• Summary: Brief, step-by-step instructions for claiming Medicare Rebates for 12 Psychology Sessions

 

• Detailed explanation of the process for claiming Medicare Rebates for 12 Psychology Sessions

 

 

 

Claiming Medicare Rebates: Psychology

 

1. Ring your GP to make an appointment. Please tell the receptionist that you may need a Mental Health Care Plan for referral to a psychologist.

2. Print out the Primary Care Psychology GP Introduction Sheet or write down the following referral details to give to your GP during your appointment:

 

Referral details:

 

Att: Jonathon Walker
Clinical Psychologist

Primary Care Psychology
PO Box 48
Brighton, Vic., 3186

Ph & Fax: (03) 9553-8838
melbourne-psychologist.com.au

 

3. Attend your appointment with your GP and create a Mental Health Care Plan.

4. Ensure Item # 2710 is present on your invoice from your GP and make a claim for this item with Medicare. If your GP clinic bulk-bills then check when they will claim this item.

5. After Item # 2710 is claimed you now have access to the first set of six sessions with a psychologist.

6. After six sessions with your psychologist, again ring your GP to make an appointment. Please tell the receptionist that you need a Mental Health Care Plan Review.

7. Attend your appointment with your GP and review your initial Mental Health Care Plan.

8. Ensure Item # 2712 is present on your invoice from your GP and make a claim for this item with Medicare. If your GP clinic bulk-bills then check when they will claim this item.

9. After Item # 2712 is claimed you now have access to the second set of six sessions with a psychologist.

 

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What is the new Psychology Medicare Rebate?

On November 1, 2006, the Australian Government introduced new Medicare rebates for psychological services. This initiative provides direct financial assistance to people who require psychological assessment and therapy. In the past, patients unable to afford private psychologist fees (E.g., $120 per hour) had no option but to enroll in the public mental health system, which was often overburdened and suffered from long waiting lists.

 

The launch of the new Medicare rebates has made a tremendous improvement in general public access to private psychology services. Combined with greater public awareness of psychological issues and significantly less stigma attached to enlisting the assistance of a psychologist, more people than ever are now considering the use of psychological therapy to improve their lives and those of the people they love.

 

If I have a psychological problem, how can a psychologist help me?

Psychologists specialise in providing therapies for psychological problems. These therapies are effective at treating common conditions such as anxiety and depression.

 

What type of psychological problems are covered under the new Medicare Rebate?

Not all psychological problems attract Medicare rebates. Medicare uses a classification system of mental disorders, which is a term used to describe a range of clinically diagnosable disorders that significantly impact on a person’s emotions, thoughts, social skills and decision-making.

 

Under this system, Medicare will provide rebates for:

• Depression
• Anxiety disorder
• Panic disorder
• Eating disorders
• Sleep problems
• Bereavement disorders
• Post-traumatic stress disorder
• Phobic disorders
• Obsessive Compulsive Disorder
• Alcohol use disorders
• Drug use disorders
• Psychotic disorders
• Schizophrenia
• Bipolar disorder
• Adjustment disorder
• Sexual disorders
• Conduct disorders
• Attention deficit disorder
• Mixed anxiety and depression

 

Specifically, Medicare will cover 12 one-hour sessions per calendar year with a psychologist. Additionally, Medicare will also cover 12 group therapy sessions per year run by a psychologist.

 

I think I have one of the problems listed above, how do I access Medicare funding for treatment?

Firstly, we urge you to be careful with self-diagnosis. Only a trained professional can decide if you fall into any of the above categories.

 

If you suspect you have one of the above problems, or you are feeling distressed but don't know exactly what the problem might be, then the first step is to make an appointment with your GP. Medicare benefits for psychological services will only be paid if you have a valid referral from a GP to a registered psychologist.

 

All psychologists working with Primary Care Psychology are registered psychologists with the Victorian Psychologists Registration Board.

You can check if your psychologist is registered via this link (popup window).

 

Obtaining a referral from a GP

When you ring to make an appointment with your GP, please tell the receptionist that you may need a Mental Health Care Plan for referral to a psychologist.  The Mental Health Care Plan is a compulsory component of the referral process and usually takes a bit longer than a standard GP consultation.

During your consultation, your GP may decide that a Mental Health Care Plan isn't necessary, or that another treatment option is preferred. For example, a patient who wants to see a psychologist to quit smoking,  lose weight or receive career counselling will be unlikely to receive a Mental Health Care Plan as these issues are not covered by the Medicare system.

Most GPs encourage referral to psychologists, however, and will create a Mental Health Care Plan wherever possible.

After your appointment with your GP you will receive an invoice for payment.

 

Please check the invoice for Item # 2710, as this is critical to obtaining your psychology Medicare benefits. You need to make a Medicare claim for this invoice before your first appointment with a psychologist. If this Medicare claim is not made prior to your first appointment then you will be unable to collect a Medicare rebate for your psychology sessions.

 

Claiming Item #2710 triggers Medicare rebates for six consultations with a psychologist.

If your GP bulk-bills your Mental Health Care Plan consultation ("bulk-bill" means you pay no fee) then your GP will make the Medicare claim on Item #2710 for you. In this case, please check with your GP or the medical receptionist how long it will take for the claim to be made. Remember, this claim must be made prior to your first session with a psychologist.

 

*** Note you can check your current eligibility status for Medicare psychology rebates by calling Medicare on 132 011 during office hours (have your Medicare card handy) ***

 

Can I choose my own psychologist?

Some GPs may not have heard of Primary Care Psychology since it is a relatively new service, or they may already have referral arrangements with psychologists in their local area. If you wish to see a psychologist from Primary Care Psychology then please mention this to your GP during your consultation.

 

You can print the following GP Introduction Sheet about the Primary Care Psychology service to give to your GP, or alternatively, most GPs have an internet connection in their office and you can direct them to this website (melbourne-psychologist.com.au).

 

Making your First Psychology Appointment

Once the Mental Health Care Plan is complete then please contact Primary Care Psychology to make your first appointment. You do not have to wait until your claim is made to organise your first appointment time.

Ph: (03) 9553-8838

or

Email:

or

 

Online Appointment Form

 

Does Medicare cover the entire psychologist's fee?

This depends on what service you choose from Primary Care Psychology. Our home / office / hospital visit services are bulk-billed, meaning that you do not pay anything for these sessions – everything is covered by Medicare.

 

If you need to see a Primary Care Psychologist at a medical clinic or office, then, on average, you will pay approximately $30 above the Medicare rebate. Please note that a $30 out-of-pocket fee is very low, and many other psychology services charge well above this rate (in the vicinity of $50-$80 above the Medicare rebate). Primary Care Psychology was designed to be a low-cost service to improve community access to psychology services.

 

What about my private health insurance?

You cannot use your private health insurance extras cover to pay for these out-of-pocket expenses where Medicare has already paid part of the fee.

 

You need to decide if you will use Medicare or your private health insurance to fund each session, but not both (this is a law, and not specific to our service).

 

What happens after the first six sessions?

After six sessions with a psychologist, you and your psychologist may decide that further sessions are required to meet your therapy goals. The initial Mental Health Care Plan only provides rebates for the first six sessions. To obtain rebates on another set of six sessions you will need to visit your GP again for a Mental Health Care Plan Review.

The process is exactly the same as your initial consultation. Ring your GP's office and inform them that you require a Mental Health Care Plan Review.

 

During your review you will discuss your progress toward therapy goals, and together with your GP you will determine if further therapy sessions would be useful. If another six sessions are required then your GP will amend your original Mental Health Care Plan.

 

At the conclusion of this consultation your invoice will show Item # 2712, which will then need to be claimed with Medicare prior to starting your next set of six sessions.

 

Claiming Item #2712 triggers Medicare rebates for the next set of six consultations with a psychologist.

Following your Mental Health Care Plan Review please contact your psychologist to resume therapy.

 

What if I can't claim Medicare rebates for my particular problem, or I have already used my 12 sessions?

Medicare rebates normally cover 12 sessions with a psychologist per calendar year. In exceptional circumstances another 6 sessions may be granted, but your GP will need to decide if this is warranted.

 

The Medicare rebate system for psychologists was designed for short-term, focused therapy and it is important that you use your time effectively.  Essentially this means turning up to your appointments on time and working hard between sessions to implement the strategies you have discussed.

If your particular psychological issue falls outside the domain of the mental disorders classified by the Medicare system, or if you require longer-term therapy, then you may be able to claim rebates from your private health insurance 'extras' cover. Please contact your health insurance company to check your eligibility, and to check what paperwork needs to be completed by your psychologist.

 

If Medicare rebates and private health insurance options are not available then it will be necessary to pay normal psychologist fees. Thankfully, Primary Care Psychology attempts to minimise these fees by offering very low-cost home / office / hospital visits, and reduced psychology clinic fees. Please see our Appointments page for more details.