You can see a Psychologist at any time with or without a GP ‘Mental Health Care Plan’. However, a Mental Health Care Plan allows you to receive Medicare Rebates to subsidise the consultation cost. In order to obtain a Care Plan you need to make an appointment with your GP to allow sufficient time to discuss your areas of concern.
Do I need a GP Mental Health Care Plan?
Medicare Rules for GP Mental Health Care Plans
You need to provide the Psychologist with a Mental Health Care Plan dated on or before your appointment. Medicare will know the Care Plan date when you claim a rebate for your GP appointment. The GP must charge you a Medicare item number for a Care Plan of either 2700 or 2701 or 2715 or 2717.
The Care Plan enables you to receive Medicare rebates for up to 6 Psychology appointments. After the initial 6 Psychologist appointments you need to visit your GP again for a Review. The GP may provide a letter or review plan to provide to the Psychologist for further sessions (maximum of 6 until next review is due).
A maximum of 10 Medicare rebates each calendar year is allowed for Psychology appointments. If your initial 6 session Care Plan appointments are in the same calendar year as the Review, then you can claim rebates for the next 4 Review appointments in the same year and for the remaining 2 Review appointments in the next calendar year. If the initial 6 Care Plan appointments cross over into the next calendar year then you can claim rebates for the next 6 Review appointments, subject to a maximum of 10 rebates per calendar year.
You need to revisit your GP after every 6 Psychologist appointments. When your 6 Review appointments are complete you need to visit your GP again for another Review. The GP may provide you with another letter or review plan to provide to the Psychologist for further sessions (maximum of 6 until next review is due).
Mental Health Care Plans Explained
You can see a Psychologist without having a Care Plan. The Care Plan is necessary to claim rebates.
A GP Mental Health Care Plan does not expire. It is an ongoing document. You don’t need a new Care Plan just because it is a new calendar year or 12 months since the Care Plan was prepared.
You can visit your GP at any time to review and discuss your mental health care. There is a formal Review item number 2712 that the GP can charge 4 weeks after the date of your care plan. However this item number is not compulsory for the GP to authorise further rebated appointments. The Psychologist just needs to receive a note from the GP before seeing you for the 7th consultation.
A Review authorises you for a further 6 rebated appointments unless the GP specifies a fewer number of Review appointments. Sometimes the GP will authorise only a further 4 appointments, to coincide with a maximum of 10 rebates each calendar year. If the Review is for 4 sessions you need to go back to the GP after the 4 sessions are complete.
The 1st formal GP Review (item 2712) can be 4 weeks after the Care Plan, and the 2nd formal GP Review (item 2712) can be 3 months after the first formal review. However this item number is not compulsory for the GP to authorise further rebated Psychology sessions. You can discuss your mental health care with your GP at any time. The Psychologist just needs a note from your GP to continue with rebated sessions.
A Review does not expire just because it is a new calendar year. If you have sessions left on your Review in the new year these can be used up before returning to your GP for your next Review. All sessions in a calendar year, regardless of which Care Plan or Review they relate to, count towards the maximum of 10 rebated Psychologist appointments per calendar year.