How to Get a Referral And Claim Medicare Rebates For Counselling

Since November 1st, 2006, the “Better Access to Mental Health Care” initiative has allowed many Australians to access Medicare rebates for counselling services. Such services must be provided by registered psychologists (who must use certain approved evidence-based approaches), following referral by a GP, paediatrician or psychiatrist.

Medicare rebates are currently available for up to ten individual counselling sessions per calendar year (and up to 10 group sessions, although these are generally more appropriate for adults).

(You can find more about the scheme in this handout for patients.)

So how do you go about getting a referral to a psychologist for yourself and/or your child, so that you can claim Medicare rebates for counselling?

Getting a referral from your GP under a “Mental Health Treatment Plan”

Book an appointment with your GP. You will need to ask for a long consultation or tell the receptionist that you specifically require a Mental Health Treatment Plan (MHTP).

Discuss your concerns with your doctor. They may ask you to complete a brief questionnaire about your child or have your child complete it. Most MHTPs are for anxiety or depression, However, there is a full list of issues (see below) which are eligible for treatment under a MHTP.

Paediatricians and psychiatrists can also refer directly to a psychologist by writing a letter (without preparing a MHTP).

You can ask for your referral to be made out to a specific psychologist or to a specific clinic.

What types of mental health issues can a GP refer for under a MHTP?

Here a list of mental health conditions which are eligible for treatment under an MHTP:

  • Anxiety disorder
  • Adjustment disorder
  • Depression
  • Conduct disorders
  • Bereavement disorders
  • Post-traumatic stress disorder
  • Sleep problems
  • Attention deficit disorder
  • Obsessive Compulsive Disorder
  • Co-occurring anxiety and depression

Do I have to visit a doctor to access counselling services?

No, you may choose to claim rebates from your private health fund (and pay the gap amount) instead or you can simply pay the full fees without any rebates. Keep in mind that private health fund rebates for counselling vary widely and are often not as high as the equivalent Medicare rebates.

Can I meet with my psychologist before getting a referral from my GP?

Yes. At Melbourne Child Psychology we usually see parents by themselves first for an initial 30 minute consultation before they visit their GP. This gives parents the opportunity to meet with their psychologist, discuss their child’s specific issues openly, ask questions and obtain a treatment plan.

Why does my GP need to be involved in the counselling process?

A multi-disciplinary team approach can help achieve the best outcomes for your child. If you have a regular family GP they will have a record of your family’s medical history and part of this may be relevant to their mental healthcare needs. In some cases there may be medical issues that are affecting your child’s development and these may require assessment and treatment by other medical professionals, such as your paediatrician. Your psychologist will also give periodic reports to your doctor (with your consent) to keep them informed of your child’s progress.

How do the rebates work?

Each time your child attends a counselling session you will need to pay the full fee first and then you can claim your Medicare rebate. If your psychologist has electronic claiming facilities you can claim your rebate immediately, otherwise you will need to visit a Medicare office. (At Melbourne Child Psychology we offer electronic claims on the spot.)

How much of the fees will the rebates cover?

The standard rebate (in 2013) is $84.80 per 50 minute session. This amount increases to $99.75 (in 2013) if your family is eligible for the Original Medicare Safety Net scheme. And you will receive a significantly higher rebate if your family is eligible for the Extended Medicare Safety Net scheme. (Read more about these schemes.)

Do I need to go back to my doctor at any point after receiving a referral?

Yes, you will need to visit your doctor for a brief review after your child has attended six (6) counselling sessions. While you can claim up to 10 rebates per calendar year, it is up to your doctor to recommend further sessions beyond the initial six.

Am I able to obtain a GP referral for both my child and myself?

If you are feeling excessively anxious or depressed (or if you have any of the other conditions on the above list) then you should consider also asking your doctor for a counselling referral for yourself. You will need to make a separate appointment with your doctor to obtain your own MHTP (in addition to the appointment for your child). If your concerns are directly related to your child’s problems (and your child is reasonably young) then it may be appropriate to see the same psychologist as your child. Alternatively, you might need to see another psychologist at the same clinic or elsewhere.

I hope this information is helpful. If you have any more questions about referrals or Medicare rebates for counselling services, please leave your questions in the comments below and I will update this post with the answers.

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