Rebates and Funding

Medicare Rebates

Some psychological therapy and assessment services are eligible for partial rebates from Medicare. An overview of the requirements for eligibility is provided below with web links for further information. Jacqui is able to process your Medicare claim once the full amount of the consultation fee has been paid. Alternatively, Jacqui can email you with a receipt for you to submit to Medicare to claim the rebate. When you visit your Health Professional, please be clear about what type of referral you are seeking (see below) and ask them to write a referral letter including the following information: client's name, client's date of birth, client's address, reason for referral, Medicare Item number, the number of sessions requested, the referring practitioners' Medicare Provider Number, and the referring practitioner's signature.

Medicare Mental Health Treatment Plan (Better Access Initiative)

This referral will be obtained through a General Practitioner (GP), Pediatrician, or Psychiatrist. Please forward this referral post or email prior to your first consultation to assist with the administration of your billing.

For the MHTP referral to be valid, it must include the following information: client's name, client's date of birth, client's address, reason for referral, request for services under Better Access, the number of sessions requested, the referring practitioners' Medicare Provider Number, and the referring practitioner's signature.

 The plan allows you to claim a rebate for up to 10 sessions in a calendar year. A review by the psychologist to the referring GP, Pediatrician, or Psychiatrist is required after the first 6 sessions.

The Medicare rebate per 50 minute consultation with a Psychologist is $96.65.

PLEASE NOTE: The Mental Health Treatment Plan does not cover the assessment of Autism. The plan also does not cover specific treatment/counselling of Autism (as it is not defined as a mental health disorder), but it does cover frequently observed mental health issues such as Anxiety, Depression, and sleep problems.

The Medicare Safety Net is designed to protect high users of health services from large out-of-pocket expenses. More information can be found on the Medicare website.

Medicare rebates for assessment of Complex Neurodevelopmental Disorder (including Autism)

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).

Psychologists can provide a total of four 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 $96.65.  

For further information see the Medicare Benefits Schedule.

Medicare rebates for the Treatment Plan for Complex Neurodevelopmental Disorders (including Autism)

Psychologists can provide treatment services for clients under 25 year following diagnosis of Autism. This plan can be prepared by a Paediatrician (MBS item 135) or a Psychiatrist (MBS item 289). Twenty services in total are eligible for the Medicare rebate - any combination of Psychology, Speech or Occupational Therapy. The rebate is $96.65 per session.

Medicare/Chronic Disease Management Plan (CDM plan)

Medicare provides a rebate of $58.30 for up to five allied health sessions per calendar year for individuals with ongoing conditions that require treatment from several health professionals. You will need a referral from your GP, who will assess whether your child meets the criteria for a CDM Plan.

Private Health Insurance rebates

Some psychological therapy services may be eligible for rebates through your Private Health Insurance extras cover. Please contact your insurance provider to confirm your eligibility for rebates. Upon payment of your fee, you will be provided with a receipt that you can submit to your health insurer for a rebate.

Please Note: Clients must determine whether they are going to claim their consultation/assessment fees through either one of the Medicare programs or their Private Health fund. Please note that Private Health funds vary widely in the amount of rebate that can be claimed, and you should contact your insurer about this. You are unable to use Medicare and your Private Health insurance for the same consultation.

National Disability Insurance Scheme (NDIS)

Clients who have NDIS packages may use their funding to cover the fees for services with Jacqui, if their package is self-managed or plan-managed by a third party.  

The funding category that can be used to claim Psychology services is Capacity Building - Improved Daily Living.  For individuals over 7 years the NDIS item code is 15_054_0128_1_3  Assessment, Recommendation, Therapy, or Training – Psychology is used and for individuals under 7 years, the item code is 15_001_0118_1_3 Early Childhood Intervention Supports, Assessment Recommendation Therapy or Training.

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