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)
Enables eligible clients to access rebates for up to 10 individual psychological sessions per calendar year.
After the first 6 sessions, your GP must complete a review to access the remaining 4.
As of 1 July 2025, Medicare rebates are:
$145.25 for a Clinical Psychologist
$98.95 for a General Psychologist
Note: The scheduled Medicare benefit does not fully cover the session fee.
Under this plan, Medicare may also rebate a limited number of sessions without the client present (e.g., parent sessions), usually capped at two per year, if clinically appropriate.
Links
2. Chronic Disease Management Plan (CDM / GPCCMP)
Allows GPs to refer patients with chronic or complex conditions to allied health professionals, including psychologists.
Typically provides up to 5 subsidised allied health sessions per calendar year.
The referral is valid for 18 months unless otherwise specified.
Rebate amounts are set by the Medicare Benefits Schedule (MBS) and may differ from Better Access rebates.
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3. Eating Disorder Treatment and Management Plan (EDP)
This plan supports individuals with diagnosed eating disorders (e.g., anorexia nervosa, bulimia nervosa, binge eating disorder).
Eligible clients can access up to 40 psychological treatment sessions (EDPT services) within 12 months, subject to medical reviews.
May include up to 20 dietetic sessions where clinically relevant.
Must be developed by a GP, psychiatrist, or paediatrician who confirms eligibility and coordinates care.
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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.
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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.