Insurance

Aug 17 2017

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Medicare and psychology

There are a number of Australian Government initiatives under which psychologists are eligible to provide services under Medicare. To provide services, psychologists must meet the eligibility requirements for the particular Medicare item, as set out in the information on these web pages.

Medicare benefits are available for a range of specified psychology services for people with certain conditions, as summarised below. To receive psychological services under Medicare, a person must be referred by his/her GP or in some instances by a psychiatrist or a paediatrician. The full requirements for provision of psychological services in the following areas must be understood before services are provided. Select from the options below or browse the A-Z topic list.

Medicare – services provided by psychologists

People with an assessed mental disorder

Medicare-rebated psychological services available:
Up to 10 individual services AND up to 10 group therapy services per calendar year.

Children with autism or any other pervasive developmental disorder (PDD) – aged under 13 years for diagnosis and under 15 years for treatment

Medicare-rebated psychological services available:
Up to 4 services for assessment (in total per child) and up to 20 early intervention treatment services in total per child.

Children up to 15 years of age with any of the following disabilities: Sight impairment, Hearing impairment, Cerebral palsy, Down syndrome, Fragile X syndrome

Medicare-rebated psychological services available:
Up to 4 Medicare items for assessment and contributing to the development of a treatment plan for eligible children under 13.

Medicare items for up to 20 treatment services for eligible children up to 15 (provided their treatment and management plans are in place by age 13).

Women who are concerned about either a current pregnancy, or one that occurred in the previous 12 months

Medicare-rebated psychological services available:
Up to 3 services per pregnancy.

People who have a chronic medical condition and complex care needs

Medicare-rebated psychological services available:
Up to 5 individual services (in total) per calendar year.

Follow-up allied health services for people of Aboriginal or Torres Strait Islander descent

Medicare-rebated psychological services available:
Up to 5 individual services (in total) per calendar year (NB: these services are in addition to the 5 services for patients with a chronic medical condition and complex care needs).

Billing options

Billing options for services provided

Obtaining a Medicare Provider Number

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