Policy and Procedure

Overview

Medicare is Australia’s universal health insurance scheme, providing low or no-cost access to health services for eligible clients. Most of our clients (approx. 90%) use Medicare; however, some may not (e.g., international students, those preferring privacy, or those unwilling to provide details).

Key rules:

• Medicare is only available for eligible Australian citizens/clients.

• Only one Medicare claim per client per day is permitted.

Eligibility

• Client must have a Medicare card.

• Client must obtain a Mental Health Treatment Plan (MHTP) from their GP.

• Each client is entitled to 10 Medicare-funded sessions per calendar year:

  • Initial referral covers 6 sessions.

  • Psychologist review letter is required for the GP to issue a further 4 sessions.

• Rebates are updated annually by Medicare.

Consultation Details

• Mode: Phone or video

• Duration: 50 minutes

• Fees: Refer to website for current pricing

Required Information (Onboarding)

Collect and record the following:

• Medicare card number and Individual Reference Number (IRN)

• MHTP/referral from GP

• Credit card (mandatory)

• Complete client details: full name, preferred name, DOB, home address, mobile number

• For minors (<17): parent/guardian must be listed as claimant (include claimant name, DOB, Medicare #, IRN)

Booking and Billing

• Full-fee clients:

  • Code: 80110 – Psychological session at consulting rooms (with rebate applied)

• Financial distress rate:

  • Code: 80110 – Financial Distress

• ; Bulk-billed clients:

  • Code: 80110 – Financial Distress Bulk Bill (Medicare rebate only)

Adding Referrals in Halaxy

1. Go to client’s General page → Attachments → Add files → Upload referral → Select General/Administrative → Save.

2. Under Funding tab → Add Referral.

Additional Notes

• Registered Psychologists (Clinical or General) only – not Counsellors or Provisionals.

• Disclosures:

  • Cancellation policy: 24 hours’ notice required.

  • Cancellation fees: $90 (General Psychologist) or full session rate (Clinical Psychologist).

• Intake forms must be sent (adult, child, or youth form as relevant).

• Referrals from GPs should include all clinic details.

• Document onboarding with a note in Halaxy (e.g., 14/11 JB – Onboarded. Medicare details added).