MEDICARE & INSURANCE INFORMATION
COUNSELLING SERVICES
MEDICARE - Key Points
Fees apply for every service. The recommended rate for psychology is $311 per 45-60 minute consultation.
PRIVATE FUNDED CLIENTS
For private clients who do not have insurance, we have reduced the fee and it ranges from $135 - $165 for a 50 minute consultation. The fee varies depending on the service required, and who you see (Counsellor, Psychologist, Provisional Psychologist, Social Worker). You will need to contact your therapist directly, to confirm fees.
INSURANCE FUNDED CLIENTS
All services accessed via insurance agencies or funded by third parties (e.g., MAIB) are set at the rate recommended by psychology, counselling and social work societies.
Refer to the relevent Australian Association for Psychologists, Counsellors or Social Workers
You may opt to visit a psychologist or MH social worker directly without a referral. However you will NOT be able to access Medicare rebates. If you are seeking support and do not have insurance, the first step is to visit your GP. Your GP will discuss your situation and determine your eligibility for a Medicare Mental Health Treatment Plan and referral.
A MHTP enables rebates for people who have the following conditions: anxiety disorder, adjustment disorder, depression, sexual disorders, conduct disorders, bereavement disorders, post traumatic stress disorder, eating disorders, panic disorder, alcohol use disorder, drug use disorder, sleep problems, attention deficit disorder, obsessive compulsive disorder, psychotic disorders, schizophrenia, bipolar disorders, phobic disorders, and co-occurring anxiety and depression.
People experiencing other conditions or seeking other services (e.g., assessments, couples counselling) can also see a therapist, however they will not qualify for a Medicare Mental Health Treatment Plan and will not be eligible for Medicare rebates.
MEDICARE REBATES ARE UNAVAILABLE FOR THE FOLLOWING SERVICES
Unfortunately Medicare does not sibsidise the following services, and fees associated with the following services are billed directly to the patient.
Payment is due on the day of service. All accounts must be paid prior to making future appointments. Each therapist offers different payment methods. Please confirm procedures with your therapist prior to attending.
CANCELLATION POLICY
A late cancellation fee will be issued, when we receive less than 48 hours notice of cancellation.
Cancellation fees are not covered by Medicare , and must be paid prior to booking future appointments.
The demand for appointments is high. As such we maintain a wait list for when cancellations occur. To enable us to offer your space to someone who is waiting for an appointment, please share the care, and provide 48 hours notice of cancellation.
- Please be aware that Medicare rebated services ARE NOT bulk billed. Also note that Medicare rebates are not automatically available - you must have a Mental Health Treatment Plan and referral in place prior to attending.
- To check your eligibility for Medicare rebates, you must talk with your referring practitioner (GP, Paediatrician, Psychiatrist). They will assess whether you are eligible for rebates, and then complete a Mental Health Treatment Plan and referral.
- Medicare rebates are ONLY available if you have a current referral and Medicare Mental Health Treatment Plan prior to attending. The maximum number of rebates on one referral is 6.
- Medicare provides a partial refund called a rebate. This is paid to you after you have paid for the service. Please note that the rebate amount varies depending on the service required, and who you see (Counsellor, Psychologist, Provisional Psychologist, Social Worker). It ranges from approximately $80-$130, and does not cover the full fee to see a psychologist or social worker.
- The out of pocket to you is the differenve between the fee for the service and the rebate refunded by Medicare. This is often referred to as a GAP. Medicare have strict rules - which do not allow people to only pay the GAP. You must pay the full fee, and only after payment is recieved, Medicare will issue a rebate.
- Medicare rebates can be accessed when seeing a psychologist or mental health social worker, but not when seeing a counsellor or provisional psychologist.
- Medicare rebates are available for therapy services.
- Medicare rebates are NOT available for diagnosis or assessment services - full fees apply.
Fees apply for every service. The recommended rate for psychology is $311 per 45-60 minute consultation.
PRIVATE FUNDED CLIENTS
For private clients who do not have insurance, we have reduced the fee and it ranges from $135 - $165 for a 50 minute consultation. The fee varies depending on the service required, and who you see (Counsellor, Psychologist, Provisional Psychologist, Social Worker). You will need to contact your therapist directly, to confirm fees.
INSURANCE FUNDED CLIENTS
All services accessed via insurance agencies or funded by third parties (e.g., MAIB) are set at the rate recommended by psychology, counselling and social work societies.
Refer to the relevent Australian Association for Psychologists, Counsellors or Social Workers
- NDIS RATES: Applicable rates are recommended by the NDIS Commission.
- PRIVATE HEALTH: Please contact your private health care fund directly to determine eligibility for rebates.
- INSURANCE & MAIB: Eligible patients may have access to cover.
- EMPLOYEE ASSISTANCE PROGRAMS (EAP): May cover fee for up to 4 consultations.
- Eligible Victims of Crime may have cover for psychology, counselling and social work services.
- Eligible veterans will have cover by the Department of Veteran Affairs.
You may opt to visit a psychologist or MH social worker directly without a referral. However you will NOT be able to access Medicare rebates. If you are seeking support and do not have insurance, the first step is to visit your GP. Your GP will discuss your situation and determine your eligibility for a Medicare Mental Health Treatment Plan and referral.
- Your Doctor will determine whether you are eligible for a MHTP. Eligible people can access rebates for up to 10 individual consultations in a calendar year (1 January to 31 December).
- After the first 6 consultations your therapsit will provide a report for your doctor and your doctor will assess your progress to determine whether further sessions are approved.
- When you have utilised 10 rebates in a calendar year you will not be eligible for any further Medicare rebates. Additional consultations incur full fees.
- Medicare is only available for therapeutic services for the individual referred.
A MHTP enables rebates for people who have the following conditions: anxiety disorder, adjustment disorder, depression, sexual disorders, conduct disorders, bereavement disorders, post traumatic stress disorder, eating disorders, panic disorder, alcohol use disorder, drug use disorder, sleep problems, attention deficit disorder, obsessive compulsive disorder, psychotic disorders, schizophrenia, bipolar disorders, phobic disorders, and co-occurring anxiety and depression.
People experiencing other conditions or seeking other services (e.g., assessments, couples counselling) can also see a therapist, however they will not qualify for a Medicare Mental Health Treatment Plan and will not be eligible for Medicare rebates.
MEDICARE REBATES ARE UNAVAILABLE FOR THE FOLLOWING SERVICES
Unfortunately Medicare does not sibsidise the following services, and fees associated with the following services are billed directly to the patient.
- Parent Consultations
- Reports
- Diagnosis and Assessments
- Stakeholder Consultations (e.g. teachers, lawyers, case workers)
- Consultations provided by a Counsellor or Provisional Psychologist
- Couple counselling
- Letters and emails
- Travel
- Cancellation fees
- The full fee applies at each consultation and a Medicare rebate is refunded after payment is recieved. Only clients who have a current MHTP plus a referral can access a rebate. If these are not completed, the client is responsible for the full fee and will not be able to access rebates.
- When you have both a Mental Health Treatment Plan and referral, Medicare will provide rebates when seeing a nationally registered psychologist, or a nationlally accedited mental health social worker, but not when seeing a professional counsellor or provisional psychologist. As such the out of pocket rate to see a counsellor or provisional psychologist is higher.
- You must contact your therapist to confirm their fee and the out of pocket incurred as each therapist is an independent practitioner with different fee structures.
Payment is due on the day of service. All accounts must be paid prior to making future appointments. Each therapist offers different payment methods. Please confirm procedures with your therapist prior to attending.
CANCELLATION POLICY
A late cancellation fee will be issued, when we receive less than 48 hours notice of cancellation.
Cancellation fees are not covered by Medicare , and must be paid prior to booking future appointments.
The demand for appointments is high. As such we maintain a wait list for when cancellations occur. To enable us to offer your space to someone who is waiting for an appointment, please share the care, and provide 48 hours notice of cancellation.
