Medicare funded services

Better Access to Mental Health Care 

To access mental health treatment under Medicare you must be referred by your GP, a psychiatrist or a paediatrician. If a GP is the referring practitioner he or she will need to prepare a Mental Health Treatment Plan before referring you to a psychologist. You should book a longer session with your GP to enable time for this.

Medicare rebates are available for psychological treatment by registered psychologists under the Australian Government's Better Access to Mental Health Care initiative. This scheme provides considerable assistance to people living with mental health problems, allowing them greater access to psychologists and providing more affordable mental healthcare.

Under this scheme individuals diagnosed with a mental health disorder can access up to 10 individual and 10 group treatment sessions per year.

'Mental disorder' is a term used to describe a range of clinically diagnosable disorders that significantly impact on a person's emotions, thoughts, social skills and decision-making. The Better Access initiative covers people with mental disorders arising from:

• Alcohol use disorder

• Adjustment disorder

• Attention deficit disorder

• Bereavement disorder

• Bipolar disorder

• Chronic fatigue

• Conduct disorder

• Co-occurring anxiety and depression

• Depression

• Dissociative disorder

• Drug use disorder

• Eating disorders

• Enuresis

• Generalised anxiety disorder

• Mental disorder, not otherwise specified

• Obsessive compulsive disorder

• Panic disorder

• Phobic disorder

• Posttraumatic stress disorder

• Psychotic disorders

• Schizophrenia

• Sexual disorders

• Sleep problems

• Unexplained somatic complaints -(APS, 2024)

Chronic Disease Management Plan

The chronic disease management (CDM) Medicare items are part of a government initiative that assists people living with a chronic or complex medical illness to get the support and help they need from allied health professionals.

Medicare rebates are available for up to five visits (in total) within a calendar year, to certain allied health professionals assisting in the care and management of a chronic disease from a range of allied health.

Chronic medical conditions that may be covered by the scheme must have been present, or are likely to be present, for six months or more. The conditions include, but are not limited to:

• Asthma

• Cancer

• Cardiovascular illness

• Diabetes

• Musculoskeletal conditions

• Stroke

In order to receive a Medicare rebate under this initiative, you must be referred to a psychologist by your GP under a specific management plan to assist in managing your chronic/complex medical illness. If you are already seeing a psychologist, discuss this with your doctor. - (APS, 2024)

Helping Children With Autism (HCWA)

Under the government funded Helping Children with Autism (HCWA) initiative Medicare rebates are available for assessment and treatment services for children and young people with an Autism Spectrum Disorder (ASD). Assessment and treatment can be provided by a number of eligible allied health professionals under this initiative.

Assessment services are available up until the child’s 13th birthday, and treatment services are available up until a child turns 15 years of age, provided their treatment plan was in place before their 13th birthday.

Before a psychologist can undertake an assessment, the young person must have been referred for assessment by a paediatrician or consultant psychiatrist.

Prior to providing treatment, the psychologist must have received a referral by a paediatrician or consultant psychiatrist, and the paediatrician or consultant psychiatrist must already have developed a treatment plan for that young person.

Under this initiative, up to four assessment sessions provided by a psychologist and other allied health professionals are available to assist the referring practitioner with diagnosis, or to contribute to a child’s treatment and management plan.

In addition, up to 20 treatment sessions provided by a psychologist and other allied health professionals are available.

It is important to note that these are the total number of services available to each child through HCWA – not an annual entitlement.

It is also important to note that these are the total number of services available for all allied health service providers, not the number of services provided by a psychologist alone. For example, an assessment might involve a speech pathologist, a psychologist and an audiologist, whose assessment sessions combined must not total more than four sessions in order for them to be eligible for Medicare rebates. If additional sessions are required, these would not be eligible for Medicare rebates under this initiative.

It is the responsibility of the referring medical practitioner to allocate these services in keeping with the child’s individual needs. -(APS, 2024)

Pregnancy support counselling

This psychology service offers pregnancy support counselling to assist clients who have any personal concerns related to a current or recent pregnancy (within the past 12 months), whether it has been full-term or part-term (including a planned termination). 

The pregnancy support counselling Medicare Item covers up to three 30 minute+ sessions with a psychologist per pregnancy.- (APS, 2024)

People of Aboriginal and Torres Strait Islander descent

Under the Medicare-funded services for People of Aboriginal or Torres Strait Islander descent initiative, Medicare rebates are available for assessment and treatment services for Aboriginal and Torres Strait Islander people who have had a health assessment from their GP and require follow-up allied health services.

A person is eligible for this service if they are of Aboriginal or Torres Strait Islander descent and had a health assessment during which the medical practitioner identified a need for follow-up allied health services. The client must not be an admitted patient of a hospital.

Medicare rebates are available for up to five allied health services in total per calendar year. The annual limit of five allied health services is in addition to other allied health services such as the Chronic Disease Management or Better Access to Mental Health Care services.

It is important to note that the available services under this initiative are the total number of services available for all allied health service providers, not the number of services provided by a psychologist alone.- (APS, 2024) 

NDIS Funded Services 

We provide NDIS- supported psychological services to self-managed and plan-managed NDIS participants.  If you have a mental illness or psychosocial disability, we provide supports that help you: 

• do activities of daily living – that is, go about your daily life

• take part in your community, your social life, study and work

• regain and rebuild skills and confidence in your usual activities of daily living.

Our paediatric psycholgists also provide therapy to children and adolescents who are NDIS self or planned managed participants. 

Private Health Care Insurance (Extras) 

Psychological services may be partially covered by private health insurance. Please check your policy. 

You cannot use your private health insurance ancillary cover to top up the Medicare rebates.