It is important to be aware of your Medicare entitlements and to be sure that you have rebates available to claim for your appointments. Not being aware of the Mental Health Treatment Plan review process and maximum annual limit can result in a situation where you do not have a rebate available to claim. The information following is about Medicare’s processes under the Better Access initiative, which is the name of the entitlement that you’re receiving if you claim Medicare rebates for your psychology appointments under a Mental Health Treatment Plan.
Do I need a referral and Mental Health Treatment Plan?
You do not require a referral or Mental Health Treatment Plan to see a psychologist, however you will need both of these if you wish to claim a Medicare rebate for your appointments.
How much can I claim?
Medicare rebate amounts vary depending on the type of psychologist that you see. The Medicare rebate to see a Clinical Psychologist is currently $145.25 per appointment.
Eligible patients can access up to 10 individual and 10 group therapy Medicare rebatable sessions per calendar year (January 1 to 31 December) under the Better Access initiative. This is your maximum annual limit.
Medicare calculates the out-of-pocket medical expenses that you pay through the year. If your out-of-pocket expenses exceed the Extended Medicare Safety Net (EMSN) threshold, Medicare will increase the support that it provides by increasing the rebate that you can claim.
How do I get the rebate?
The Medicare rebate is available for you to use once your GP prepares a Mental Health Treatment Plan and a referral for you. The preparation of a Mental Health Treatment Plan activates the rebate entitlement with Medicare for you, and the referral letter enables you to claim those rebates for your appointments with the psychologist on the referral.
Although you are entitled to 10 individual Medicare rebatable sessions per calendar year, a GP can refer you for a maximum of 6 rebatable sessions at a time when they prepare a referral. A GP will usually refer you for 6 rebatable sessions initially, followed by an additional 4 rebatable sessions when your plan is reviewed. However, it is at the GP’s discretion how many sessions they include in a referral within the maximum allowable limits. Refer to Scenario 1 below to see an example of how this typically works.
If you are attending your first appointment and you wish to claim a Medicare rebate, it is important to have your initial Mental Health Treatment Plan and referral from your GP before you attend. This is because Medicare rebates cannot be claimed retrospectively of the date of a Mental Health Treatment Plan or referral and your GP cannot backdate these documents. This means you would not be able to claim a Medicare rebate for an appointment that you attended before you had a Mental Health Treatment Plan and referral from your GP. See Scenario 2 below.
How is the rebate processed?
The psychologist fee is $230 per appointment (from 1 January 2026). At this practice the fee is paid in full first and then the Medicare rebate can be claimed. If you have a Medicare rebatable session available, your psychologist will submit a claim on your behalf to Medicare. Once your claim is submitted to Medicare in this way you will receive your rebate into the bank account that you have registered with Medicare. Your Medicare rebate can also be processed instantly into your bank account using the terminal at the practice.
If you prefer, you can submit the rebate claim to Medicare yourself, however most people prefer that this is done by the psychologist because it is more convenient.
What happens when I have used the rebates included in my referral?
Once you have claimed all of the Medicare rebates for the sessions included in your referral, you must return to your GP for a review of your Mental Health Treatment Plan plan before you can claim a Medicare rebate for any subsequent session. This is important because, as explained above, Medicare rebates cannot be claimed retrospectively of the date of a referral and your GP cannot backdate this document. If you attended an appointment after you had claimed all Medicare rebatable sessions included in your referral, and before you saw your GP for a new referral, you would not be able to claim a rebate for that appointment. See Scenario 3 below.
What happens when I have used all of the maximum 10 rebatable sessions in a calendar year?
Once you have claimed 10 Medicare rebatable sessions in a calendar year, you have reached your annual limit. You would not be able to claim a Medicare rebate for any subsequent sessions, even if you had rebatable sessions remaining in a referral from your GP. You could continue to see your psychologist as a private client or you may claim another rebate, for example a private health rebate, if you had one available under your private health insurance policy. See Scenario 4 below.
What if I don’t use all of the Medicare rebatable sessions that were included in my referral?
When you do not use all rebatable sessions included in a referral during a calendar year the unused rebates are automatically rolled into next calendar year. When they are claimed in the next calendar year they count towards the maximum available rebates available that year. See Scenario 5 below.
Does my GP need to prepare a new Mental Health Treatment Plan to provide a referral for ongoing appointments? Do I need to wait a period between referrals for additional appointments?
No they do not, and you do not have to wait. Mental Health Treatment Plans do not expire. They are valid for the number of rebatable sessions that are included in a referral. Once 10 Medicare rebates are claimed under a Mental Health Treatment Plan, GPs do not have to prepare a new Mental Health Treatment Plan in order to refer their patients for ongoing appointments with a psychologist. GPs can provide ongoing management and referrals for further services through either a GP Mental Health Treatment Consultation Medicare item, a Mental Health Treatment Plan review item, or standard consultation Medicare items as required.
There is no requirement that patients wait 3 months, 12 months, or any other time period, between referrals for services. Once a patient has used all the Medicare rebatable sessions included in their referral, they are eligible to seek re-referral at any time from their GP. How a GP manages this process is at their discretion. It is at the clinical judgement of the GP to determine the number of services, if any, for which the patient is referred.
More information about Medicare rebates is available on the Department of Health website and the APS website.
Keeping track of your Medicare rebates as you use them
Keeping track of your Medicare rebates, booking in to see your GP for the required Mental Health Treatment Plan reviews, and making sure the referral documentation reaches your psychologist are your responsibility. However your psychologist can help you to keep a count of your Medicare rebatable sessions.
Once you are set up to receive Medicare rebates under a Mental Health Treatment Plan, your invoices and receipts will contain information about the number of Medicare rebatable sessions that your GP included in your referral and how many of those rebates you have remaining to use for future appointments.
For example, if your GP referral included 6 Medicare-rebatable sessions, the invoice and receipt that you will receive after you claim the first of the 6 rebates will say:
“1 of 6 sessions used in Mental Health Treatment Plan referral that included 6 Medicare-rebatable sessions“.
In this case you would have 5 Medicare rebated sessions remaining for future appointments. This running tally, highlighted in green to show you where it is located on your invoices and receipts, will count down with subsequent appointments indicating the number of remaining rebated sessions you have available to use.
Remember, you have a maximum of 10 Medicare rebates available each calendar year. To check the number of Medicare rebates you have claimed in a calendar year please refer to your Medicare Online Account or call Medicare on 132011 (24/7).
Example scenarios
Scenario 1:
This person received a Mental Health Treatment Plan and referral from their GP at the end of January. Their referral included 6 Medicare rebatable sessions. They attended 6 appointments in February, March, and April; and claimed rebates for those sessions.
As required by Medicare, after this person attended 6 sessions they returned to their GP for a review of their Mental Health Treatment Plan. Their GP provided a referral that included 4 additional Medicare rebatable sessions. They attended 4 further appointments in May, June, and July; and claimed rebates for those sessions.
This person used the maximum 10 Medicare rebates available in the calendar year.
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Scenario 2:
This person attended an appointment before seeing their GP for a Mental Health Treatment Plan and referral. Mental Health Treatment Plans and referral cannot be backdated so the person was unable to claim a Medicare rebate for their first appointment.
This person received a Mental Health Treatment Plan and referral from their GP at the end of January. Their referral included 6 Medicare rebatable sessions. They attended 6 appointments in February, March, and April; and claimed rebates for those sessions.
As required by Medicare, after this person attended 6 sessions they returned to their GP for a review of their Mental Health Treatment Plan. Their GP provided a referral that included 4 additional Medicare rebatable sessions. They attended 4 further appointments in May, June, and July; and claimed rebates for those sessions.
This person used the maximum 10 Medicare rebates available in the calendar year.
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Scenario 3:
Just like the example scenario above, this person received a Mental Health Treatment Plan and referral from their GP at the end of January. Their referral included 6 Medicare rebatable sessions. They attended 6 appointments in February, March, and April; and claimed rebates for those sessions.
This person did not return to their GP for a new referral for more Medicare rebatable sessions before they attended a 7th appointment.
This person would not be able to claim a Medicare rebate for their 7th appointment because they did not see their GP on time for a review of their Mental Health Treatment Plan and a referral for more Medicare rebatable sessions.
This person went on to see their GP for a review of their Mental Health Treatment Plan and their GP provided a referral that included 4 additional Medicare rebatable sessions. They attended 4 further appointments in May, June, and July; and claimed rebates for those sessions.
They used the maximum 10 Medicare rebates available in the calendar year.
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Scenario 4:
Just like the example scenario above, this person received a Mental Health Treatment Plan and referral from their GP at the end of January. Their referral included 6 Medicare rebatable sessions. They attended 6 appointments in February, March, and April; and claimed rebates for those sessions.
As required by Medicare, after this person attended 6 sessions they returned to their GP for a review of their Mental Health Treatment Plan and their GP provided a referral that included 4 additional Medicare rebatable sessions. They attended 4 further appointments in May, June, and July; and claimed rebates for those sessions.
This person used the maximum 10 Medicare rebates available in the calendar year, but they attended an additional appointment.
This person did not have a Medicare rebate available for their 11th appointment. This person could continue in treatment claiming a rebate through their private health insurance, if psychology is included in their policy; or they could continue as a private client.
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Scenario 5:
This person received a Mental Health Treatment Plan and referral from their GP in August. Their referral included 6 Medicare rebatable sessions. This person attended 6 appointments in August, September, and October; and claimed rebates for those sessions.
As required by Medicare, after this person attended 6 sessions they returned to their GP for a review of their Mental Health Treatment Plan and their GP provided a referral that included 4 additional Medicare rebatable sessions. They attended 2 further appointments before the end of the calendar year and claimed rebates for those sessions.
This person used 8 of the maximum 10 Medicare rebates available in the calendar year (and 2 of the 4 rebatable sessions included in the last referral from their GP).
When rebatable sessions that are included in a GP referral are not used in a calendar year, the unused rebatable sessions are automatically rolled into the next calendar year. This enabled this person to claim Medicare rebates for 2 appointments the next year before they were required to return to their GP for a review of their Mental Health Treatment Plan and new referral.
When the person had their Mental Health Treatment Plan reviewed, their GP provided a referral for 6 rebatable sessions, which the person attended in February, March, and April. They claimed rebates for these sessions.
As required by Medicare, after this person claimed all of the 6 Medicare rebatable sessions that were included in their referral they returned to their GP for a review of their Mental Health Treatment Plan and their GP provided a referral that included 4 additional Medicare rebatable sessions.
The two rebates that the person rolled into the calendar year from the previous year counted towards the 10 maximum rebates available in that year. This means this person had 2 Medicare rebatable sessions included in their last referral but they could not use them because they had claimed the maximum of 10 rebates for that year. The Medicare rebatable sessions that remained unused would be available from January 1 the next year.
As this person used their 10th Medicare rebate available for the year, their invoice and receipt would say “2 of 4 sessions used in Mental Health Treatment Plan referral that included 4 Medicare-rebatable sessions“. This indicates that the person has 2 rebates that are unused, however these 2 rebates would not be available to claim that year. This is why it is important to keep track of your maximum annual limit (10 rebates per calendar year) as well as your GP Mental Health Treatment Plan reviews.
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