To access psychology services under Medicare, you need to have a referral from your GP, a psychiatrist or a paediatrician.
People who are eligible for a mental health care plan can receive up to 10 individual or group therapy sessions covered under Medicare in one calendar year (12 months from 1 January to 31 December).
However, referrals do not cover all 10 sessions. With a mental health care plan from your GP, you are entitled to a maximum of 6 Medicare rebatable sessions.
If you complete these six sessions within the calendar year and need to continue treatment with your psychologist, you will need to visit your GP for a mental health plan review.
Your GP will determine whether further sessions are needed and if so they will provide another referral for the remaining four sessions.
What happens if I complete all 10 sessions within the calendar year?
If you complete all 10 sessions within the calendar year, you can still see your psychologist for psychology services, however, you will not be able to claim the Medicare rebate using your mental health care plan.
If your mental health practitioner recommends to continue treatment, you may be eligible for an EPC plan.
An EPC plan enables you to claim a rebate of $51.95 for a maximum of 5 sessions per calendar year through Medicare.
If within the calendar year, you use all 10 sessions on your mental health care plan and you still wish to continue treatment with your psychologist and receive Medicare benefits, you will need to see your GP for a mental health review to determine whether you are eligible for an EPC plan.
Once a new calendar year begins (1 January), you can visit your GP for a new mental health care plan.
Do I need a GP referral to see a psychologist?
You do not need a referral from your GP to see a psychologist. If you see a psychologist without a GP referral, you will be required to pay the full amount for your session.
If you have private health insurance with psychological counselling as extras, you may be able to claim a partial rebate.
It is best to contact your private health fund for further information about your coverage.
If I am already seeing a psychologist, can I access Medicare benefits?
If you have been seeing a psychologist and paying for your sessions out of your own pocket, you will need to visit your GP for a mental health assessment to determine whether you are eligible for Medicare benefits.
Can I receive 100% Medicare Bulk Billed sessions?
We do offer a limited number of bulk billed sessions per week to cater to those who are under financial strain. You will need a mental health care plan and it is subject to eligibility and availability. Please contact us for more information.
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