The Cost of Therapy: Navigating Medicare and Mental Health Treatment Plans
The Someone.health blog
If you are seeking psychological support, a Mental Health Treatment Plan (MHTP) can help cover the cost of seeing a psychologist or clinical psychologist.
What are the costs of therapy?
If you have a MHTP, which you can obtain with your GP, or in some instances with your psychiatrist, consulting physician, or your child’s paediatrician, then Medicare will cover some, or all, of the cost of your appointment with a psychologist or clinical psychologist, for up to 10 appointments per calendar year.
The amount charged for your session or rebated by Medicare will largely depend on:
- The amount of time in the session;
- If your psychologist has agreed to bulk-bill you, and;
- The type of psychologist (general or clinical) you have booked to see.
You can find more information about Medicare rebates here.
Bulk-billing
If your psychologist or clinical psychologist has agreed to bulk-bill you then you will have no out-of-pocket expense. Your Medicare rebate will completely cover your appointment cost.
Someone.health has a limited number of psychologists who accept up to 10 bulk-billed appointments; see the website for further details on the financial hardship program. If you have an out-of-pocket expense for your appointment, the most you will pay is $40, as long as you have a GP referral and MHTP. Visit the Someone.health schedule of fees page for more information.
Why is there a higher rebate for a clinical psychologist?
A clinical psychologist will participate in 2 more years of supervised clinical practice on top of their 6 years of training, hence the difference in the amount rebated by Medicare.
Regardless, with Someone.health, if you have an out-of-pocket expense, it is only $40 to see either a general or clinical psychologist.
When does my referral end?
Your referral for a MHTP under the Australian Government’s Better Access Initiative allows you access to 6 appointments for your first referral and 4 appointments for your second referral, up to a total of 10 appointments per calendar year. Your referral only ends once you have had the 6 (first referral) or 4 (second referral) appointments.
Case study: Sandra’s GP refers her for 6 appointments with a psychologist in December 2023. Sandra sees the psychologist for 2 appointments in December 2023. She can then continue to use this referral for 4 more sessions in 2024. When Sandra returns to her GP, she learns that she can now get a new referral for 6 more sessions in 2024, to a total of 10 sessions in 2024.
Face-to-face or telehealth: Is the rebate different?
Medicare rebates are identical for face-to-face and telehealth therapy. In part, this is because research to date has shown that face-to-face and telehealth psychological therapy are equally effective. [1], [2], [3]
Furthermore, the ease of access to a telehealth appointment can be helpful to people who work a busy schedule, live in a non-metropolitan area, or experience financial hardship. This is partly because an appointment can be booked at times that suit your schedule, with no need to drive to and from a physical location. Online appointments provide Someone.health with greater reach in geographically isolated locations.
If you prefer, you can access face-to-face Medicare-supported appointments. Usually, these appointments will have an out-of-pocket expense (usually $100-300, depending on the appointment type) as it costs the psychologist more to run a face-to-face clinic. You can read more about the Australian Psychological Society’s national schedule of recommended fees here.
Keeping track
It is essential that you maintain your own record of the number of sessions you have already used. Do not rely solely on statements from Medicare, as they may not be provided regularly.
It is your responsibility to ensure that you do not exceed the available funds as Medicare does not provide more than 10 sessions per calendar year. If you would like to, or accidentally, go over the 10 Medicare sessions available to you, then you can pay privately for additional sessions.
Are there other mental healthcare rebated services?
There are other types of mental-healthcare rebated services other than the MHTP accessible under the Better Access Scheme.
If you don’t think a MHTP is right for you, talk to your GP about other benefits that may be more appropriate for your situation. For example, you might want to talk about the available benefits for:
- • People living with mental health conditions
- • Helping children with autism (under 13 years for a diagnostic assessment; under 15 years for treatment)
- • Supporting children with an eligible neurodevelopment disorder or eligible disability
- • Women concerned about a current or recent pregnancy
- • People living with a chronic medical condition
- • People of Aboriginal or Torres Strait Islander descent
Where to go for more information
You can find more information on the Someone.health page about GP referrals.
APPENDIX
Table 1 presents some more information on the rebates provided for some of the most common session types with Someone.health.
Table 1. More detail on some of the most commonly-used claiming items for psychological support under a Mental Health Treatment Plan with Someone.health
| Medicare claiming item | Referral notes | Time and Format | Rebate | |
|---|---|---|---|---|
|
Brief telehealth conference by clinical psychologist |
Requires two referrals: 1) for 6 sessions, and 2) for 4 sessions |
# sessions: 10/year
Time: ≥30 minutes
Format: Telehealth; 1 on 1 |
$93.35 |
|
|
Average telehealth conference by clinical psychologist |
Requires two referrals: 1) for 6 sessions, and 2) for 4 sessions. |
# sessions: 10/year
Time: ≥50 minutes
Format: Telehealth; 1 on 1 |
$137.05 |
|
|
Brief telehealth conference by psychologist |
Requires two referrals: 1) for 6 sessions, and 2) for 4 sessions. |
# sessions: 10/year
Time: ≥30 minutes
Format: Telehealth; 1 on 1 |
$66.20 |
|
|
Average telehealth conference by psychologist |
Requires two referrals: 1) for 6 sessions, and 2) for 4 sessions. |
# sessions: 10/year
Time: ≥50 minutes
Format: Telehealth; 1 on 1 |
$93.35 |
REFERENCES
- Greenwood, H., Krzyzaniak, N., Peiris, R., Clark, J., Scott, A. M., Cardona, M., … & Glasziou, P. (2022). Telehealth versus face-to-face psychotherapy for less common mental health conditions: Systematic review and meta-analysis of randomized controlled trials. JMIR Mental Health, 9(3), e31780.
- Krzyzaniak, N., Greenwood, H., Scott, A. M., Peiris, R., Cardona, M., Clark, J., & Glasziou, P. (2021). The effectiveness of telehealth versus face-to face interventions for anxiety disorders: A systematic review and meta-analysis. Journal of Telemedicine and Telecare, 1357633X211053738.
- Luo, C., Sanger, N., Singhal, N., Pattrick, K., Shams, I., Shahid, H., … & Samaan, Z. (2020). A comparison of electronically-delivered and face to face cognitive behavioural therapies in depressive disorders: A systematic review and meta-analysis. EClinicalMedicine, 24.