Psychology Referral pathways
If a patient is suffering from a mental health condition their GP can complete a mental health care plan, which enables them to obtain a medicare rebate for psychological therapy. If a mental health care plan is not obtained, individuals are eligible to attend psychology sessions for a private fee. Please note, depending on individual policies, some patients may be eligible for rebates with their private health insurer.
GP Mental Health Care Plan & Psychology Medicare Rebates
With a mental health care plan clients are eligible for a Medicare rebate of $129.55 (for treatment with a clinical psychologist) or a Medicare rebate of $88.25 (for treatment with a registered psychologist or clinical psychology registrar).
What is a valid referral?
A Mental Health Treatment Plan is NOT a referral and alone is not sufficient for the psychologist to provide a service unless it contains the following information:
- date
- patient’s name, date of birth and address
- diagnosis / problem
- request for services and number of sessions
- referring practitioner’s Medicare Provider Number
- practitioner’s signature
- a statement about whether the patient has a GPMHTP, shared care plan or a psychiatrist assessment and management plan.
Referral course of treatment
The number of services stated in the referral is a ‘course of treatment’.
The maximum number of sessions you can include on a referral for each course of treatment is:
- 6 sessions using the initial MBS items
- 10 sessions using the additional MBS items (until 30 June 2022)
A patient can have 2 or more courses of treatment within their calendar year with a limit of:
- 10 initial services
- 10 additional services (until 30 June 2022).
Patients need a new referral for each course of treatment.
Referrals/MHTPs and new calendar year
Referrals are valid for the number of services shown on the referral letter and do not expire. If your patient has unused sessions on the referral at the end of the calendar year, they can continue to use them the next year. A Mental Health Treatment Plan also does not expire. A patient does not need a new MHTP just because it is a new calendar year or 12 months since the existing MHTP was prepared. Many patients will not require a new plan after their initial plan has been prepared. A new plan should not be prepared unless clinically required.
Further information can be found at The Australian Government Department of Health or MBS Online.
Please do not hesitate to contact us to ask any further questions. If preferred, referrals may be sent via fax to (02) 4077 5812.