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Medicare Rebates for Psychologists and Psychiatrists

Medicare Rebates for Psychologists and Psychiatrists

This section contains information on:

- Fees to see a psychologist
- How Medicare rebates work
- The Medicare Safety Net and whether you will be eligible for higher rebates

 

Seeing a psychologist can be very affordable with support from Medicare. For example, for a consultation with a Clinical Psychologist you will be approximately $57.85 out-of-pocket if you have an appropriate GP referral, and this amount will reduce to $6.26 when you meet the Medicare Safety Net. This section below contains information on our practice fees and Medicare rebates. This information is of a general nature only, and you should clarify your individual circumstances with Medicare regarding rebates, and consult our reception staff for exact fees and rebates for each VCPS practitioner. Please also note that the fees of some practitioners in our clinic are slightly different to those specified here.

Our fees are less than the recommended fees of the Australian Psychological Society. We offer on the spot Medicare rebates without the need to visit a Medicare office. Private health insurance rebates and rates for Health Care Card holders are also available in some situations. Medicare allows you to receive a rebate to see a psychologist for up to 16 consultations per calendar year. To obtain a Medicare rebate you will need to be eligible for, and obtain, a Mental Health Treatment Plan referral from your GP or a general referral from a psychiatrist or pediatrician. If you are yet to obtain a referral, please contact our practice and we will provide you with an appointment with an appropriate VCPS practitioner and their details for which the referral should be addressed. We can also recommend General Practitioners in your local area who we have a working relationship with.

If you have a Mental Health Treatment Plan, the out-of-pocket fee for a 50 minute consultation will usually be $57.50 if you see a Clinical Psychologist, or $97.50 if you see a Consultant Psychologist or a Clinical Neuropsychologist. Please note, a Mental Health Treatment Plan does not provide Medicate rebates for a Neuropsychological assessment, and the fees of some practitioners in our clinic are slightly different to those specified here.

Your Medicare rebate will also be significantly higher once you reach the Medicare Safety Net (this means once you spend a specified amount out of your own pocket). If you plan to see a psychologist regularly, or you have other medical expenses, the Medicare Safety Net helps reduce these costs. As an individual, you don’t need to register for the Medicare Safety Net as Medicare will automatically provide a higher rebate to you once you become eligible. However, if you are part of a family or couple you should register with Medicare for the Safety Net by phoning 132 001 so that your combined couple/family expenses are counted.

Medicare will keep a running total of the medical expenses you have incurred and the VCPS accounts system automatically communicates your expenditure at our clinics with Medicare if you register your Medicare card with us.

The amount you need to spend on out-of-pocket expenses in 2012 to meet the Medicare Safety Net thresholds and receive higher rebates for our services is:

  1. $413.50 - You will then receive 100% back of the MBS fee – for item 80010 this is $143.70, for item 80110 this is $97.90 (assuming a consultation fee of $180.00)
  2. $1,198.00  (or $598.80 if you hold a Health Care Card or you are in a family eligible for Family Tax Benefit Group A) - You will then receive 100% back of the MBS fee, plus an additional 80% back of the gap payment - for item 80010 this is $172.74, for item 80110 this is $163.58 (assuming a consultation fee of $180.00).

Some examples of services where costs count towards the safety net are GP and specialist consultations, blood tests, CT scans, MRIs, pap smears, psychiatry, psychology, radiotherapy, tissue biopsies, ultrasounds and x-rays.

 

Example 1: Based on having a Mental Health Treatment Plan referral and a psychologist consultation fee of $180 per 50 minute session.

If you see a clinical psychologist, your usual rebate would be $122.50, and the out-of-pocket cost to you would be $180.00 minus $122.50, equaling $57.50.

If you see a consultant psychologist, your rebate would be $83.25, and the out-of-pocket cost to you would be $180.00 minus $83.25, equaling $96.75.

Once you spend $413.50 on out-of-pocket costs in 2012 (this is referred to as The Original Safety Net) your rebate will increase to $143.70 per consultation if you see a Clinical Psychologist and $97.90 if you see a Consultant Psychologist.

A much larger rebates come into effect once you spend $1,198.00 on out-of-pocket costs in 2012 (or $598.80 if you hold a Health Care Card, or you are in a family eligible family for Family Tax Benefit Group A). This is referred to the Extended Safety Net, and your rebate will increase to $172.74 if you see a Clinical Psychologist and $163.58 if you see a Consultant Psychologist. 

Medicare Item Number

Practitioner Type

Standard Medicare Rebate on a $180.00 consultation fee
(Your out-of-pocket
expense in brackets)

Original Safety Net Rebate Medicare Rebate on a $180.00 consultation fee
(Your out-of-pocket expense in brackets)

Extended Safety Net Rebate Medicare Rebate on a $180.00 consultation fee
(Your out-of-pocket expense in brackets)

80110

Psychologist

$83.25   ($96.75)

$97.90    ($82.10)

$163.58   ($16.48)

80010

Clinical Psychologist

$122.15   ($57.85)

$143.70    ($36.30)

$172.74   ($6.26)