Medicare rebates for mental health services

More help for children with mental health difficulties

 

Medicares rebate for psychological treatment of mental health difficulties

In November 2006, the Australian Government extended the Medicare Benefits Scheme to include psychological treatments for many childhood mental health difficulties. You will be able to obtain a rebate if your child is referred by a general practitioner, psychiatrist or paediatrician to an eligible allied health professional for treatment of mental health difficulties such as:

  • Anxiety, phobias, and depression
  • Behaviour problems
  • Difficulties in controlling anger
  • Sleep problems
  • Concentration and attention problems
  • Bed-wetting
  • Obsessive compulsive disorder
  • Autism, Aspergers, or Pervasive Developmental Disorder**
If I am concerned about my child, what do I do?

Step 1:

  • If your child is already seeing a psychiatrist or paediatrician, then discuss your concerns with them
  • If not, make an appointment with your GP to discuss your concerns. Your GP will assess your child.
Requirements for eligibility for the new Medicare rebate

Step 2:

  • If the GP, psychiatrist or paediatrician assesses your child as having a mental health problem that is covered by the extended Medicare rebates, then they can refer you to an eligible allied health professional (where the GP is the referrer a mental health care plan must be written)
  • The eligible allied health professional can be a psychologist or a social worker or occupational therapist who specialises in treating mental health problem
  • The allied health professional must have a Medicare provider number
  • If your child is already seeing an allied health professional, payments for these services do not meet the criteria for eligibility for a Medicare rebate. To qualify for the Medicare rebate, it is necessary to follow the process outlined above
  • Your child will be eligible for up to 10 sessions per year. The referring doctor will assess progress after the first six sessions.
  • Your child is also eligible for up to 10 group therapy sessions where these services are available and are seen as appropriate by the referring doctor

**If your GP assesses your child as requiring assessment or treatment for Autism, Aspergers or Pervasive Developmental Disorder your child may also be eligible for a Medicare rebate. Your child may be eligible for up to four assessment sessions and 20 treatment sessions with an eligible allied health professional. The eligible allied health professional can be a psychologist or a speech pathologist or occupational therapist who specialises in assessing or treating developmental disorders. The eligible allied health professional must have a Medicare provider number.

What will it cost?

The cost and the rebate available from Medicare will vary according to the length of the session and the fee being charged. The allied health professional determines the fee charged. If there is a gap between the consultation fee and the Medicare rebate, you will be responsible for the additional payment. You cannot use private health insurance extras cover to cover the out of pocket expense.

More information

The extended Medicare benefits are also available for many adolescent and adult mental health problems. Further information can be found by downloading:

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