(as at 1/1/20)
|Private Health Fund Rebate|
|50min Psychology consultation (in rooms)||$190||$126.50 with MHCP||Check with your fund|
|30 min Psychology Consultation (in rooms)||$120||$86.15 with MHCP||Check with your fund|
|50min telehealth consultation||$190||$126.50 with MHCP||Check with your fund|
|30 min Telehealth consultation||$120||$86.15 with MHCP||Check with your fund|
|50 min Psychology Consultation (at location other than consultation rooms)||$220||$148.00 with MHCP||Check with your fund|
|50 min Team Management Arrangement (TCA) Consultation
for Chronic Disease Management
|$190||$53.80 with eligible TCA||N/A|
|50 min Pregnancy Support Counselling Consultation||$190||$63.20 with eligible referral||N/A|
|50 min Donor Implications counselling Consultation||$190 ph||N/a||Check with your fund|
|Pre-surrogacy implications counselling (6 hours) and report||$2215 total (incl GST)||N/a||Check with your fund|
|Post -surrogacy implications counselling (3 hours) and report||$1200 total (incl GST)||N/a||Check with your fund|
|Late cancellation/failure to attend fee||If cancellation occurs within 24 hrs 100% of scheduled fee may be applied.||Medicare rebates cannot be applied.||Health fund rebates cannot be applied.|
You are welcome to attend as a privately funded patient (ie out of pocket or with health fund rebate) and no referral is required.
However, if you wish to claim a Medicare rebate, you must attend with a valid referral. Medicare rebates apply under the following conditions:
a. Better Access to Mental Health – Clinical Psychology consultation: If you wish to claim a rebate through Medicare, under a Mental Health Care Plan, you will need to consult your GP or psychiatrist. It is advisable that you book a long session with your treating doctor, who will conduct an assessment to determine if you have a diagnosed mental disorder that will allow you to access psychology services through Medicare. Conditions that are covered by Medicare include:
- Mood disorders
- Bipolar disorder
- Anxiety disorders
- Generalised anxiety disorder
- Post-traumatic stress disorder
- Panic disorder
- Obsessive Compulsive disorder
- Mixed anxiety and depression
- Psychotic disorders (incl schizophrenia & drug-induced psychosis
- Adjustment disorders
- Unexplained somatic complaints
- Conduct disorder
- Attention deficit disorder
- Bereavement disorder
- Eating disorders
- Alcohol use disorders
- Sleep problems
- Sexual disorders
- Enuresis (non-organic)
Conditions that are not covered by Medicare include:
- Tobacco-use Disorder
- Mental Retardation
b. GP Team Management Plan for Chronic Disease Management – Allied Health Professional consultation: If you wish to claim an allied health professional service under a Medicare rebated GP Team Management Plan for Chronic Disease Management, you will need to consult your GP.
c. Pregnancy Support Counselling – Clinical Psychology consultation: If you wish to claim a Medicare Rebated non-directive pregnancy support counselling service, you will need to consult your GP. You may be eligible if you are currently pregnant or have been pregnant in the preceding 12 months. The service may be used to address any pregnancy related issues for which non-directive counselling is appropriate. You can claim a maximum of three non-directive pregnancy support counselling services per patient, per pregnancy.
Please note, that regardless of the referral condition, Medicare will not accept your claim without the relevant referral information from a medical practitioner, and you cannot claim both a private health and Medicare rebate for the same session.
To review Medicare’s Better Access to Mental Health Care: Fact Sheet for Patients
How many sessions per year does Medicare offer rebates for?
a. Mental Health Care Plans: 10 sessions in a calendar year (1 January to 31 December).
b. GP Team Management Plans: 5 sessions in a calendar year (1 January to 31 December).
c. Pregnancy Support Counselling: 3 sessions per pregnancy
How much is the Medicare rebates?
a. Mental Health Care Plan – Clinical Psychologist:
Services attract a rebate of $126.50 (hour session) or $86.15 (30 min session)
Telehealth services attract a rebate of $126.50 (hour session) or $86.15 (30 min session)
Services provided at a location other than usual consulting rooms attract a rebate of $148 (hour session)
b. GP Team Management Plan Arrangement (Chronic Disease Management Plan)
Services attract a rebate of $53.80 per session (for up to five sessions in a year). Sessions must be at least 20 minutes.
c. Pregnancy Support Counselling – Psychology
Services attract a rebate of $63.20
To review the complete Medicare Benefits Schedule list of fees and rebates for psychology items click here
What happens when I reach the Medicare Safety Net?
The Medicare Safety Net provides a higher Medicare benefit (85% of the fee) once you reach a certain threshold. If you are single Medicare will automatically pay you the higher benefit when you reach your threshold. However, if you are a family, or a couple, you must register as a Medicare Safety Net Family. This includes those on the same Medicare card. If you are registered as a family or couple, Medicare combines your medical costs so you are more likely to reach the thresholds sooner.
A family is:
– A married couple – not separated, with or without dependent children
– A couple in a de facto relationship, with or without children
– A single person with dependent children
The Safety Net is calculated on a calendar year, 1 January to 31 December. To register for the Medicare Safety Net as a couple or family use the form at this link: https://www.humanservices.gov.au/customer/forms/ms016
For further information, you can visit the Australian Psychological Society’s website here.
Private Health Fund Referrals and Rebates:
You do not require a referral to see a psychologist if you are self-funding the session or being funded by your private health fund (e.g. BUPA).
Private health fund plans may provide rebates for psychological services. You are advised to check with your health fund about your eligibility requirements for psychology services before attending an appointment. You cannot use both your Medicare referral and private health to rebate on the same session.
Department of Veterans’ Affairs (DVA) Rebates:
We can process DVA clients through the Medicare online portal.
DVA issues health cards to veterans, their war widow(er)s and dependants to ensure they have access to health and other care services. There are two types of DVA health cards available, Gold and White Cards. Both cards have different entitlements to access health services.
A Gold Card entitles the holder to DVA funding for services for all clinically necessary health care needs, and all health conditions, whether they are related to war service or not. The card holder may be a veteran or the widow(er) or dependant of a veteran. Only the person named on the card is covered. Generally, health services listed on the Medicare Benefits Scheme (MBS) (including Psychological services) are available to Gold Card holders and are consistent with the limits under the MBS. For any other health services that are not listed on the MBS, you will require prior financial authorisation from DVA. To check if you are entitled to Psychological Therapy services you can call the DVA Health Provider Line on 1300 550 457 (Metro) or 1800 550 457 (Non-Metro).
Services covered by a DVA White Card are the same as those for a Gold Card but must be for:
- accepted injuries or conditions that are war caused or service
- malignant cancer, pulmonary tuberculosis, any mental health condition whether war caused or not; and
- the symptoms of unidentifiable conditions that arise within 15 years of service (other than peacetime service).
The card also entitles the holder to transport related to treatment of their accepted condition. Accepted conditions will have been outlined in a letter from the DVA to the veteran.
To check your entitlements please call the DVA Health Provider Line on 1300 550 457 (Metro) or 1800 550 457 (Non-Metro), and quote the file number on the White Card. It is important to check with DVA prior to your first consultation regarding your entitlements for treatment rebates. For White Card holders you may need prior financial authorisation for Psychology services.