What is the Better Access to Mental Health Care Initiative?
The Better Access to Mental Health Care Initiative is a scheme funded by the Australian Government which is designed to provide greater access to psychological assessment and treatment in Australia. This is achieved through Medicare rebates which make the services of mental health professionals more affordable. Mental health practitioners who can be accessed as part of this scheme include psychologists, clinical psychologists, and mental health accredited social workers.
Eligible users of the Better Access initiative are able to access a certain number of Medicare rebates for their psychology sessions every calendar year. For most people this will be 10 Medicare rebates per calendar year, though some individuals may be eligible for additional sessions which we detail later in this guide.
It is common for people to use their Medicare rebates to partially fund various forms of evidence-based psychological treatment, such as Cognitive Behaviour Therapy (CBT), Acceptance and Commitment Therapy (ACT) and Eye Movement Desensitisation Reprocessing (EMDR) therapy. In addition, the rebates may be used to address a wide range of mental health issues including depression, anxiety disorders, panic attacks, phobias, personality disorders, borderline personality disorder, post-traumatic stress disorder (PTSD), and Complex Trauma.
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How do I access Medicare rebates for psychology sessions under the Better Access to Mental Health Care Initiative?
There are two ways you can set up access to Medicare rebates for psychology sessions under the Better Access Initiative. They are:
Visit your general practitioner (GP) who will create a Mental Health Care Plan for you as well as provide you with a referral to a psychologist. Most people will access their psychology Medicare rebates through this pathway.
Visit your psychiatrist who will refer you to a psychologist. A psychiatrist can provide you with a referral letter which enables you to access Medicare rebates for psychology sessions. Note that in this pathway, a Mental Health Care Plan is not involved, as these are only created by GPs.
What is a Mental Health Care Plan?
A Mental Health Care Plan (MHCP) is created by a General Practitioner (GP) for someone who experiencing difficulties with their mental health and/or wellbeing. Having a Mental Health Care Plan can make accessing mental health services more financially accessible, because it enables for part of the cost psychology sessions with a mental health practitioner to be covered by Medicare. A Mental Health Care Plan alone will not enable access to Medicare rebates, your GP also needs to provide a referral (a separate document) to a mental health professional.
A Mental Health Care Plan will detail the nature of the mental health issues to be treated as well as outline a plan for how this will be achieved. For this reason, sometimes the Mental Health Care Plan is referred to as a Mental Health Treatment Plan. Understanding individual needs and circumstances when seeking therapy is crucial, and a Mental Health Care Plan can help tailor the treatment to those needs.
At Cova Psychology, all of our Melbourne psychologists and Mental Health Accredited Social Workers offer Medicare-rebated psychology sessions for those who have a Mental Health Care Plan.
Please note, that if you are seeing a psychiatrist, they can create a referral for you which will act in the same way as a Mental Health Care Plan created by a GP. In this case, the referral from the psychiatrist serves the exact same function as a GP-created Mental Health Care Plan.
Am I eligible for a Mental Health Care Plan and referral to a mental health practitioner?
If you are eligible for Medicare and you are currently struggling with your mental health, you can ask your GP for a Mental Health Care Plan and referral to a mental health professional.
You are eligible for Medicare if you live in Australia and are:
An Australian or New Zealand citizen
An Australian permanent resident
Applying for permanent residency, or
Hold a temporary (humanitarian) or bridging visa.
What type of appointment should I book with my GP when seeking a Mental Health Care Plan and referral for the first time?
A Mental Health Care Plan and referral are developed during an extended GP appointment (generally at least half an hour). As such, when booking your GP appointment, let your doctor’s clinic or reception know that you are seeking a Mental Health Care Plan so that an appropriate amount of time can be booked for the appointment.
What will happen in my GP session when I am seeking a Mental Health Care Plan and referral?
During the appointment, you and your GP will work together to write a Mental Health Care Plan. The plan usually includes information such as your main aims and areas of focus for psychological sessions, your past psychiatric/medical history and strategies that may help you to improve/maintain your mental health.
It is completely normal to feel nervous about your Mental Health Care Plan appointment. It might help you to bring in a list with some of the mental health concerns that you would like to discuss during the appointment and include in your plan, such as mood disorders, trauma, and other mental health issues.
Your GP will also create a referral letter to the mental health professional you are seeking to engage. This letter is considered a separate document to your Mental Health Care Plan and needs to be provided to your therapist in order for you to access sessions under your Mental Health Care Plan.
Do I need to be booked in with a mental health practitioner prior to getting a Mental Health Care Plan and referral?
You are not required to have sessions scheduled with a psychologist before seeing your GP for a Mental Health Care Plan and referral. If you do not know which psychologist you will engage, your GP can write an open referral letter addressed as “Dear Psychologist” or something similar.
If there is a psychologist that you would like to see, let your GP know so that they can address the Mental Health Care Plan and referral to them. However, if you do have a particular psychologist that you are interested in seeing, it is also advisable to first check them first via email or over the phone to find out:
Are they taking new clients?
Will they be a good match for you both therapeutically and schedule-wise?
Check-out our guide for how to choose the right therapist for you, here.
Many people will first book in with an available psychologist, then attend their GP to attain a referral and Mental Health Care Plan addressed to the psychologist. It doesn’t need to be done in this order, however, as you are still able to search for and book a psychologist after you have your mental health care plan and referral in place.
What is the difference between a GP referral and a Mental Health Care Plan?
The terms “referral” and “mental health care plan” are often used interchangeably which can cause confusion because the two are actually distinct and different documents. The Mental Health Care Plan is tabulated in boxes, generally over 3-4 pages, and consists of a treatment plan for the mental health issues being experienced by the patient. The Mental Health Care Plan is not a referral, it is a treatment plan, and Medicare rebates for psychology cannot be accessed through the mental health care plan alone. A referral also needs to be created by your doctor in order to complete the process. A referral is a letter from your doctor which is generally addressed to a psychologist and requests for your mental health issue to be assessed and treated.
How will the mental health care plan and referral reach my psychologist?
Firstly, whilst it can be helpful for your psychologist to have a copy of your Mental Health Care Plan, it is actually the referral letter which first and foremost must be held by your psychologist in order for you to be eligible for psychology Medicare rebates. Your Mental Health Care Plan can only be released to your psychologist by your GP with your consent.
It is not uncommon for a GP to provide their patient with physical copies of their referral and Mental Health Care Plan, which the patient then passes on to the psychologist themselves. Some GP’s will send the referral to a psychologist rather than providing it to their patient. Bear in mind that your psychology Medicare rebates will not be able to be processed until your psychologist has received the referral from your doctor.
What information needs to be included on my referral in order for it be valid under Medicare?
A valid referral must include specific information which includes:
The date of referral
The patient’s name, date of birth, and address
The referring doctors name and Medicare provider number
A request for service under the Better Access Initiative
The doctors signature
What if my referral is addressed to a psychologist who is unavailable? Am I able to take the same referral to another therapist?
Yes. It is not a problem if your referral is addressed to a mental health practitioner who you do not end up seeing. Medicare permits for the referral to be used with any therapist, even if the name on the referral is different to the one that you choose.
How many Medicare rebates for psychology can I access under a Mental Health Care Plan?
Standard Mental Health Care Plans allow access to 10 Medicare rebates per calendar year. Your initial referral will enable you to access 6 Medicare rebated sessions. Following your 6th session you will need to visit your doctor who can provide a re-referral, which will allow access to your remaining 4 sessions for the year. Psychology Medicare rebates do not accrue from year to year, the maximum number of sessions you can access per calendar year on a standard mental health care plan is 10.
What will happen when I have used all the Medicare rebates allocated on a referral? E.g. after my first 6 Medicare rebates have been processed?
After the Medicare rebates allocated on a referral have been processed, your psychologist will write to your doctor providing them with an update regarding your progress. If there are remaining sessions that can be accessed on your Mental Health Care Plan, your psychologist may recommend that your doctor re-refer you. You will need to attend your doctor to discuss this and attain a re-referral before further Medicare rebates for psychology can be accessed.
Do GP referrals and Mental Health Care Plans expire?
Mental Health Care Plans do not expire, however, if your mental health issue or condition significantly changes, your GP may conduct a Mental Health Care Plan review, which is essentially an update to your treatment plan.
Referrals also do not expire, however, many psychology clinics require the referral to be dated within the last 12 months. This ensures that the information on the referral is accurate and relevant.
What are the Three Different Types of Mental Health Care Plan?
Standard Mental Health Care Plans
A standard Mental Health Care Plan is for anyone who may be experiencing mental health conditions such as mood disorders (depression, anxiety, bipolar, OCD), personality disorders, stress, or trauma and PTSD. A standard Mental Health Care Plan allows access to up to 10 Medicare rebated psychology sessions per year, which are activated through an initial referral from your doctor (first 6 sessions) and then a re-referral from your doctor (final 4 sessions).
How much are my Medicare rebates or how much do I get back from Medicare for my psychology sessions under a standard Mental Health Care Plan?
As of July 2024, Medicare rebates under a standard Mental Health Care Plan are as follows for sessions with a:
Mental Health Social Worker – $81.90
General Psychologist – $ 96.95
Clinical Psychologist – $141.85
Enhanced Primary Care Plans
After all 10 sessions of a standard Mental Health Care Plan are used, some people will go on to access up to 5 additional Medicare rebates for psychology sessions under an Enhanced Primary Care Plan. An Enhanced Primary Care Plan is designed to help support people with chronic condition through a collaborative approach involving all of their various healthcare providers, such as their GP, psychiatrist, psychologist, nutritionist, and/or other allied health professionals. Enhanced Primary Care Plans can also support individuals dealing with chronic pain, which often requires a collaborative approach involving various healthcare providers.
If there is more than one professional in your treating team, you may be eligible for an Enhanced Primary Care Plan. We encourage you to discuss this with your GP. Note that the Medicare rebates provided under an Enhanced Primary Care Plan are lower than those provided under a standard Mental Health Care Plan.
How much are my Medicare rebates or how much do I get back from Medicare for my psychology sessions under an Enhanced Primary Care Plan?
As of July 2024, Medicare rebates under the EPC are as follows for sessions with a:
Mental Health Social Worker – $60.35
General Psychologist – $60.35
Clinical Psychologist – $60.35
Eating Disorder Mental Health Care Plans
An Eating Disorder Mental Health Care Plan (EDP) is a specific type of plan tailored for individuals who are diagnosed with an eating disorder. This type of mental health plan allows you to engage in individual therapy which involves a more focused approach to address the complex needs associated with eating disorders. This type of plan can only be used to access psychology support from a psychologist or clinical psychologist.
How many Medicare rebated psychology sessions can I access under an Eating Disorder Mental Health Care Plan and how are they accessed?
Up to 30 Medicare rebated psychology sessions can be accessed under the eating disorder treatment pathway with the following referral structure:
Initial 10 sessions
The initial 10 Medicare rebates for psychology sessions under an Eating Disorders Mental Health Care Plan can be accessed through your GP setting up the plan and creating a referral to a psychologist. Alternatively, a psychiatrist can create a referral without setting up the care plan.
Sessions 11 to 20
A subsequent 10 Medicare rebates can be accessed by visiting your GP or psychiatrist for review. They are able to create a re-referral which will allow access to a further 10 Medicare rebated psychology sessions for your eating disorder treatment.
Sessions 21 to 30
Following your 20th Medicare rebate to be eligible for further Medicare rebates you are required to:
Have had an least one session with a dietician (who is engaged in your care ongoing)
Have had at least one session with a psychiatrist (who is engaged in your care ongoing)
Your GP is required to create another re-referral to a psychologist so you can access a further 10 Medicare rebates for the calendar year (sessions 21 to 30).
Sessions 31 to 40
Following your 30th session, your GP can create another re-referral to a psychologist which will allow you to access a further and final 10 Medicare rebates for the calendar year. The maximum number of Medicare rebates one can access in a calendar year under the Eating Disorder Care Plan is 40.
How much are my Medicare rebates or how much do I get back from Medicare for my psychology sessions under an Eating Disorder Mental Health Care Plan?
As of July 2024, Medicare rebates under the EDP are as follows for sessions with a:
General Psychologist – $ 96.95
Clinical Psychologist – $141.85
What if I have more questions about accessing Medicare rebates under the Better Access to Mental Health Initiative?
If you have more questions, contact Medicare directly on 132 011.
Alternatively, the friendly reception team at Cova Psychology in the Melbourne CBD can also help. Our psychologists in Melbourne treat a wide range of mental health issues and all of our therapists offer services which are eligible for Medicare rebates. Contact our experienced team to explore booking and we will support you through the process of setting up access to Medicare rebates for your psychology sessions.
Can I also use private health insurance to fund my psychology sessions?
Yes, if you are covered for psychology sessions under your health insurance fund. Check directly with your health fund to find out what is possible.
What are some key points to remember?
Mental Health Care Plans: All plans require a referral from a GP. You will need a long appointment (at least half an hour) to develop a plan together. GP services are accessible in various locations, such as the Melbourne CBD and throughout Victoria. Melbourne psychologists and offer a range of services accessible through various locations, including the Melbourne CBD.
Session limits: Be aware of the number of Medicare rebated sessions offered for the different types of plans. You will need to attend a review appointment with your GP to access the full number of rebated sessions for each plan.
Calendar Year Limits: The number of available sessions per year operates on a calendar year, so from the 1st January each year, you are eligible for further Medicare rebates. Sessions are not cumulative across the years (so if you have been referred for 10 sessions in 2024 under a MHCP but you only attend 8, you are not able to carry forward those 2 sessions to 2025. You are again eligible for 10 sessions. Having said that your referral remains in place, so you will not need to re-visit your GP until you have had the 10 sessions.
Documentation: It might help to keep track of all your appointments and referrals, and maintain copies of your care plans. You can access your personal information through the Medicare MyGov website.
Communication: Discuss your mental health regularly with your GP and other clinicians involved in your care. Always consult with your healthcare providers to get personalised advice and ensure that you are accessing the services that you need.
Therapy session: Understanding the structure and costs of a therapy session can be important. This includes knowing the average costs, potential insurance coverage, and the structured nature of sessions like cognitive behavioural therapy and couples therapy.
