Written by: Therapy Near Me Editorial Team
Clinically reviewed by: qualified members of the Therapy Near Me clinical team
Last updated: 26/11/2025
This article is intended as general information only and does not replace personalised medical or mental health advice. Learn more about our Editorial Policy.
At a glance (what you can claim in 2025)
- Under Better Access, eligible people can claim up to 10 individual and up to 10 group therapy services per calendar year (1 Jan–31 Dec) when referred by a GP with a Mental Health Treatment Plan (MHTP), a psychiatrist or a paediatrician (Department of Health and Aged Care, 2025a; MBS, 2025a).
- Services can be delivered in‑person or via Telehealth when clinically appropriate (Department of Health and Aged Care, 2025a).
- Psychologist rebates are claimed against MBS allied mental health items. Clinical psychologists use 80002/80006/80012/80016; registered psychologists use 80102/80106/80112/80116; there are comparable items for social workers and occupational therapists (Services Australia, 2025a; MBS, 2025b).
Good to know: You’ll usually be referred for an initial block of up to 6 sessions, with a GP/psychiatrist review before you can access the remaining up to 4 (the exact number on your referral controls what can be claimed) (Department of Health and Aged Care, 2025a; MBS, 2025a).
Written by: Therapy Near Me Editorial Team
Clinically reviewed by: qualified members of the Therapy Near Me clinical team
Last updated: 26/11/2025
This article is intended as general information only and does not replace personalised medical or mental health advice. Learn more about our Editorial Policy.
The simple claiming paths
There are three common ways your Medicare rebate is processed:
- Bulk billed (no gap): Your provider bills Medicare directly. You pay $0. You sign an assignment of benefit. (Services Australia, 2025b).
- Patient claim (you pay, then claim): You pay the full fee and claim the rebate yourself—on the spot at the clinic if they offer Medicare Online claiming, or later via your myGov → Medicare online account. (Services Australia, 2025b; myGov, 2024).
- Part‑paid at the desk: The clinic submits the claim and your rebate is sent to your bank, leaving only the gapto pay. (Services Australia, 2025b).
Time limits (important):
- Patient‑lodged Medicare claims are generally accepted for up to 2 years from the date of service (MBS, 2025c).
- Bulk‑billed provider lodgements must be submitted within 1 year of the date of service for services provided from 5 September 2025 (Department of Health and Aged Care, 2025b; ADA, 2025).
Step‑by‑step: from GP plan to your rebate
1) Book your GP for a Mental Health Treatment Plan (MHTP)
- Tell reception you’re booking a long appointment for a mental health plan.
- Your GP will assess, diagnose and create a treatment plan and referral. From 1 November 2025, the government is shifting some GP mental‑health billing to time‑based attendance items and linking care to your usual GP/MyMedicare practice, but your pathway as a patient is unchanged—you still get a plan, a referral and rebates (MBS, 2025c; RACGP, 2025).
2) Check your referral carefully
- It must include your name, diagnosis, number of sessions referred, provider details (or “open referral”), and whether Telehealth is approved.
- Referrals can be addressed to a specific clinician or be open so you can choose a provider. If the number of sessions is not specified, providers must use clinical judgment up to the annual cap (Department of Health and Aged Care, 2024; 2025a).
3) Book your psychologist (Telehealth or clinic)
- Ask about fees, MBS item they’ll use, and whether they offer bulk billing or on‑the‑spot claims.
- If you are using Telehealth, confirm the platform, privacy, and your location at session start (clinics must record it) (AHPRA, 2020).
4) Pay and claim
- Bulk billed: you sign and leave.
- Patient claim at the clinic: show your Medicare card and a referral/MHTP; the clinic submits through Medicare Online and your rebate goes to your bank, usually within days.
- Claim yourself at home: log in to myGov → Medicare → Make a claim. Upload the paid invoice (shows provider name, ABN, item number, date, amount paid). Add your bank details to Medicare first (Services Australia, 2025b; myGov, 2024).
5) Review after your first block
- After the first set of sessions (often up to 6), you’ll need a GP or psychiatrist review to unlock the remaining sessions for the year (Department of Health and Aged Care, 2025a).
Rebates, gaps and item numbers (plain English)
- The rebate is a fixed amount set in the MBS and is not the same as the psychologist’s fee. Many clinics charge a gap. Ask the clinic for the gap after rebate.
- Common items:
- Clinical psychologist: 80002 (initial ≥50 min), 80006 (subsequent ≥50 min), 80012 (Telehealth initial), 80016 (Telehealth subsequent).
- Psychologist (registered): 80102, 80106, 80112, 80116.
- Group therapy items are available in addition to individual sessions—up to 10 per year (MBS, 2024; 2025a; Services Australia, 2025a).
Tip: If your referral doesn’t state a number, your clinician can provide services up to the annual cap using their clinical judgement for each block (Department of Health and Aged Care, 2024; 2025a).
What can be done by Telehealth vs in‑person?
Most psychological therapies—including CBT, ACT, exposure‑based treatments and CBT‑I—can be delivered effectively via video when sessions are structured and private (Backhaus et al., 2012; Berryhill et al., 2019; Batastini et al., 2021; Trauer et al., 2015). Choose in‑person if privacy is limited or if specialised assessments/equipment are required.
Avoid the 5 most common claim mistakes
- No referral or expired block: claim submitted without a valid referral for the current block of sessions (MBS, 2025a).
- Wrong item number: Telehealth vs in‑room item mismatch.
- Missing bank details in Medicare online: delays payout.
- Invoice doesn’t show “amount paid”: Medicare needs proof you actually paid for a patient claim.
- Waiting too long: claim inside 2 years (patient‑lodged); clinics must submit bulk bills within 1 year for services from 5 Sept 2025 (Department of Health and Aged Care, 2025b; MBS, 2025c).
How to claim online via myGov (checklist)
- myGov account linked to Medicare.
- Bank account saved in Medicare.
- Itemised invoice/receipt with provider details, ABN, date, item code, fee and amount paid.
- Photo or PDF of your referral/MHTP if requested.
- Submit under “Make a claim” and keep the claim ID for your records (Services Australia, 2025b; myGov, 2024).
Medicare vs private health, EAP and NDIS
- You can’t claim both Medicare and private health for the same session (no double dipping).
- EAP sessions are employer‑funded and don’t use your Medicare cap.
- NDIS funding is separate; you cannot bill NDIS and Medicare for the same time, but you may use Medicare for non‑NDIS issues (NDIA, 2025; Department of Health and Aged Care, 2025a).
Frequently asked questions (2025)
How many sessions can I claim?
Up to 10 individual + 10 group per calendar year, in blocks set by your referrer (Department of Health and Aged Care, 2025a).
Does my Mental Health Treatment Plan expire?
The plan itself doesn’t expire, but you need new referrals/reviews for additional blocks and each calendar year’s entitlements (Queensland Health, 2023).
Can I switch psychologists?
Yes. Ask your GP for an open referral or request your psychologist to transfer. The referral follows you for the remaining sessions in that block (Queensland Health, 2023).
How fast do rebates arrive?
Digital claims are typically paid within about a week; in‑person or mail can take longer (Services Australia, 2025b).
Will Telehealth affect my rebate?
No—Telehealth items attract rebates when used correctly and clinically appropriate. Your GP may need to be your usual GP/MyMedicare practice for the plan and reviews from 1 Nov 2025 (MBS, 2025c; Department of Health and Aged Care, 2025c).
Evidence: why using your plan matters
Early use of evidence‑based therapy reduces symptoms and improves role functioning; network meta‑analyses show CBT‑type interventions are effective for common conditions, and CBT‑I is first‑line for insomnia (Cuijpers et al., 2021; Trauer et al., 2015; Hofmann et al., 2012). Telehealth delivery is generally non‑inferior for many presentations (Backhaus et al., 2012; Batastini et al., 2021).
AHPRA & quality disclaimer
This article is general information, not a substitute for individual medical advice. TherapyNearMe.com.au does not publish testimonials. Always follow your practitioner’s advice and current MBS rules.
References
AHPRA (2020) Telehealth guidance for practitioners. Melbourne: Australian Health Practitioner Regulation Agency. Available at: https://www.ahpra.gov.au/
ADA (2025) ‘Medicare claim changes for bulk‑billed services from Sept 2025.’ Australian Dental Association. Available at: https://ada.org.au/
Backhaus, A., Agha, Z., Maglione, M.L., Repp, A., Ross, B., Zuest, D., Rice‑Thorp, N.M., Lohr, J. & Thorp, S.R. (2012) ‘Videoconferencing psychotherapy: A systematic review’, Psychological Services, 9(2), pp. 111–131.
Batastini, A.B., Paprzycki, P., Jones, A.C. & MacLean, N. (2021) ‘Are videoconferenced mental and behavioral health services just as good as in‑person? A meta‑analysis of a fast‑growing practice’, Clinical Psychology Review, 83, 101944.
Berryhill, M.B., Culmer, N., Williams, N., Halli‑Tierney, A., Betancourt, A., King, M., et al. (2019) ‘Videoconferencing psychotherapy and depression: a systematic review’, Telemedicine and e‑Health, 25(6), pp. 435–446.
Cuijpers, P., Karyotaki, E., Reijnders, M. & Purgato, M. (2021) ‘Psychological treatments for depression in adults: a network meta‑analysis’, World Psychiatry, 20(2), pp. 283–293.
Department of Health and Aged Care (2024) Better Access resources collection. Canberra: Australian Government.
Department of Health and Aged Care (2025a) Better Access factsheets (patients and professionals), October 2025.Canberra: Australian Government.
Department of Health and Aged Care (2025b) Reduction in timeframe to submit bulk‑billed claims: factsheet. Canberra: Australian Government.
Department of Health and Aged Care (2025c) MBS changes to the Better Access initiative from 1 November 2025 (linking to usual GP/MyMedicare practice). Canberra: Australian Government.
Hofmann, S.G., Asnaani, A., Vonk, I.J.J., Sawyer, A.T. & Fang, A. (2012) ‘The efficacy of cognitive behavioral therapy: a review of meta‑analyses’, Cognitive Therapy and Research, 36(5), pp. 427–440.
MBS (2024) Group therapy MBS changes under Better Access — Factsheet. Canberra: Australian Government.
MBS (2025a) Allied Mental Health items (e.g., 80002/80006/80102/80106) and full item descriptors (e.g., 80102, 80110). Canberra: Australian Government.
MBS (2025b) Allied mental health items list by profession and Telehealth equivalents. Canberra: Australian Government; Services Australia summary page (QC 74153).
MBS (2025c) Note MN.13.14 — two‑year lodgement limit for direct‑billing claims; November 2025 updates to Better Access and GP attendance items. Canberra: Australian Government.
myGov (2024) Claim your Medicare benefit through myGov. Canberra: Australian Government.
NDIA (2025) Therapy supports (funding interface guidance). Canberra: National Disability Insurance Agency.
Queensland Health (2023) Better Access (patient factsheet): referral and session rules. Brisbane: Queensland Government.
Services Australia (2025a) MBS billing rules for mental health services (QC 74153): item lists by profession. Canberra: Australian Government.
Services Australia (2025b) Medicare claims: how to make a claim online or at your doctor (QC 60338). Canberra: Australian Government.
Trauer, J.M., Qian, M.Y., Doyle, J.S., Rajaratnam, S.M.W. & Cunnington, D. (2015) ‘Cognitive behavioral therapy for chronic insomnia: a systematic review and meta‑analysis’, Annals of Internal Medicine, 163(3), pp. 191–204.
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