Medicare

Accessing Healthcare Professionals with Medicare

Under the Better Access to Mental Health Care Initiative, the Department of Health and Ageing is aiming to achieve four main goals:

• more GPs will be encouraged to participate in early intervention, assessment and management of patients with mental health conditions and in appropriate psychological interventions in primary care
• private psychiatrists will be encouraged to see more new patients
• referral pathways will be provided for appropriate treatment of patients with mental disorders e.g. psychiatrists, GPs, clinical psychologists, and other mental health professionals
• GPs and primary care service providers will be provided with education and training to better diagnose and treat mental illness

Through this new initiative, Medicare consumers are now able to access rebated services from psychologists, psychiatrists, social workers, occupational therapists and mental health workers for the elderly, provided that they receive a referral from their GP.  The total amount of Medicare rebates depend on the type of service a consumer seeks to receive. 

Once a mental health professional has been sought after, s/he may decide to either bulk bill or not.  If s/he charges the schedule fee, then the patient must take responsibility to claim the rebate through Medicare, and pay the difference between the schedule and the rebate. 

Psychologists

A patient is entitled to up to 12 individual services per calendar year, and up to 12 group therapy sessions per calendar year.  The costs will depend on three factors: length of the session, whether the psychologist is a generalist or specialist clinical, and the fee charged by the psychologist.   Also note that the referred psychologist must be registered with a Medicare Provider Number, otherwise a patient will have to pay the full amount.

Psychiatrists

Under the new Medicare Benefits Schedule (MBS), rebates for seeing private psychiatrists have been increased, especially for patients seeing a private psychiatrist for the first time.  Please note that public psychiatrists who work in places like hospitals and community centres can be seen without incurring fees.

Occupational Therapists (OT)

To access an OT through Medicare, the OT must be a member of OT Australia, with a minimum of two years experience in mental health who abide by The Australian Competency Standards for Occupational Therapists in Mental Health.

Social and Mental Health Workers

Social workers must have membership with the Australian Association of Social Workers (AASW), and certification by the AASW as meeting the standards for mental health set out in the AASW’s Standards for Mental Health Social Workers 1999.

For more information about the Better Access to Mental Health Care Initiative, please go to the following websites:

• Australian Psychological Society
• OT AUSTRALIA
• Department of Health and Ageing