How and for what services can I claim Medicare rebates under an MHCP?
This article deals primarily with the Better Access Initiative ( Better Access).
Introduction
Medicare rebates are available for psychological treatment by registered psychologists under the Australian Government's Better Access. Provisionally registered psychologists are not eligible to provide services under this scheme.
Better Access assists people with mental health problems, allowing them greater access to psychologists and providing more affordable mental healthcare. Under the scheme, individuals diagnosed with certain mental health disorders can receive a rebate from Medicare for access to up to 10 individual and 10 group treatment sessions per year ( under certain conditions).
Better Access at Quirky Kid
Only some psychological services at The Quirky Kid Clinic delivers are eligible for rebates under Medicare Better Access.
To access mental health treatment under Medicare, you must be referred by your GP, a psychiatrist or a paediatrician (referring medical practitioner). If a GP is a referring practitioner, he or she must prepare a Medicare Health Care Plan ( MHCP) before referring you to a psychologist. You should book a more extended session with your GP so that you can use the time for this. Your child must be present during the consultation with the GP as they are the identifiable patient for intervention at Quirky Kid.
Important
- The MHCP documentation or referral stating the MHCP must be issued AND received by our team before your consultation.
- We won't alter an invoice after one has been issued. For this reason, a copy of your MHCP must be received before your consultation if you are claiming a rebate from Medicare.
Other Requirements and Validity
The referring medical practitioner can initially refer you for a course of treatment up to ten (6) individual mental health services. After the initial six (6) sessions, the referring medical practitioner managing the patient (the child) will conduct a review based on the psychologist’s report.
The review will determine if there is a need for further sessions, and the referring medical practitioner may renew the plan for up to a further ten (4) sessions (to a maximum of 10 psychological sessions per calendar year).
At the end of ten sessions, we must prepare a brief update report and send it to your GP. An MHCP does not expire. A referral is valid until the referred number of sessions has been completed, regardless of whether a patient chooses to change their allied mental health provider.
Cost and Payment
Quirky Kid will charge you privately under our schedule of fees. The cost of a consultation is greater than the Medicare rebate. Quirky Kid does not Bulk Bill.
The typical rebate you will receive or a consultation of 50+ minutes will range between $92.20 and $136.35
If you comply with the requirements set by Medicare, you will receive a tax invoice containing the relevant Medicare Benefits Scheme (MBS) number and additional details. Pay the total amount of the consultation and use your detailed receipt to claim a Medicare rebate from Medicare.
Important
Quirky Kid is not a bulk billing practice. You are required to pay the full amount of the consultation upfront.
Distribution of Sessions
Medicare requires that the identifiable patient is present for the entire clinic session. At The Quirky Kid Clinic, the identifiable patient is your child.
From July 2023, you can also choose to use up to two sessions for consultation with a parent or carer. However, this can not be utilised for the initial parent (only) consultation. These sessions replace sessions provided to the child and will come off the client’s 10 available sessions for the year. The child cannot be in attendance during the session.
Non-rebatable services
Furthermore, some service types are excluded under Medicare Guidelines under the scheme. Under these circumstances, we will not be able to include an MBS number in the tax invoice, and consequently, you will not be able to claim a rebate. Excluded services include, but are not restricted to:
- Some Parent only sessions.
- School observations.
- Assessments and psychometric tests.
- Workshops.
- Some non-face-to-face services.
Private Insurance and Medicare Rebates
You cannot use your private health insurance ancillary cover to top up the Medicare rebates. You need to decide if you will use Medicare or your private health insurance ancillary cover to pay for any psychological services you receive.
That is, you can either access rebates; from Medicare by following the claiming process or claim were available on your private health insurer's ancillary benefits.
Medicare benefits are not payable when the service is wholly or partially funded under a Federal or State Government arrangement. Quirky Kid psychologists can still provide non-Medicare services to a patient under a GP referral.
How do I Claim?
To make a claim, you have the following options:
- Medicare online account (via MyGov)
- Medicare Express app (mobile or desktop)
- Medicare Service Centre
- Telephone claiming for rural and remote residents (call 1300 360 460, available 24/7)
Here are the simplified steps to help you easily claim your rebates:
- Sign in: Access your myGov account or open the Medicare Express app.
- Select 'Make a Claim': Read the disclaimer notice and click 'Accept' if you agree. Please note that Quirky Kid Clinic does not process clients' rebates. When asked if the provider has already made a claim on your behalf, choose 'No' to proceed with the claim.
- Confirm your details: Choose the name of the person who received the Medicare service from the options provided.
- Confirm payment details: Indicate if the account has already been paid or if payment is still pending.
- Attach your document: Upload a copy of your account, either by taking a picture or scanning it in the specified formats.
- Add provider and item details: Locate your psychologist's Provider Number on your account and enter it. Also, enter the 5-digit Medicare item number for the treatment received, along with the amount you paid. You can add more items if necessary. Provide the referral details, including the Provider Number of the referring medical practitioner and the referral date.
- Review and submit: Carefully review the information and click 'Submit' to send the claim for processing. Make any necessary changes by clicking 'Edit'. Once submitted, Medicare will assign you a Claim ID. You can download and print a PDF copy of your claim summary. Please allow up to 7 days for Medicare to process your claim.
- Sign out: Remember to sign out of your myGov account or exit the Medicare Express app.
By following these steps, you can easily claim your rebates. Please remember that the Quirky Kid Clinic does not process client rebates; the claims are handled directly by the clients themselves.
More information
It is the patient's obligation to ensure you meet Medicare requirements prior to engaging our services. More information is available via:
This information is correct at the time of writing and is based on our interpretation of the current regulation. Please check directly with Medicare for details about your specific situation.