Medicare Referrals

There are two programs under which clients can be referred to a psychologist by a GP and be eligible for a Medicare rebate. The first is the Better Access to Mental Health initiative where GP’s can prepare a Mental Health Treatment Plan for their patients and then refer the client to a psychologist who has a Medicare Provider Number. Mental health issues covered by this initiative include psychotic disorders, schizophrenia, bipolar disorder, phobic disorders, anxiety disorder, panic disorder, obsessive compulsive disorder, adjustment disorder, depression, sexual disorders, conduct disorders, attention deficit disorder, bereavement disorders, post-traumatic stress disorder, eating disorders, alcohol use disorders, drug use disorders and sleep problems. Patients are referred for an initial 6 sessions and an additional 6 sessions may be approved by the GP after reviewing a report prepared by the psychologist after the first 6 sessions. Generally, patients can claim a Medicare Rebate for a maximum of 12 sessions per calendar year. Patients with private health insurance may be eligible for further rebates.

The second is the Enhanced Primary Care initiative where GPs can prepare a GP Management Plan and Team Care Arrangement for their patients with chronic diseases and complex care needs who also have co-morbid psychological and behavioural features and then refer the client to a Medicare approved Psychologist. The capacity of this program is limited to only 5 sessions per year and those sessions may need to be shared with other allied health professionals.

With a GP Mental Health Care plan and referral to a psychologist, clients are eligible for a Medicare rebate on their sessions with our psychologists. In most instances a gap payment is still payable, though this gap payment does contribute to the Medicare Safety Net.

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