Medicare Funding Fact Sheet

Medicare Rebates for Psychology Services

At Little Insights, we are registered with Medicare, which allows eligible clients to receive rebates for psychology services under a range of government-supported referral pathways.

These plans must be prepared and referred by a GP, psychiatrist, or paediatrician prior to your initial session.

1. Mental Health Treatment Plan (Better Access Initiative)

2. Chronic Disease Management Plan (CDM / GPCCMP)

3. Eating Disorder Treatment and Management Plan (EDP)

4. Complex Neurodevelopmental Disorder Treatment and Management Plan (Including: Autism Spectrum Disorder)

  • Available for clients under 25 years old with complex neurodevelopmental disorders or eligible disabilities (e.g., Autism Spectrum Disorder).

  • Requires a treatment and management plan prepared by a Pediatrician.

  • Enables access to specific allied health assessment and therapy MBS items.

    • One-off development of the treatment & management plan

      • A specialist (paediatrician or psychiatrist) can bill for creating a treatment and management plan (under certain MBS items).

      • That development is claimable once in a patient’s lifetime.

    • Allied Health Assessment / Diagnostic Services

      • Up to 8 allied health assessment services are eligible for Medicare rebate (over the person’s lifetime) to assist in diagnosis or contribute to the plan.

      • These may include services by psychologists, speech pathologists, occupational therapists, etc.

      • The specialist must refer to each allied health provider, and usage beyond 4 sessions per provider may require review by the referring clinician.

    • Allied Health Treatment Services

      • Once the plan is in place, up to 20 treatment services (across allied health disciplines) are rebated via Medicare.

      • These 20 services in total may include any blend of eligible providers (psychology, speech, OT, physiotherapy, audiology, etc.).

      • After 10 sessions, the allied health provider(s) must report back to the referring specialist and a new referral may be needed for the remaining sessions.

  • Links

Important Medicare Notes

  • You cannot claim multiple funding sources (e.g., Medicare + NDIS + Private Health) for the same therapy session.

  • Always check with your referring practitioner or Medicare to confirm:

    • Eligibility and correct item numbers,

    • Required reviews, and

    • Remaining available sessions.

  • If your family reaches the Medicare Safety Net threshold, your out-of-pocket costs may reduce further, increasing your rebate amount.

  • Government policies and rebate values are reviewed periodically; always refer to Services Australia or MBS Online for current information.