Medicare and psychology
There are currently 2 programs available under Medicare that offer financial assistance for counselling:
- Better Access Medicare Initiative
- Chronic Disease Management
Better Access Medicare Initiative
The “Better Access“ Medicare initiative for Focused Psychological Strategies offers the opportunity for clients to receive a rebate for up to 10 sessions of counselling that uses specific evidence based techniques. A Medicare rebate of at least $84.80 is available (if your doctor assesses you as eligible), which leaves a gap fee payable by you.
To be eligible for this rebate, you first need to meet with your doctor (either a General Practitioner or Psychiatrist) before the counselling appointment. Your doctor must decide whether you have ‘an assessed mental health disorder’ that significantly interferes with your cognitive, emotional or social functioning.
Your doctor may need a longer appointment to make this assessment. Note that not all General Practitioners refer under this scheme, and if you can afford to pay for counselling you may not be eligible. If your doctor assesses that you are eligible, they will complete a mental health care plan.
A psychologist’s report is provided to your doctor after the first six psychology sessions, and you will then need to meet with your doctor for a review. Your doctor will decide whether a further four sessions is available.
Medicare – Enhanced Primary Care (EPC)
The Enhanced Primary Care (EPC) program allows chronically ill people who are being managed by their GP to Medicare rebates for allied health services. Eligible patients may access Medicare rebates for a total of 5 allied health services (including Osteopathy, Dietitian, Physiotherapy, Chiropractic, Speech Pathology, and Psychology) in a calendar year. The Medicare rebate for psychology under the EPC is currently $51.95. Please note that the EPC rebate is lower than the rebate for Mental Health Care plans, and as a result the gap fee is higher.
- Under the Better Access Initiative, any cancellation or missed session fees are the responsibility of the client, and will not be covered by Medicare. (This does not apply to TPSS referrals – See the TPSS Info Sheet).
- If the service is not covered by Medicare, the cost of the service remains the responsibility of the client.
- To prevent exceeding the number of rebated sessions available, clients will need to advise if they have received a Medicare rebate for psychological therapy with another psychologist in the same calendar year.