Medicare Rebates and Insurance
MEDICARE REBATES AND INSURANCE
Mental Health Care Plan
Psychologists can accept Mental Health Care Plans and will be eligible for a Medicare rebate between $92.90 and $136.35 per session.
A General Practitioner, Psychiatrist, or Paediatrician can provide referrals for A Mental Health Care Plan.
Please click here for further information.
Your psychologist can only provide you with a valid Medicare receipt (which you will need to claim the rebate) if:
- You can provide a referral letter from your GP that is dated prior to your appointment date, signed by your GP, and addressed to your treating psychologist AND
- Your GP has completed a Mental Health Care Plan AND
- The person identified on the Mental Health Care Plan attends the session.
- Paediatricians and Psychiatrists can refer to psychologists for Medicare-eligible services. A Mental Health Care Plan is not required; however, you need a referral letter from your specialist.
Your psychologist can provide you with valid Medicare receipts for up to six sessions (or only as specified if the referring practitioner has recommended a reduced number).
If you wish to claim the Medicare rebate for additional sessions, you must attend a review with your GP and provide your psychologist with a letter of approval before or during your seventh session. If your Mental Health Care Plan is not reviewed before your 7th session, your psychologist cannot issue you a valid Medicare receipt.
assessment and treatment of Complex Neurodevelopmental Disorder (including Autism Spectrum Disorder)
A number of services for people under 25 years of age are eligible for Medicare rebates if they are provided as part of a Diagnosis and/or Treatment Plan established by a Paediatrician or Psychiatrist.
Diagnostic Assessment Plan for Complex Neurodevelopmental Disorders (including Autism Spectrum Disorder)
Psychologists can provide a total of eight services to collaborate with a Paediatrician or Psychiatrist on the assessment and diagnosis of Autism. The person must be under 25 years old and have been referred by a Paediatrician or Psychiatrist. The rebate for each session is $89.65. For children being assessed at Entelechy Therapy this item only covers the child’s assessment session with a Psychologist – the total rebate for the assessment is $89.65. For further information see the Medicare Benefits Schedule.
Treatment Plan for Complex Neurodevelopmental Disorders (including Autism Spectrum Disorder)
Psychologists can provide treatment services for clients under 25 following diagnosis of Autism. This plan can be prepared by a Paediatrician or a Psychiatrist. Twenty services in total are eligible for the Medicare rebate – any combination of Psychology, Speech or Occupational Therapy. The rebate per session is $92.90.
National Disability Insurance Scheme
If you are an NDIS participant and have selected to have self-managed or account-managed your funding as part of your NDIS package, you may be able to access the services at Entelechy. We encourage you to confirm your ability to use your funding with your NDIA case manager before commencing therapy at Entelechy. Payment needs to occur on the day of the appointment with a claim submitted by the client’s family directly through the NDIA.
Unfortunately, we are not registered with NDIA and therefore can not provide support for individuals whose funds NDIA managed.
Chronic Disease Management PLan
A chronic medical condition has been, or is likely to be, present for at least six months or is terminal. Anyone with a chronic or terminal medical condition can have a GP Management Plan in place.
If you have a chronic medical condition, your doctor may suggest a GP Management Plan.
The GP Management plan is an agreed plan of action between you and your GP. The plan:
- identifies your health care needs
- sets out the services to be provided by your GP and
- lists the steps that you need to take
If you need treatment from 2 or more health professionals, your doctor may also put a Team Care Arrangement plan in place for you. The Team Care Arrangement lets your doctor work with and refer you to at least two other health professionals who will provide treatment or services to you.
You may be eligible for Medicare benefits for specific allied health services if your doctor prepares both types of plans for you.
Private Health Insurance
Most private health insurers offer a rebate for psychological services if you have Psychology Extras coverage. You can claim rebates directly through your health insurer once a receipt is issued. Some health funds also require a medical referral. Contact your insurer for further information.