How and for what services can I claim Medicare rebates under a MHCP?

This article deals primarily with the Better Access to Mental Health Care Program (MHCP) 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. 

The Better Access provides considerable assistance to people living with mental health problems, allowing them greater access to psychologists and providing more affordable mental healthcare.

Under the scheme, individuals diagnosed with a mental health disorder can receive a rebate from Medicare for access up to 10 individual and 10 group treatment sessions per year under certain conditions. 

Better Access at Quirky Kid

Some psychological services delivered by The Quirky Kid Clinic are eligible for rebates under Medicare Better Access. The Better Access initiative covers people with some types of mental disorders but not others. 

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 the referring practitioner he or she will need to prepare a Medicare Health Care Plan (MHCP) before referring you to a psychologist. You should book a longer session with your GP to enable time for this. Your child will need to be present during that session as they are the identifiable patient for the purposes of intervention at Quirky Kid.

Important

The MHCP documentation or referral stating the MHCP must be issued AND received by our team before your consultation. The Quirky Kid Clinic can't and won't alter an invoice after one has been issued. It is very important that a copy of your MHCP is 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 six (6) individual mental health services.

After an initial group of up to six (6) sessions, the referring medical practitioner managing the identified 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 refer the client for up to further four (4) sessions (to a maximum of 10 psychological sessions per calendar year).

At the end of six sessions, we are required to prepare a brief update report and send it to your GP. You then need to obtain a new referral stating the number of additional sessions (not necessarily a new MHTP) to access these additional four (4) sessions. 

An MHTP does not expire. A referral is valid until the referred number of sessions have been completed, regardless of whether a patient chooses to change their allied mental health provider.

Cost and Payment

Quirky Kid will charge you normally in accordance with 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 consultation of 50+ minutes will range between $86.15 and $148.80.

If you comply with the requirements set by Medicare (eg provide us with a copy of a valid plan before your consultation), you will receive a tax invoice containing the relevant  Medicare Benefits Scheme (MBS) number and additional details. Pay the full 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.

Identifiable Patient

Medicare requires that the identifiable patient is present for the full clinic session. At The Quirky Kid Clinic, the identifiable patient is your child. Because we sometimes meet with the patient's parent/s without the child present (for example, before the child's first appointment), this means these parent-only sessions are NOT eligible for Medicare rebates.

Non-rebatable services

Furthermore, some services types are excluded under Medicare Guidelines under the scheme. Under these circumstances, we will not be able to include an MBS number to the tax invoice and consequently, you will not be able to claim a rebate. Excluded services include, but are not restricted to: 

  • Parent only sessions. 
  • Telephone consultations with parents. 
  • Teleconferences with other parties (e.g., teachers, doctors). 
  • Phone of VideoSkype consultations (exceptions apply during COVID-19)
  • 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 fully 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.

More information

It is the patient's obligation to ensure you meet Medicare requirements prior to engaging our services. More information is available via the Australian Psychological Society website and the Department of Health website.
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. 


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