MEDICARE REBATES

MEDICARE REBATES

Psychology Medicare Rebates

There are two main types of GP referrals that provide our clients with a Medicare rebate on their psychology sessions:

    1. Mental Health Care Plan (MHCP)
    2. Eating Disorder Management Plan (EDMP)

For both types of referral plans, the current Medicare rebate from 1st July 2023 is $136.35 for consultation with a Clinical Psychologist and $92.90 for consultation with a Registered Psychologist

The third option is a Chronic Disease Management Plan (CDMP – formally known as an Enhanced Primary Care ‘EPC’ Plan) which allows for up to 5 visits with an Allied Health Practitioner each calendar year, and can include Psychology. Please see below for more information.

Mental Health Care Plans:

Clients with a valid Mental Health Care Plan (MHCP) psychology referral provided by their GP/Psychiatrist are eligible for up to 10 Medicare rebated psychology sessions per calendar year.  MHCPs are designed to help provide financial assistance to those people with mental health difficulties to access the services of a Registered Psychologist or Clinical Psychologist. Book an appointment with your GP to discuss getting a MHCP if you feel you would benefit from psychological help.

Note: Medicare does not provide a Medicare Rebate for ‘Relationship Counselling/Couples Therapy’ under the MHCP as the Medicare rebates are for treatment of mental health issues. If you require couples counselling, the applicable consultation fee is payable in full by the client. If you have private health cover, you may be able to receive a rebate from your Private Health Care Fund. Please enquire with your individual fund.

Eating Disorder Management Plans:

Clients with an Eating Disorder Management Plan (EDMP) are also eligible for Medicare rebated sessions. Similar to the MHCP, you can receive this treatment plan from your GP however you will receive up to 40 sessions with a Psychologist or Clinical Psychologist under Medicare. You will also receive 20 additional sessions with a Dietician under the eating disorder dietetic treatment (EDDT) within a 12-month period. If you are eligible for both a MHCP and an EDMP, you will be able to access medicare rebates for up to 60 psychology sessions per calendar year.

HOW MHCP’S & EDMP’S WORK:
      • To obtain a plan, you/the client will need to see their GP or Psychiatrist and discuss their mental health/eating disorder issues with their doctor for the doctor to assess if they are eligible for a MHCP or EDMP. A decision on eligibility for a plan is made by your doctor.
      • Once a MHCP is in place, the client is able to access the initially approved psychology sessions under Medicare that your GP specifies on the referral (usually 6 sessions initially). Once the client has completed the initial 6 sessions (if the client requires all 6 sessions of psychology), the client is required to see their referring GP for a review of their MHCP to obtain access to the remaining 4 Medicare sessions. The review is required to be in place before the client attends for their 7th session.
      • Once the client has completed 10 psychology sessions, the client is required to go back to their referring Doctor to obtain another MHCP review. 
      • If a client has used all Medicare sessions of their referral/s in the calendar year, no more Medicare rebated sessions are available until January of the following year. If the client wishes to continue with psychology treatment after all Medicare rebates have been exhausted, the client has the option to pay for their consultation privately.
      • If the client has a Private Health Fund that provides cover for psychology treatment, the client can obtain part of their consultation fee back from their health care fund. The client will need to contact their Private Health Fund directly to find out how much rebate they are entitled to as this varies between health funds and by level of cover.
      • With an EDMP, the client is able to access up to 10 initial psychological sessions. If the provider believes the client requires further sessions, the provider will send an updated letter to their GP so they can review the client for additional sessions.
      • Once additional sessions are approved by the GP, the client is then eligible to complete sessions 11-20 on their plan.
      • This process repeats after the client’s 20th session and 30th session.
      • Between sessions 1 and 20, the client is required by the EDMP to have a consultation with a Psychiatrist. We recommend booking in for this as soon as possible after getting your EDMP from your GP. 
      • After the client’s 40th session, the provider sends an updated letter to the GP to complete the plan for that year.
    • It is important to note the 10 x MHCP rebates run on the calendar years, whereas EDMP’s run on the Referral year (12 months from date of first EDMP referral)
Dietitian Medicare Rebates

There are two main types of GP referrals that provide our clients with a Medicare Rebate on their Dietitian sessions. These are:

    1. Eating Disorder Management Plan (EDMP)
    2. Chronic Disease Management Plan (CDMP)

For both types of referral plans, the current Medicare rebate from 1st July 2023 is $58, regardless of the duration of the session with the dietitian.

Eating Disorder Management Plan (EDMP):

Clients with an Eating Disorder Management Plan (EDMP) are eligible for Medicare rebated sessions with their Dietitian for their eating disorder treatment. This referral allows you to receive a Medicare rebate of up to 20 dietitian sessions under Medicare per 12 month period. 

Chronic Disease Management Plan (CDMP):

Clients with a Chronic Disease Management Plan (CDMP – formally known as an Enhanced Primary Care Plan or ‘EPC’) are eligible for up to 5 medicare rebated sessions with a dietitian per calendar year.
These sessions must be a minimum of 20 minutes duration. The referring GP will need to specify on the CDMP how many of the 5 sessions they allocate to dietitian treatment for you, as the CDMP also allow people to see other allied health practitioners (such as Psychologists), with a maximum of 5 sessions in total per calendar year.
The rebate for this is $58/consultation.