Medicare Rebates

Medicare offer five programs under which eligible clients can claim back intervention and assessment fees:

  • The Mental Health Care Program (referral needed from your GP)

  • Chronic Disease Management Initiative (referral needed from your GP)

  • Helping Children with Autism (referral needed from Pediatrician or Psychiatrist)

  • Better Start for Children with a Disability (referral needed from Pediatrician or Psychiatrist)

  • Pregnancy Support Counselling (referral needed from your GP)

 

You are unable to access the above rebates if you are being provided therapy by one of our Provisional Psychologists. Provisional Psychologists can see clients under an individual therapy session at a reduced fee.

 

Out of pocket expense are similar to receiving treatment by a Registered Psychologists and claiming the rebate. 

1. Mental Health Care Plan (MHCP)

  • Clients of Augmentia Health may be entitled to a rebate for their therapy session under Medicare. This rebate is applicable under a Mental Health Care Plan. Augmentia Health is not a bulk billing clinic so there will be out of pocket expenses for clients seen under a MHCP

  • To receive a Medicare rebate, you will need to be referred under a Mental Health Care Plan from a general practitioner or psychiatrist. Bring your Mental Health Care Plan or your GP’s details with you to your first session

  • The out-of-pocket expense will count towards your Medicare Safety Net. If you have reached the Safety Net amount Medicare will rebate you 80% of the out-of-pocket-expense

  • Medicare offers a rebate for up to 10 sessions per calendar year in conjunction with your GP

  • Our Provisional Psychologists cannot see a client under a CDM plan however they can see patients under an individual therapy session. The fee would be $85.00 (onsite) and $95.00 (off site) for our Provisional Psychologists.

  • The MHCP needs to be in the client’s name and addressed to our clinic

  • If you already have a MHCP for your child in another Psychologist's name you will need to organise it being changed into Augmentia Health's name for us to be able to offer a Medicare Rebate per session. We will only be able to utilise the remaining sessions available on that current MHCP to claim the Medicare Rebate per session. 

  • You can be eligible for group classes under a MHCP.

Find out more about obtaining a Mental Health Treatment Plan by asking our receptionist for a fact sheet or for further details or call Medicare Australia on 132 011.

2. Chronic Disease Management Plan (formerly EPC)

  • Clients of Augmentia Health may be entitled to a rebate for their therapy session of under Medicare. This rebate is applicable under a Chronic Disease Management Plan (CDM) Augmentia Health is not a bulk billing clinic so there will be out of pocket expenses for clients seen under a CDM plan.

  • A CDM plan can help people with chronic medical conditions by providing an organised approach to care and a plan of action you have agreed with your GP. Medicare offers a rebate for up to 5 sessions per calendar year in conjunction with your GP

  • The CDM plan needs to be in the client’s name and addressed to clinic Augmentia Health 

  • If you already have a CDM for your child in another Psychologist's name you will need to organise it being changed into Augmentia Health's name for us to be able to offer a Medicare Rebate per session. We will only be able to utilise the remaining sessions available on that current CDM to claim the Medicare Rebate per session. 

  • Unfortunately, without this referral and plan, we cannot allocate a Medicare rebate to your Therapy and/or Assessment Sessions with our Registered Psychologist. 

3. Helping Children with Autism

  • The Helping Children with Autism program help client access early intervention services for children undergoing diagnosis/assessment or treatment for autism of any other PDD

  • When a treatment and management plan is in place, the medical practitioner who develops the plan can refer a child for allied health treatment services, providing the child is aged under 15 years and had a treatment and management plan prepared for them before their 13th birthday can access the Autism Medicare services provided they have not already accessed services under the Better Start for Children with a Disability Initiative and providing they meet the requirements of each service

  • Only one autism treatment and management plan can be prepared for a child in their lifetime

  • Under the Helping Children with Autism program, a child can be referred by a consultant pediatrician or psychiatrist for the following allied health services:

  • Up to four diagnostic / assessment services from psychologists, speech pathologists, occupational therapists, audiologists, optometrists, orthopedists or physiotherapists to assist the referring practitioner with diagnosis or to contribute to a child’s treatment and management plan (for a child under 13 years of age)

  • Up to twenty treatment services from psychologists, speech pathologists, occupational therapists, audiologists, optometrists, orthopedists or physiotherapists (for a child under 15 years of age, providing a treatment and management plan is in place before their 13th birthday).

  • These are the total number of services available to each child through the Helping Children with Autism program – not an annual entitlement.

4. Better Start for Children

  • The Better Start for Children with a Disability initiative provides funding for early intervention services for children diagnosed with a range of disabilities who can access up to $12,000 in funding

  • Each disability included in the Better Start program is subject to an eligibility threshold. These thresholds have been determined by the Department of Social Services

  • Children with an eligible diagnosis must register for Better Start before they turn 6 years old. A child will have until they turn 7 to access funding.

 

For more details please go to https://www.betterstart.net.au/

5.  Pregnancy Support Counselling

This psychology service offers pregnancy support counselling to assist clients who have any personal concerns related to a current or recent pregnancy (within the past 12 months), whether it has been full-term or part-term (including a planned termination).

 

The pregnancy support counselling Medicare Item covers up to three 30 minute+ sessions with a psychologist per pregnancy.

Our clinic is going live for Telehealth from April 6th 2020.  Phone us to find out how we can assist you with your needs on 1800 683 442.

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