Medicare rebates are only available for individual therapy. They can't be claimed against the cost of psychological reports, late cancellation fees, couples counselling or family therapy. Diagnostic assessments, such as ADHD or ASD assessments, among others, are not covered by the Medicare Better Access Program.

What is a Mental Health Care Plan?

The Australian government has implemented a rebate program under Medicare for people seeking treatment from a psychologist. The ‘Better Access’ program has helped Australians access affordable mental health care.

If you are experiencing a mental health disorder, you and your GP may be able to create a Mental Health Care Plan or Mental Health Treatment Plan. A Mental Health Care Plan will outline the support you need from mental health professionals when treatment is required. It should also have the goals you and your GP agreed upon and the treatment options.

How much is a Psychologist’s Medicare Rebate?

The Medicare rebate covers a portion of sessions with a General Psychologist. The out-of-pocket or gap fee will depend on the psychologist’s session fee.

As of the 1st of July 2024, the Medicare rebates are as follows:

• $96.65 rebate per 50+ minute session with a General Psychologist.

You don’t need a Mental Health Care Plan or GP referral to see a psychologist. However, you need them to claim Medicare rebates.

To know whether you can get a Mental Health Care Plan and claim Medicare rebates, you must make a long appointment with your GP or see your psychiatrist. They will assess your eligibility and may refer you to a Psychologist under a Mental Health Care Plan.

Eligible clients with a GP referral and Mental Health Care Plan can claim Medicare rebates for up to 10 individual sessions per calendar year.

After your appointment with a psychologist, they will invoice you the full session fee. Once the invoice has been paid in full, they can submit it to Medicare on your behalf (or you can submit it yourself). Once Medicare has assessed and approved your invoice, the corresponding rebate amount is deposited into your nominated bank account registered with Medicare, generally within 24 hours.

The Medicare program covers the treatment of some of the most commonly presenting psychological conditions, such as:

• Alcohol use disorder

• Adjustment disorder

• ADHD - Attention deficit hyperactivity 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

• OCD Obsessive-compulsive disorder

• Panic disorder

• Phobic disorder

• PTSD Posttraumatic stress disorder

• Psychotic disorders

• Schizophrenia

• Sexual disorders

• Sleep problems

• Unexplained somatic complaints.

Private Health Rebates

Private Health Insurance options are available to both Australian residents and overseas students.

If you have private health insurance, you may be eligible to claim rebates for sessions with a psychologist.

Private health typically covers both in-person and online therapy sessions. These include individual therapy sessions, couples counselling and family therapy.

The level of cover and applicable waiting periods vary between insurance companies and depend on your extras cover policy.

Don’t hesitate to contact your private health insurance to determine eligibility and how much funding you can claim for psychological sessions.

It is best to call your Private Health Insurance fund and find out if you are eligible, how many appointments you can claim and the exact amount of your rebates.

How does Private Health Insurance cover sessions with a psychologist?

If your insurer cover includes psychological counselling, you can claim rebates directly with your insurer after the session with your psychologist, via an online portal or by completing one of their forms. You will need a copy of the invoice and receipt provided by your psychologist.

The National Disability Insurance Scheme (NDIS) has been established to support people with a disability. The scheme offers a variety of funding options for NDIS participants to access support services, such as therapy or counselling from a psychologist.

The process of accessing NDIS-funded services from a psychologist varies, depending on your circumstances. To find out if you are eligible or how to apply and access services, visit the NDIS website ndis.gov.au.

What does NDIS registered mean?

Service providers such as psychologists can choose to formally register with the NDIS. These are known as NDIS-registered providers. Registered providers are audited to make sure they meet strict requirements to do with safety, quality and compliance. Unregistered providers don’t go through this process and aren’t required to meet the same requirements – but that doesn’t mean they don’t provide the same quality as NDIS-registered providers.

The Family Room psychologists are unregistered NDIS providers. As a smaller provider we do not have the resources or inclination to go through the NDIS registration process.

A psychologists’ NDIS registration status doesn’t guarantee they’ll meet your personal standards of support and customer service. Make sure you do your research to find out if they are the right fit for you and your family.

NDIS Plan Funding Options

There are three ways to manage your NDIS funding. These include the following options:

• Self-managed Funding

• Plan-managed Funding

• NDIA or Agency-managed Funding

Self-managed and plan-managed clients may access psychological services funded by NDIS from any psychologist.

As The Family Room is not registered with the NDIS, we are unable to provide psychological services to clients who are NDIA or Agency-managed Funded.

Workcover Queensland is a Queensland government-funded program that provides worker’s compensation for employees who have acquired an injury or illness on the job.

WorkCover is an insurer and you need to lodge a claim with them. WorkCover then assesses your claim against criteria and decides to either accept or reject your claim. If your claim is accepted, your psychologist will send your appointment invoices to WorkCover, referencing your claim number. WorkCover will then pay directly for your appointment.

Physical Injury and Adjustment to Injury Counselling: If WorkCover has accepted your claim for a physical injury, your GP may decide you would benefit from adjustment to injury counselling. Adjustment to injury counselling can help you adapt to your physical injury, the rehabilitation process and the challenges it presents in your daily life. Seeing a psychologist can help you cope with your physical injury and improve your mental health.

Psychological Injury and Counselling

1. Lodging a claim: WorkCover's process for assessing psychological injury claims is often longer and more complicated than for a physical injury. For this reason, while your claim is being assessed, you can usually access psychological treatment funded by WorkCover to support your recovery. When you lodge your psychological injury claim, you can discuss this early intervention option with WorkCover.

2. Accepted Claim: If WorkCover accepts your claim for a psychological injury, WorkCover will fund your counselling as part of your treatment and rehabilitation.