How many psychology sessions are covered by medical care?
To access psychology services within medical care, you need a referral from your GP, psychiatrist, or pediatrician.
People who are eligible for the Mental Health Care Plan can have up to 10 individual or group therapy sessions covered by Medicare in one the calendar year (12 months from January 1 to December 31).
However, referrals do not cover all ten sessions. With a general health care plan from your GP, you are entitled to 6 rehabilitation sessions from Medicare.
If you completed these six sessions during the calendar year and you need to continue treatment with your psychologist, you will need to see your doctor to review the mental health plan.
Your doctor will determine if additional sessions are needed and if so, they will provide another referral for the remaining four sessions.
What happens if you complete all ten sessions during the calendar year?
If you complete all ten sessions during the calendar year, you can still visit a psychologist for psychology services, however, you will not be able to claim a healthcare discount using your mental health care plan.
If a mental health practitioner recommends continuing treatment, you may be eligible for an EPC plan.
The EPC plan allows you to claim a discount of $ 51.95 for a maximum of 5 sessions per the calendar year with Medicare.
If during the calendar year you used all ten sessions on your mental health care plan and still want to continue treatment with your psychologist and receive medical care benefits, you will need to see your doctor for a mental health review to determine if you qualify for the EPC plan.
Once you start a new calendar year (January 1), you can visit your doctor to get a new mental health care plan.
Do I need a GP referral to see a psychiatrist?
You do not need a referral from your GP to see a psychiatrist. If you see a psychologist without a referral from a general practitioner, you will be required to pay the full amount for your session.
If you have private health insurance with psychological counseling as additions, you may be able to claim a partial discount.
It is best to contact your health fund for more information about your coverage.
If I already see a psychiatrist, can I access Medicare benefits?
If you are seeing a psychiatrist and pay for your session fee out of your pocket, you will need to visit your doctor for a mental health assessment to determine if you qualify for Medicare benefits.
Can I have 100% medical billing sessions?
We offer a limited number of bulk-billing sessions per week to cater to people in financial stress. You will need a mental health care plan which is subject to eligibility and availability. Please contact us for more information.
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