item 291 consultation must last more than 45 minutes at the consultant psychiatrist’s consulting rooms.
What does the psychiatrist provide after the assessment?
The psychiatrist prepares a written report containing the comprehensive diagnostic assessment and a management plan covering the next 12 months, which is provided to the referring practitioner within two weeks.
Is a 291 Assessment the same as ongoing psychiatric treatment?
No. Item 291 is intended for situations where the psychiatrist considers it clinically appropriate for the referring practitioner to manage the patient’s ongoing care without ongoing management by the psychiatrist.