Understanding Medicare Rebates
Medicare rebates can help reduce the cost of psychology appointments if you have an eligible referral from your GP or psychiatrist.
There are a few things worth knowing about how rebates work, particularly how many sessions you can claim and when you may need to return to your GP.
How are Medicare rebates processed?
After each eligible appointment has been paid, my front desk support team will submit your Medicare rebate claim on your behalf.
Medicare pays the rebate directly into your nominated bank account, usually within 24–48 hours.
If you pay for your appointment after the due date, please let us know once payment has been made so that we can process your rebate.
What's the difference between a treatment plan and a referral?
Your GP may prepare a Mental Health Treatment Plan (MHTP) or an Eating Disorder Management Plan (EDMP) to help you access Medicare rebates for psychology sessions.
Your GP will also provide a referral letter, which specifies how many sessions you can attend before you need a further referral on the plan.
The number of sessions available depends on which type of plan you have.
Mental Health Treatment Plan (MHTP)
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Your GP can provide an initial referral for 6 sessions.
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After these sessions, you can return to your GP for a review and, if appropriate, the GP can make a further referral for 4 sessions.
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Medicare provides rebates for a maximum of 10 individual psychology sessions per calendar year under this pathway.
Eating Disorder Management Plan (EDMP)
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Your GP can provide an initial referral for up to 10 psychology sessions.
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Following a review, your GP can provide a further referral for up to 10 sessions.
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A specialist review with a psychiatrist or paediatrician is required to access rebates beyond the first 20 sessions.
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If clinically appropriate, you may be eligible for up to 40 rebated eating disorder psychological treatment sessions in a calendar year.
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An Eating Disorder Management Plan can only be used to claim rebates for treatment of an eating disorder, not for other mental health concerns.
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Not all eating disorders meet Medicare's eligibility criteria for an Eating Disorder Management Plan. Your GP will assess whether you are eligible.
Keeping your referral up to date
Medicare has rules about how long referrals remain valid and how many sessions can be claimed.
It's important to keep track of both:
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How many rebated sessions you have used under your current referral.
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When your referral is due to expire.
If your referral expires or you have used all the sessions it authorises, you may need to return to your GP for a review and a new referral before further Medicare rebates can be claimed.
You can continue attending psychology appointments without a current Medicare referral, but those appointments will not be eligible for a Medicare rebate.
When you're returning to your GP
Your GP will usually need a progress update from me when reviewing your treatment and considering a further referral.
Please let me know when you have booked your GP review, ideally with some notice, so I can prepare and send your progress letter in time.
Who keeps track of Medicare sessions?
Ultimately, it is your responsibility to ensure you have a current referral and sufficient sessions remaining to claim Medicare rebates.
I keep a record of your referrals and rebated sessions within my practice system. This helps me monitor your treatment and know when to prepare progress letters for your GP. I'll often remind you when I notice that you're approaching the end of a referral. If you're ever unsure about your referral or how many sessions you have remaining, you're very welcome to ask. However, practice systems and Medicare records don't always align perfectly, particularly if you have accessed rebated appointments with another provider.
What about couples therapy?
Medicare rebates are not available for couples therapy. These appointments are privately funded, even if one or both partners have a Mental Health Treatment Plan.