17 September 2026
How to Get a Mental Health Care Plan in Australia
A mental health care plan lets eligible patients claim Medicare rebates for up to 10 individual therapy sessions each calendar year. You get this plan by booking an assessment with your GP. The doctor reviews your symptoms, writes a referral, and connects you with a psychologist, social worker, or occupational therapist.
Key Takeaways
Medicare provides rebates for up to 10 individual allied mental health sessions every calendar year.
Your doctor writes an initial referral for up to six sessions before doing a review.
You can take your referral to any registered psychologist, even if another clinic is named on the letter.
You cannot use private health insurance extras to pay the remaining gap fee on a Medicare session.
Medicare cannot pay for a therapy session that is already funded by an NDIS package.
What Is a Mental Health Care Plan
A mental health care plan is an official treatment document created by your GP. In the Medicare system, it is called a GP Mental Health Treatment Plan. Figures from the Australian Institute of Health and Welfare (AIHW) show that 43% of Australians experience a mental disorder in their lifetime. A plan helps you access funded clinical support instead of paying full commercial rates out of pocket.
The document records your diagnosis, your clinical history, and your goals for treatment. Once your doctor logs the plan with Medicare, you can claim rebates under the Australian Government Better Access initiative. The rebates apply to registered psychologists, clinical psychologists, accredited mental health social workers, and occupational therapists.
Medicare resets your session quota on 1 January each year. You can access up to 10 individual therapy sessions and 10 group therapy sessions per calendar year.
Step-by-Step Guide to Getting Your Plan from a GP
Getting a plan requires a standard visit to your regular medical clinic. Four straightforward steps get the paperwork completed.
Book a Longer Appointment with Your Doctor
Tell the receptionist you need an appointment for a mental health treatment plan. Ask for a double appointment or a long consultation. GPs cannot complete the required clinical paperwork during a standard 10-minute slot.
Clinics bill this longer session under Medicare Benefits Schedule item 2715 (20 to 39 minutes) or item 2717 (40 minutes or longer). You can see your usual GP, or any doctor at the practice where you are enrolled in MyMedicare.
Complete the Assessment and Discuss Your Concerns
Your doctor will ask about your day-to-day symptoms, work or home stress, sleep patterns, and medical history. You may be asked to complete a short clinical questionnaire.
The K10 (Kessler Psychological Distress Scale) uses 10 questions to score distress levels from mild to severe.
The DASS-21 measures symptoms across three scales: depression, anxiety, and stress.
Answer the questions based on how you have actually felt over the past few weeks. The score gives your doctor an objective baseline to confirm eligibility.
Agree on Goals and Receive Your Referral
Once the assessment confirms an eligible condition, you and your doctor set goals for therapy. Your doctor then writes the referral letter.
Under Medicare rules, your doctor cannot write a single referral for 10 sessions. The initial referral covers an initial course of treatment for a maximum of six sessions. Your doctor gives you a copy of the referral along with your signed care plan.
Book Your First Therapy Appointment
Take your referral letter to your chosen mental health provider. Review our allied health services to see our therapy options, assessments, and clinical focus areas.
Psychologists often run waiting lists, so book as soon as you have your paperwork. Send your referral letter to the clinic reception ahead of your first appointment so they can log your Medicare details.
How Medicare Rebates and Gap Fees Work
The Medicare Benefits Schedule (MBS) fixes the rebate amount for each type of health provider. Private practices set their own appointment fees, which means fees vary between clinics.
If a clinic bulk bills, they accept the Medicare rebate as full payment. You pay nothing out of pocket. If the clinic charges a private fee, you pay the full fee at your visit, and Medicare refunds the rebate into your bank account. The difference between the clinic fee and your rebate is your out-of-pocket gap fee.
Rebates fall into two main tiers based on provider qualifications:
Registered Psychologist: Consultations of 50 minutes or longer (MBS item 80110) receive a set rebate tier.
Clinical Psychologist: Consultations of 50 minutes or longer (MBS item 80010) receive a higher rebate tier reflecting specialist endorsement.
By law, you cannot claim a Medicare rebate and a private health insurance rebate for the same appointment. You must choose one or the other. Most people use their 10 Medicare sessions first, then switch to private health extras if they need more sessions that year.
The Mid-Point Review: Accessing Sessions 7 to 10
Your first referral covers six visits. If you still need therapy after your sixth visit, you must complete a formal mid-point review before Medicare will rebate sessions 7 through 10.
The Progress Report from Your Therapist
After your sixth session, your therapist writes a progress report for your GP. This document outlines:
The psychological interventions used during your sessions.
How your symptoms have changed against your initial goals.
Recommendations on whether you need four more sessions.
Your therapist sends this report directly to your GP clinic before you attend your review.
The Doctor Review Appointment
Book an appointment with your GP after your sixth therapy session. Your GP reviews your therapist's report and discusses your current symptoms.
If your doctor agrees that ongoing care is needed, they bill a GP review (MBS item 2712). They then issue a second referral letter for the remaining four sessions. Under Medicare rules, this review cannot happen within four weeks of your initial plan, and generally no more than once every three months.
Important Rules You Need to Know
Patients often run into confusion around provider choices and calendar dates. Two core rules give you flexibility:
You can change your therapist at any time. Even if your GP addressed your referral to a specific clinic or psychologist by name, you can use that letter at any Australian practice. The new clinician just needs to work in the same profession (e.g., psychology). You do not need to visit your GP for a replacement letter.
Unused sessions roll into the next calendar year. Your referral letter does not expire on 31 December. If your doctor approves six sessions in October and you only use three by year end, your remaining three sessions stay valid in January. They simply count toward your new 10-session allowance for that next calendar year.
Managing NDIS Supports and SIRA Claims
People with complex needs often use multiple funding programs. You need to know how these systems work together so you stay compliant.
Under Section 19(2) of the Health Insurance Act 1973, you cannot claim a Medicare rebate for a service funded by another public body. If your therapy session is paid for through NDIS Capacity Building, you cannot bill Medicare for that same hour.
You can hold both funding types if they cover separate supports:
Use your NDIS budget for ongoing functional assessments, capacity building, or behavior support.
Use your Medicare care plan for individual psychological therapy treating an acute condition like anxiety or depression.
For injuries linked to work or a motor vehicle accident, therapy runs through the State Insurance Regulatory Authority (SIRA). SIRA claims need approval from your case insurer before appointments begin, rather than going through Medicare.
Individualised Care for Your Journey
Therapy works best when you work with someone who understands your life and communication preferences. Treatment needs to fit the individual, not a rigid script.
Proper Allied Health provides psychological support across Western Sydney, including Westmead and Parramatta. Our lead clinician, Sara, is an AHPRA registered psychologist and Medicare provider. She conducts consultations in English and Tagalog, giving Filipino-Australian clients the option to talk through concerns in their home language.
Support should move at a pace that suits you. Getting your GP paperwork sorted early lets you focus on your therapy sessions instead of the administrative rules.
Frequently Asked Questions
Does having a mental health care plan stay on my permanent record?
Your plan stays on your confidential medical record at your GP clinic and with Medicare. Australian privacy law prevents employers, banks, and private insurance companies from viewing these medical files without your signed consent.
Can a psychiatrist or paediatrician prepare my treatment plan?
A psychiatrist or paediatrician can write a direct referral letter to a psychologist without creating a treatment plan. The formal Mental Health Treatment Plan document itself is written by a general practitioner.
What happens if I use all 10 sessions before the year ends?
Once you claim 10 Medicare-rebated sessions in a calendar year, you cannot get another rebate until 1 January. To continue therapy, you can pay the full private fee, use eligible private health insurance extras cover, or wait for the new calendar year.
What should I do if I need urgent help while waiting for an appointment?
Mental health care plans are for non-emergency care. If you need urgent support right now, call Lifeline on 13 11 14, text 0477 13 11 14, or call emergency services on 000.
Ready to Discuss Your Referral
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