03 Dec MHCP explained: Medicare Rebates and the New Calendar year
A great deal of confusion sometimes surrounds the beginning of the New Year and referrals for Psychology under a Mental Health Care Plan (MHCP). In this article we hope to demystify this process and make it very clear for all concerned.
The tricky thing for many to understand is that a referral to a Psychologist does not expire. When a GP writes a referral for other specialists (e.g. a cardiologist or dermatologist) the referral is valid for 12 months. After 12 months you must get a new referral to keep seeing that specialist and keep getting a Medicare rebate.
But for Psychologist referrals they are valid for a course of treatment with the maximum course being 6 sessions.
Medicare allows up to 10 sessions in one calendar year (i.e. 1 January to 31 December) to be eligible for a rebate.
Let’s say your GP referred you to a Psychologist and you first saw them on November 15th 2019. You attended for 4 sessions before the 1st of January 2020. When you go to see your Psychologist again in January you will have 2 sessions still available under your existing referral. You do not need a new referral because it is the start of the year.
Once you have attended these 2 sessions you must see your GP for a new referral. If granted this new referral will also be valid for 6 sessions (unless stated otherwise by your GP).
If you then use these 6 sessions, you can again be referred by your GP as you will have 2 eligible sessions remaining for 2020 that can get a rebate. Remembering that there is a maximum of 10 sessions in one year.
If you still required sessions after this point you would need to use private health or pay privately to continue attending as there would be no further Medicare rebates available until the New Year.
If you still require appointments into 2021, your existing referral would still have 4 valid rebates on it without seeking a new referral. Chances are, however, that you would have seen your GP in this time and your Psychologist would have been writing to them and keeping them up to date with your progress so it may well be that a new referral has been issued anyhow.
The table below relates this information in a visual form:
If you are still feeling uncertain about your Medicare rebates or referrals please do not hesitate to give us a call at Prosper Health Collective on 6381 0071.
