As
of the 1st November 2006 some psychological services became eligible
to attract a rebate from Medicare. The information listed below
address some key issues regarding this federal government program.
More information can be obtained by phoning Betterlife Directions
on 07 4124 4521, or visiting www.medicare.gov.au
frequently
asked questions
What is the new Medicare Rebate?
What is a psychologist?
If I have a mental health problem, how can a psychologist
help me?
What is meant by mental disorder under the new Medicare
Rebate?
From what date can I claim a Medicare rebate
for seeing a psychologist?
What is a Medicare Provider Number?
Can I go directly to a psychologist and access
these benefits?
Can I access any/all psychologists?
What is a Registered Psychologist?
Can I request a referral to a specific psychologist
or does my doctor have to choose?
If I am already seeing a psychologist, can
I access these benefits?
How many sessions with a psychologist am I
entitled to?
What will it cost me?
How do I pay?
Does the Medicare Safety Net apply to my out-of-pocket
expenses under this initiative?
What about my private health insurance?
What is the new Medicare Rebate?
From 1 November 2006, the Australian Government will introduce new
Medicare items for psychological treatment by registered psychologists.
This service will provide considerable assistance to people living
with a mental illness and to their families, allowing them greater
access to psychologists and providing more affordable mental healthcare.
New Medicare services promote a team approach to mental health care,
with general practitioners, psychiatrists and paediatricians encouraged
to work with psychologists, and other allied mental health professionals
as well as mental health nurses, to increase the availability of
care.
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What is a psychologist?
Psychologists study the way people feel, think, act and
interact. Through a range of strategies and therapies they aim to
reduce distress and to enhance and promote emotional wellbeing.
Psychologists can assist people who are having difficulty controlling
their emotions, thinking and behaviour, including those with mental
or physical health problems such as: anxiety and depression, serious
and enduring mental illness, neurological disorders, addictive behaviours
as well as childhood behaviour disorders. Psychologists are experts
in human behaviour, and have studied the brain, memory, learning
and human development.
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If I have a mental health
problem, how can a psychologist help me?
Psychologists specialise in providing therapies for mental health
problems. These therapies are effective at treating common mental
health conditions including anxiety and depression and most childhood
problems. Psychologists differ from counsellors in that they are
required to study for a much longer period of time, and they are
required to register with the government before they can offer services
as a Psychologist.
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What is meant by mental disorder
under the new Medicare Rebate?
Mental disorder is a term used to describe a range of clinically
diagnosable disorders that significantly impact on a person’s
emotions, thoughts, social skills and decision-making. This includes
patients with mental disorders arising from:
- Psychotic disorders
- Schizophrenia
- Bipolar disorder
- Phobic disorders
- Anxiety disorder
- Adjustment disorder
- Depression
- Sexual disorders
- Conduct disorders
- Bereavement disorders
- Post-traumatic stress disorder
- Eating disorders
- Panic disorder
- Alcohol use disorders
- Drug use disorders
- Sleep problems
- Attention deficit disorder
- Obsessive Compulsive Disorder
- Co-occurring anxiety and depression
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From what date can I claim
a Medicare rebate for seeing a psychologist?
From 1 November 2006 psychologists who have been allocated a provider
number from Medicare will be able to start providing services under
this program.
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What is a Medicare Provider
Number?
Medicare is Australia’s universal public healthcare system.
Medicare provider numbers are issued by Medicare Australia to practitioners
who are able to provide services for which a Medicare rebate can
be claimed. Betterlife Directions’s fully-registered psychologists
have been allocated Medicare Provider Numbers for the provision
of psychological services under this program. If you are referred
to another psychologist you will need to check whether they have
a Medicare Provider Number before you book your appointment.
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Can I go directly to a psychologist
and access these benefits?
You must be referred to a psychologist by your GP, your psychiatrist
or paediatrician in order to be eligible for this Medicare rebate.
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Can I access any/all psychologists?
Under the Medicare rebate you can only see a registered psychologist
with a Medicare Provider Number upon referral from your GP, psychiatrist
or paediatrician.
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What is a Registered Psychologist?
All psychologists are legally required to register with the Psychologist
Registration Board in their State or Territory, in the same way
medical practitioners must be registered. This means that they must
be competent and follow a strict Code of Conduct.
Not all counsellors or therapists are Registered
Psychologists. Seeing someone who is registered ensures you receive
high quality ethical treatment.
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Can I request a referral
to a specific psychologist or does my doctor have to choose?
Your doctor may allow you to request a specific psychologist or
may refer you to a registered psychologist that he/she recommends.
The psychologist in question must be registered and have a Medicare
Provider Number for you to be able to claim the rebate.
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If I am already seeing a
psychologist, can I access these benefits?
You will need to see an appropriate medical practitioner (GP, psychiatrist
or pediatrician) to request a referral to your psychologist under
the approved system. Your psychologist would need to have a Medicare
Provider Number. Your psychologist can assist you with this process.
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How many sessions with a
psychologist am I entitled to?
Eligible patients can generally receive:
- Up to 12 individual services in a calendar year. Your referring
doctor will assess your progress after the first six sessions.
Provision will exist for patients to receive additional services
where exceptional circumstances arise (exceptional circumstances
will be identified by the referring doctor).
- Up to 12 group therapy services in a calendar year where such
services are available and seen as appropriate by the psychologist.
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What will it cost me?
The cost to you and the rebate available from Medicare can vary
depending on the:
- Length of the session;
- Type of psychologist; and
- Fee being charged by the psychologist.
Fees may vary and you must check this out with the psychologist
before commencing your treatment.
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How do I pay?
When you see a psychologist through Betterlife Directions, the settlement
of the account is your responsibility. You will be issued with a
detailed receipt with which you may receive a rebate by lodging
a claim through Medicare.
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Does the Medicare Safety
Net apply to my out-of-pocket expenses under this initiative?
Yes. You are responsible for paying any charges in excess of the
Medicare benefit for items under this initiative. However, these
out-of-pocket costs will count towards the Medicare Safety Net.
The family-based Safety Net protects high users of
health services from big out-of-pocket costs. This covers the difference
between the Medicare rebates and the schedule fee for families who
exceed a threshold level of payments in a year, but not for charges
that are above the schedule fee.
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What about my private health
insurance?
You cannot use your private health insurance ancillary cover to
top up the Medicare rebates for these services.
You need to decide if you will use Medicare or your
private health insurance ancillary cover to pay for psychological
services you receive. You can either access rebates from Medicare
by following the claiming process or claim where available on your
insurer’s ancillary benefits.
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To contact us regarding making an appointment, or to find out more
information on how we can help you - click
here to fill in our online contact form, or phone us on 1800
118 912.
or visit www.medicare.gov.au
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