Medicare: Mental Health Care Plan
You may be referred for psychological services under the 'Better Access Initiative'. This process usually involves a doctor developing a Mental Health Care Plan (MHCP) for your specific needs.
Under this initiative, eligible individuals can receive Medicare rebates for up to ten sessions with a mental health professional in a calendar year. With the impact of the COVID-19 pandemic on the mental health of Australians, Medicare has provided funding for access to an additional ten sessions under the 'Better Access Pandemic Support' item numbers until 30th June 2022 (rebates for Telehealth sessions under these item numbers can be claimed up until 31st December 2021). This means that individuals may receive rebates for up to 20 sessions in one calendar year.
It is up to your General Practitioner (GP), Psychiatrist or Paediatrician to determine if you or your child are eligible for these sessions. If deemed eligible, the process for accessing these sessions is outlined in the diagram below:
That is, once you have a valid referral letter or Mental Health Treatment Plan from your doctor:
You are eligible for a maximum of six initial sessions under this scheme, before requiring a re-referral
After your sixth session, your Psychologist must write back to your doctor to request additional sessions if needed
You will have to contact your doctor for a re-referral for an additional four sessions maximum. Please note, you only require a re-referral not a review, though the paperwork provided
After your tenth session, your Psychologist must write back to your doctor to request additional sessions if required
You will have to contact your doctor for a re-referral for an additional ten sessions maximum. Please note, you only require a re-referral not a review
After your 20th session, your Psychologist must write back to your doctor to report progress
Frequently Asked Questions (FAQs)
Do I need a referral to access sessions?
No. You can access Psychological services as a privately paying patient and do not need a referral from a doctor. If you wish to access Medicare rebates for your sessions, you do require a valid referral.
Who can access Better Access rebates?
The rebate is available to people with a diagnosed mental disorder. This includes many conditions, such as depression and anxiety. The first step is to get a mental health treatment plan from your doctor. This plan identifies the health care you need, and outlines the goals you and your doctor want to achieve.
My first referral letter says I can have 10 sessions with a psychologist. Do I still need a re-referral letter after the sixth session?
Yes. Although your referral letter may state more than six sessions, Medicare requires a report back from your Psychologist to your referring doctor after the sixth session and a re-referral letter for sessions to be eligible for rebates.
My session with my Psychologist is today and I don't have re-referral letter. What happens now?
Your treatment can continue without a re-referral. However, please note that your session will be billed privately. If you have private health insurance, you may be able to claim a rebate through your fund. Your session is eligible for a Medicare rebate if the re-referral letter from your doctor is dated prior to or on the day of your appointment.
I have private health insurance and a Medicare referral. Can I claim both?
You are able to collect a rebate from only one source, either Medicare or your private health fund.
For further information or support regarding this process, please contact us on 8091 7867 or email firstname.lastname@example.org.