Medicare Mental Health Care Plan

How to access more affordable mental health therapy and services

Are you looking for affordable high-quality therapy services?

Do you have a doctor’s referral or Mental Health Treatment Plan?

The Medicare ‘Better Access’ program has helped thousands of Australians access affordable mental health care and services.

What is the gap fee with a Mental Health Care Plan?

Gap Fee = Appointment Fee – Medicare Rebate

Below is an example of a Clinical Psychologist’s Medicare gap fee.

MEDICARE GAP FEE

$157.15

Medicare Gap Fee
Clinical Psychologist
50-min appointment

APPOINTMENT FEE

$299

Appointment Fee
Clinical Psychologist
50-min appointment

MEDICARE REBATE

$141.85

Medicare Rebate
Clinical Psychologist
50-minute appointment

What is a Medicare Mental Health Care Plan (MHCP)?

A Mental Health Care Plan is a plan created by you and your GP. It outlines the support you need from mental health professionals when you have been diagnosed with a mental health condition, and treatment is recommended. It should also have the goals you and your GP agreed upon and suggested treatment options.

Your Mental Health Care Plan should include a safety plan for you to follow in a crisis or to help you prevent relapse.

Your health information and treatment plan will be private. GPs can’t share your information unless you agree to it; for instance, if you both agree for your Mental Health Care Plan to be sent to a mental health professional such as a Clinical Psychologist.

Who is eligible for a MHCP?

To determine whether you are eligible, you must make a ‘long’ appointment with your GP to undertake an assessment. During that appointment, your GP will ask you questions about your mental health concerns. They may also ask you to complete psychometrics, like the K10 Anxiety and Depression test.

A Mental Health Care Plan under Medicare covers the treatment of some psychological conditions, including:

Alcohol use disorder
Adjustment disorder
Attention deficit 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.

Not all psychological issues are covered by Medicare. Psychological assessments, such as cognitive or ADHD assessments, reports and couples therapy, are not covered by Medicare either.

What are the benefits of getting a MHCP?

Better Access aims to encourage more people in Australia to seek mental health treatment and support. The Better Access program has helped Australians with mild to moderate mental health conditions access affordable evidence-based mental health services by providing Medicare rebates to eligible people.

You don’t need a GP referral and Mental Health Care Plan to see a psychologist; however, you need a Mental Health Care Plan to be able to claim Medicare rebates.

To claim Medicare rebates, you must provide your psychologist with a copy of your GP referral and valid Mental Health Care Plan, which must be dated on the day or before the date of your appointment. Medicare rebates cannot be backdated for sessions before your GP referral date.

How much can I save with a GP Referral or MHCP?

The Medicare rebate typically covers a portion of a psychologist’s session fee. Learning about your psychologist’s session fees before attending your first appointment is essential.

Additionally, the Medicare rebate differs for sessions with Clinical Psychologists and General Psychologists. The Medicare rebate for sessions with a Clinical Psychologist is higher than that of the General or Registered psychologist rebate.

As psychologists’ session fees and Medicare rebates can differ, it is essential to determine the actual out-of-pocket investment (or the difference between the session fee and the Medicare rebate).

You can check the current Psychologist Medicare Rebates for 50+ min sessions with a Clinical and General Psychologist.

More info on Psychologist Fees and Rebates.

How many sessions can I claim with a MHCP?

A GP referral and Mental Health Care Plan allow you to claim up to 10 sessions with a psychologist per calendar year.

This is how it generally works:

Your GP will issue an initial referral and Mental Health Care Plan for up to six sessions.
Upon completing the sessions under the initial referral, your psychologist will produce a treatment progress report and send it to your referring GP. On that letter, your psychologist may request additional sessions for you to continue treatment.
You will need to return to your referring GP, who will review your psychologist’s treatment progress report and ask some questions. If you and your GP consider that you would benefit from further sessions, your GP will write a new referral for you to claim additional sessions.

Once you have completed ten sessions under a Mental Health Care Plan, you can continue therapy privately. You may also be able to get a new referral in the following calendar year.

Can I use my Mental Health Care Plan to see a different psychologist?

Yes. Mental Health Care Plans are transferrable. If your current Mental Health Care Plan was issued with the name of a clinic or psychologist different to the one you wish to see, that is OK. Alternatively, you can ask your GP to reissue your referral with your new psychologist’s name.

Can I claim rebates for online therapy sessions with a psychologist?

Yes. You can claim rebates for psychologist sessions in person, at the psychologist’s consulting rooms, or online therapy sessions. Depending on the session length and mode, your invoice’s Medicare item code will be different. A 50+ min session with a psychologist either in-person or via Telehealth (online therapy) should provide you with the same rebate amount.

How do I go about claiming Medicare rebates?

To be able to claim Medicare rebates, the following steps must be followed:

At the end of your session, you must pay the psychologist’s session fee in full. Your psychologist will provide you a copy of the invoice, marked as ‘paid in full’.
Your psychologist should be able to submit your Medicare claim electronically (only invoices paid in full can be used to claim the Medicare rebate). Alternatively, you can submit your claim yourself. Find out the different ways you can claim a Medicare rebate here.
Medicare will assess your claim, and upon approval, the rebate amount will be deposited into your nominated bank account, typically within 24 hours.

What if I don’t have a GP Referral or MHCP?

If you are not eligible to get a Mental Health Care Plan, and consequently, Medicare rebates, there may be other funding schemes and organisations in Australia that can help you fund psychological treatment. Some of these include:

Private Health Insurance (which can cover individual and couples counselling)
NDIS
DVA – Department of Veterans’ Affairs
Australian Insurance Companies
Overseas Insurance Companies
WorkCover
EAP – Employee Assistance Program
Other funding organisations.

Suppose you are eligible for funding through a different organisation. In that case, you may want to check whether your psychologist needs to be registered with them for you to be able to claim rebates or seek reimbursement. It is always recommended to check with your insurer or their party funding organisation for the exact rebate amounts.

Make an Appointment

Send a request to a Psychologist in Brisbane by completing the form below.