Referral Requirements
- Medicare – Psychology consultation: If you wish to claim a rebate through Medicare, under a Mental Health Care Plan, you will need to consult your GP, psychiatrist or paediatrician for a referral to a psychologist. If you are provided with a Mental Health Care Plan, you will be entitled to up to 10 sessions on this plan in a calendar year. If you are consulting a clinical psychologist you will be rebated $129.55 for each session. If you are consulting a registered psychologist you will be rebated $88.25 for each session.
- Medicare – Allied Health Professional (Psychologist/Dietitian): If you wish to claim a psychology or dietetic service under a Medicare rebated GP Team Management Plan for Chronic Disease Management, you will need to consult your GP who may refer you to LifePsyche under a Medicare Chronic Disease Management plan. These plans allow you access to a Medicare rebate of $55.10 for 5 Allied Health appointments each calendar year. Please discuss with your regular GP whether you would be eligible. Please see the Medicare website for more information
Medicare will not accept your claim without the relevant referral information from a medical practitioner.
You cannot claim both a private health and Medicare rebate for the same session.
- In all cases, rebates from Medicare and private health funds do not apply to any services provided by an intern psychologist. We will tell you if a service is to be provided by an intern.
To review Medicare’s Better Access to Mental Health Care: Fact Sheet for Patients
Psychology Conditions Covered by Medicare Rebates
Many, but not all, conditions are eligible for Medicare rebates. If you want to ascertain your eligibility for rebates for psychological services under Medicare’s Better Access to Mental Health it is advisable that you book a long session with your treating doctor. Your doctor will conduct an assessment to determine if you have a diagnosed mental disorder that will allow you to access psychology services through Medicare.
Conditions that are covered by Medicare include:
Mood disorders
Depression
Bipolar disorder
- Anxiety disorders
Phobias
Generalised anxiety disorder
Post-traumatic stress disorder
Panic disorder
Obsessive Compulsive disorder
Mixed anxiety and depression
Psychotic disorders including schizophrenia and drug-induced psychosis
- Adjustment disorders
Unexplained somatic complaints
Conduct disorder
Attention deficit disorder
Bereavement disorder
Eating disorders
Alcohol use disorders
Sleep problems
Sexual disorders
Enuresis (non-organic)
Conditions that are not covered by Medicare include:
Dementia
Delerium
Tobacco-use Disorder
Mental Retardation
To review the complete Medicare Benefits Schedule list of fees and rebates for psychology items click here
Medicare Safety Net and Higher Rebates
The Medicare Safety Net provides a higher Medicare benefit (85% of the fee) once you reach a certain threshold. If you are single Medicare will automatically pay you the higher benefit when you reach your threshold. However, if you are a family, or a couple, you must register as a Medicare Safety Net Family. This includes those on the same Medicare card. If you are registered as a family or couple, Medicare combines your medical costs so you are more likely to reach the thresholds sooner.
A family is:
– A married couple – not separated, with or without dependent children
– A couple in a de facto relationship, with or without children
– A single person with dependent children
The Safety Net is calculated on a calendar year, 1 January to 31 December.
To register for the Medicare Safety Net as a couple or family use the form at this link: https://www.humanservices.gov.au/customer/forms/ms016
For further information, you can visit the Australian Psychological Society’s website here.