Supporting Your Mental Health with Medicare Obtaining a Referring to Access a Psychologist under Medicare

As your psychologist, my goal is to support your mental health and well-being. If you’re accessing psychological services through Medicare, you may be eligible for subsidised sessions under the Better Access initiative. Depending on your situation, there are different pathways and options available to ensure you get the support you need.
You may have heard that Medicare covers up to 10 psychological sessions per year, but there’s often some confusion about whether you can access more sessions or if you need a new Mental Health Care Plan (MHCP) to continue your treatment. In reality, there are several options available to you, even if you don’t need a new MHCP or review right away.

Here’s are the referral options for how we can work together to ensure that you have ongoing access to the support you need.

Mental Health Care Plan (MHCP, Item 2715)

To access Medicare rebates for psychological services, you’ll first need a Mental Health Care Plan (MHCP) from your GP. This plan outlines the support you’ll receive and helps ensure you can access the subsidised sessions.
Important: If you’ve already had an MHCP in the past year, you don’t have to wait a full 12 months to get a new referral. As long as you meet the criteria, your GP can issue a new referral to help you access more sessions.

Review of the Mental Health Care Plan (Item 2712)

Every 3 months, your GP can review your MHCP using Item 2712 to see how you’re progressing and determine whether you need more sessions. This review allows your GP to assess your progress and decide if additional sessions are needed.
Important: If your review is due, it’s important to have it documented with your GP. This ensures that we can continue to work together without interruptions in your therapy.

Mental Health Consultation/Referral (Item 2713)

If you’re not yet eligible for a review or a new MHCP (due to timing restrictions), there’s still a way to continue your therapy. The Mental Health Consultation/Referral (Item 2713) allows you to access up to 6 more subsidised sessions under Medicare without waiting for a new MHCP or review. Your GP just needs to write a referral to the psychologist and bill you under Item 2713 for you to be eligible for further rebates.

This pathway ensures that you can continue to receive the help you need without unnecessary delays.

What You Need to Know

To ensure you continue to receive the benefits of Medicare-rebated psychological services, it’s essential to stay on top of a few key requirements. Below are the key steps and potential consequences to help you stay on track with your care:

1. Follow Medicare Guidelines: Medicare provides rebates for a set number of sessions each year (up to 10 sessions, with reviews every 3 months). You must ensure that you’re aware of the number of sessions available under your MHCP, and that you adhere to the guidelines around timing and eligibility. If you exceed the number of allowed sessions, you may no longer be eligible for Medicare rebates without a new referral or review.

2. Cooperate with Reviews: If your GP recommends a review of your MHCP, it’s essential to attend these appointments to assess your progress and determine whether you need additional sessions. Reviews are typically done every 3 months, and cooperating with these reviews will help ensure that your treatment is aligned with your needs.

3. Be Aware of Time Limits: Medicare rebates are available based on specific time frames (e.g., once every 12 months for a new MHCP and every 3 months for a review). You must be mindful of these timeframes to ensure your continued eligibility for subsidised sessions and avoid delays in accessing further support.
If you do not attend a required scheduled review, obtain a new referral once you have used the number of services recommended by your GP, or receive a new Mental Health Care Plan when the old one expires, the following may occur:

• Loss of Medicare Rebates: Without a current review or referral, you may lose access to Medicare- funded sessions, meaning you’ll need to cover full costs for ongoing therapy.

• Disruptions in Treatment: Missing a review or failing to update your MHCP may result in a lack of necessary adjustments to your treatment plan, potentially delaying your progress.

• Increased Costs: If you don’t have the required documents, you won’t be eligible for subsidised services, leading to higher out-of-pocket expenses.

To avoid these issues, please make sure to attend all required appointments and keep your MHCP and referrals up to date.