Information for Referrers

Under the Medicare Better Access initiative, eligible people with a clinically diagnosed mental health disorder can receive Medicare rebates for up to 10 individual psychological therapy sessions per calendar year.

Medicare Referral Requirements for Individual Therapy

To ensure your patient can claim their Medicare rebates smoothly, please ensure the referral or Mental Health Treatment Plan (MHTP) includes the following information:

A psychologist referral does not have a formal expiry date. It remains valid for the specific number of sessions noted on the referral letter, even if those sessions are used across two calendar years.

Unused sessions: if a patient does not use all 6 sessions before 1 January, the remaining sessions roll over into the new year. However, those rolled-over sessions still count toward the patient’s Medicare cap for the new calendar year.

Calendar year reset: Medicare allows a maximum of 10 rebated individual sessions per calendar year, resetting on 1 January each year. Once a patient has used their initial 6 sessions, they will need to return to their GP for a review and a new referral to access the remaining sessions.

In addition to 10 individual sessions, patients are also eligible for up to 10 group therapy sessions per calendar year under the Better Access initiative [1]. Group therapy provides a safe space for shared support, diverse perspectives, and the development of coping skills.

Medicare Referral Requirements for Group Therapy

The referral requirements for group therapy are similar to those for individual therapy, with a few key distinctions:

We offer telehealth (video and phone) consultations for both individual and group therapy, where clinically appropriate. The same annual limits and referral requirements apply to telehealth services as they do to individual and group face-to-face sessions.

Sydney Psych Hub provides psychological treatment services for workers with accepted NSW workers compensation claims.

Our SIRA-approved psychologists are experienced in supporting workers with both primary psychological injuries (such as workplace trauma, bullying, or harassment) and secondary psychological conditions arising from a physical workplace injury (such as anxiety or depression following an accident).

Please note that in NSW, “WorkCover” now refers to the scheme regulated by the State Insurance Regulatory Authority (SIRA), with icare acting as the insurer for most claims.

Eligibility

A worker may be eligible for funded psychology sessions under the NSW workers compensation scheme if:

• They have a work-related injury or illness that has been accepted as a workers compensation claim.
• The injury has a psychological component, either as a primary psychological injury or as a secondary condition arising from a physical injury.
• The nominated treating doctor (GP) has recommended psychology as part of the worker’s treatment.

How to Refer

As the nominated treating doctor, your role in the referral process is as follows:

1. Issue a workers compensation certificate of capacity, certifying the worker’s injury and capacity for work.
2. Provide a written referral to a SIRA-approved psychologist, clearly recommending psychology treatment as part of the worker’s injury management plan.
3. Include relevant clinical information in the referral, such as the worker’s diagnosis, current symptoms, any relevant medications, and the nature of the work-related injury.

The worker can then contact Sydney Psych Hub directly to book an initial assessment. Our psychologist will conduct an initial session and subsequently submit an Allied Health Treatment Request (AHTR) to the insurer, outlining the proposed treatment plan and number of sessions required.

Sydney Psych Hub provides psychological services to NDIS participants. Please note that we accept plan-managed and self-managed participants only. We are not currently registered to provide services to NDIA-managed (agency-managed) participants.

Eligibility

Psychology services under the NDIS are funded when they are directly related to a participant’s disability and support them in working towards the goals outlined in their NDIS plan. Services are not intended to address general mental health concerns unrelated to a participant’s disability.

Psychology is typically funded under the Capacity Building budget, most commonly within the Improved Daily Living support category. In some cases, funding may also be available under the Improved Relationships category.

If you are unsure whether a participant has psychology funding in their plan, we recommend they contact their Support Coordinator or Local Area Coordinator (LAC) to confirm.

How to Refer

A formal referral is not required for participants to access psychology services through the NDIS. However, a referral from a GP, paediatrician, support coordinator, or other health professional is always welcome and helps us to better understand the participant’s needs and goals.

When making a referral, please include the following information where possible:

• The participant’s name, date of birth, and contact details.
• The participant’s NDIS number and plan management type (plan-managed or self-managed).
• A brief summary of the participant’s presenting concerns and relevant history.
• The participant’s NDIS goals that psychology support will address.
• Any relevant diagnoses or supporting documentation.

Plan-Managed Participants

For plan-managed participants, Sydney Psych Hub will invoice the participant’s plan manager directly. We will ask for the plan manager’s contact details and may require a service agreement to be signed prior to commencing services. Sessions are billed in accordance with the current NDIS Pricing Arrangements and Price Limits.

Self-Managed Participants

For self-managed participants, payment is required at the time of each session. The participant can then submit the invoice to the NDIS for reimbursement through their myGov account.

Sydney Psych Hub welcomes referrals for psychological treatment for patients with eating disorders.

Patients who meet Medicare eligibility requirements may access Medicare-rebated eating disorder psychological treatment services under an Eating Disorder Treatment and Management Plan (EDP).

An EDP may be prepared by a GP or other medical practitioner working in general practice, a consultant psychiatrist, or a consultant paediatrician. The referring practitioner determines the patient’s eligibility and the appropriate combination of allied health services.

When referring a patient to Sydney Psych Hub, please clearly state that the referral is for eating disorder psychological treatment under an EDP and specify the number of psychology sessions being referred for, up to a maximum of 10 sessions per referral. Please also include the patient’s diagnosis, relevant clinical and medical information, current medications, and any treatment goals or risk considerations.

Eligible patients can access up to 40 Medicare-rebated eating disorder psychological treatment services within the 12-month period beginning on the date of their EDP. A specialist review by a psychiatrist or paediatrician is required before a patient can access more than 20 psychological treatment services under the plan.

Our psychologists will work collaboratively with the referring practitioner and other members of the patient’s care team. We will provide written reports after the first and final services, or more frequently where clinically appropriate.

People requiring urgent medical or psychiatric assessment should be directed to the appropriate emergency or specialist service rather than routine outpatient referral.