Medicare rebates for therapy

What a Mental Health Treatment Plan covers, what it does not, and what you will pay

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With a Mental Health Treatment Plan from your GP, Medicare rebates $149.05 of each individual 50 minute therapy session with a clinical psychologist, for a child, an adolescent or an adult. Our fee is $270, so you are out of pocket $120.95 per session. A plan covers up to ten sessions per calendar year. We process the claim at the end of the appointment and the rebate is usually in your account within a day or two. Telehealth sessions attract the same rebate. Family sessions do not.

How do I get a referral?

1. Book a long appointment with your GP

Say when you book that it is to discuss a Mental Health Treatment Plan, and ask for a longer consultation. A standard fifteen-minute appointment is usually not enough, and being turned around for a second visit is the most common delay in this process.

2. The GP writes the plan

This involves a conversation about what has been happening, followed by a written plan and a referral letter. The referral can name Dr Winter or be addressed generally. If the Mental Health Treatment Plan is for your child, GPs differ on whether they need your child present, so ask when you book.

3. Bring it to the first session

Or email it ahead, which is easier. The referral must be dated before your first session for the rebate to apply. This is the most common thing that goes wrong and it cannot be fixed afterwards.

A paediatrician or psychiatrist can refer instead

If your child already sees one, they can refer directly for psychological therapy without a GP-written Mental Health Treatment Plan. Where you are already in that system, it is usually the faster route.

What will I actually pay?

Session fee, 50 minutes $270.00

Medicare rebate, clinical psychologist -$149.05

Your out-of-pocket, per session $120.95

You pay the full $270 at the end of the session and we lodge the Medicare claim on the spot. The rebate goes to the bank account Medicare has on file for you, usually within one to two business days.

Rebate current as at 1 July 2026. Medicare adjusts it each July and this page is updated when it changes.

How many sessions does it cover?

Up to ten individual sessions per calendar year.

Your first referral usually covers six. After those, you return to your GP for a review. They receive a letter from us and, where further sessions are appropriate, refer you for the remaining four.

The count resets on 1 January and does not carry over. Sessions you do not use are lost rather than banked. The ten are shared across every psychologist, social worker and occupational therapy you might see under the scheme in that year.

Therapy does not have to stop at ten. Sessions after that are $270 with no rebate. Check with you private health insurer as they may cover a portion of the fee if psychology is part of your extras cover.

What is covered when it is not only the client in the room

Therapy with a child often involves the parents, and sometimes the whole family. Medicare treats those two things differently.

Sessions with parents or carers, without the child present

These can be claimed. Where it is clinically appropriate and the client consents, Medicare allows a small number of sessions each calendar year to be provided to a parent, carer or support person as part of the client's treatment. The current limit is two.

They are for work that forms part of the client's therapy. A parent's own therapy is a separate matter and requires a referral in the parent's own name.

This is one of the least-known provisions in the scheme. It allows a session to work through how to respond at home without the child present.

Family sessions, with everyone together

These are not covered by Medicare. The rebate attaches to individual services provided to the referred client, and a session where the family comes together as a group falls outside that. This is a limit of the scheme. No referral or plan changes it.

Family sessions are charged privately, at a higher rate than an individual session because they run longer and are more complex. The fee is confirmed when you book.

Adults have their own referral

An adult seeing us in their own right needs their own Mental Health Treatment Plan, in their own name, with their own ten sessions. A parent cannot use a child's plan for their own therapy, and a child cannot use a parent's. Where both of you are working with us, that is two referrals.

Does Medicare cover an autism or ADHD assessment?

Not through a Mental Health Treatment Plan. This is where most of the confusion sits.

A Mental Health Treatment Plan funds therapy. It does not fund a diagnostic assessment. They are separate pathways with separate rules.

There is one separate pathway, for autism

For a person under 25 with a written referral from a paediatrician or a consultant psychiatrist, not a GP, Medicare provides a rebate of $101.55 per session towards an autism assessment, under its complex neurodevelopmental disorder items.

This is a partial rebate against our fee rather than a subsidised assessment. You pay the assessment fee in full and claim the rebate on the eligible sessions.

Medicare also limits how many of these sessions a person can claim in their lifetime, and they are shared across psychology, speech pathology and occupational therapy. If your child has seen a speech pathologist under the same referral, some may already be used. Your paediatrician can tell you how many remain.

ADHD assessment has no Medicare pathway

There is no rebate for ADHD assessment in any circumstance, and NDIS does not fund it either. It is private pay.

Assessment funding options will be discussed with you over the phone on your enquiry.

What Medicare does not cover

  • Any session held before the referral date.

  • Family sessions, where the family comes together as a group rather than an individual session with one referred client.

  • Couples counselling.

  • A parent's own therapy under their child's referral. That needs a referral in the parent's own name.

  • Missed appointments and late cancellations.

  • Report writing, letters and documentation prepared outside a session (exclusive of GP letters)

  • School meetings, case conferences and NDIS reports.

  • More than ten sessions in a calendar year.

  • Diagnostic assessment for autism or ADHD, except through the paediatrician-referred pathway for autism assessments described above.

None of these are unusual. They are the standard limits of the scheme rather than anything particular to this practice, but they are worth knowing in advance.

 FAQs

 

  • Yes, and it can be claimed. Medicare allows a small number of sessions each calendar year, currently two, to be provided to a parent, carer or support person as part of the client's treatment, where it is clinically appropriate and the client consents.

    It cannot be used for your own therapy. That is a separate referral in your own name.

  • No. The rebate applies to individual sessions with the referred client. A session where the family comes together as a group is charged privately, at a higher rate than an individual session because it runs longer. No referral or plan changes this.

  • Adults are covered on the same terms: a Mental Health Treatment Plan from your GP, up to ten sessions per calendar year, $149.05 back per session. The plan has to be in your own name.

  • GPs differ. Most will want to see your child at least briefly. Some will write the plan with you alone, particularly for a younger child. Ask when you book the appointment.

  • Yes. Telehealth sessions attract the same rebate as sessions in the room, under the same referral, and count towards the same ten per calendar year.

  • Possibly. Each private health insurer has different rules about psychology sessions. Check with your insurer whether psychology is covered under your extras.

  • Sessions continue at $270 with no rebate, and the count resets on 1 January. We will tell you when you are getting close to using all ten sessions so we can plan and prepare.

  • Yes, and so can a psychiatrist. Neither needs to write a Mental Health Treatment Plan for you to be eligible. Their referral is enough. If your child is already under a paediatrician, this is usually the quicker route than going back to your GP.

  • Usually not, where it names someone specifically. A referral addressed generally can be used with any eligible provider. If yours names another practice, your GP can reissue it, which is generally a phone call rather than another appointment.

Get In Touch

We'll be in touch within two business days to arrange an initial conversation. You don't need a referral, and there is no obligation to proceed.