Medicare benefits are available for a range of specified psychological services.
To be eligible to receive psychological services under Medicare, a person must be referred by their GP and in some instances by another medical specialist. Speak to your GP about your eligibility to claim these Medicare benefits and the best person to make your referral.
There are a range of referral types that can be made under Medicare.
Up to 10 individual sessions in a calendar year (1 January to 31 December). Up to 10 group therapy sessions in a calendar year where such services are available and seen as appropriate by your referring doctor and the psychologist.
A referral is for a maximum of six sessions. Your referring doctor will assess your progress after the first six sessions and determine whether further sessions are needed, they will then provide a re-referral of upto 4 sessions.
This scheme can be used for both in person and telehealth consultations.
This scheme cannot be used to claim rebates for assessment services.
The CDM/EPC Medicare items are part of a government initiative that assists people living with a chronic or complex medical illness to get the support and help they need from allied health professionals.
Medicare rebates are available for up to 5 visits (in total) within a calendar year, to certain allied health professionals assisting in the care and management of a chronic disease from a range of allied health professionals.
This scheme can be used for both in person and telehealth consultations.
This scheme cannot be used to claim rebates for assessment services.
You CANNOT use your private health insurance ancillary cover to top up the Medicare rebates.
You need to decide if you will use Medicare or your private health insurance ancillary cover to pay for any psychological services you receive. That is, you can either access rebates from Medicare by following the claiming process or claim where available on your insurer’s ancillary benefits.
The National Disability Insurance Scheme is responsible for supports that focus on functional ability and long term recovery, and are not clinical. That is, they may fund supports to help with the things you or your child can and can’t do due to a disability.
If you have a mental illness or psychosocial disability, the NDIS is responsible for supports that help you:
The NDIS provides options for participants to pay providers for services. CAYA psychology accepts the following methods of payment from NDIS participants.
Following provision of supports by CAYA Psychology, the participant will be required to pay the fee for service, in full, on the day of the service. The participant will be provided with an invoice which can be used to submit a request for a rebate from the NDIS.
Following provision of supports by CAYA Psychology. CAYA Psychology will provide the participant’s Nominee an invoice for the NDIS Schedule Fee. The participant will be responsible for the paying the gap between the NDIS schedule Fee and CAYA Psychology’s service fee.
You may be eligible to claim psychological services from your Private Health insurer depending on your level of cover. To claim a rebate you need to ensure that you are covered by ancillary benefits insurance (extras).
The rebate you will receive is be based on your level of cover. It is advised that you contact your insurer to confirm your eligibility.
You cannot use your private health insurance cover to top up the Medicare rebates for psychological services. If you are eligible for Medicare rebates then you need to decide which service you will use to cover the payment for psychological services you receive.