Medicare, in plain language.

What it pays, what you pay, and exactly what to say to your GP. Current figures, dated, so you can check them rather than take our word for it.

Figures below are the Medicare benefits in force from 1 July 2026. Medicare indexes them once a year, on 1 July.

“Can I claim on a social worker?” Yes.

Better Access is the Medicare scheme that puts a rebate behind therapy. It recognises three kinds of provider: clinical psychologists, registered psychologists, and Accredited Mental Health Social Workers. Same scheme, same referral, same paperwork.

An AMHSW is a social worker with additional accreditation in mental health practice, assessed by the Australian Association of Social Workers. Lauren is one, is AASW #461419, and is also an ANZAED Credentialed Eating Disorder Clinician — which is what opens the 40-session eating disorder pathway below.

One number, not two. Your rebate is $89.50 for every session of 50 minutes or more — in the rooms in Nedlands or by video anywhere in Australia, on either plan. A psychology practice has to explain two different tiers depending on who you see. Here there is one.

Ten sessions, or forty.

Which one you are on depends on what is going on and what your GP assesses. Most people start on the first.

Most people

GP Mental Health Treatment Plan

10 rebated sessions per calendar year. Your GP writes the plan, reviews it along the way, and the count resets on 1 January.

Since 1 November 2025 the plan must be prepared by your MyMedicare-registered or usual GP practice for rebates to apply.

Eating disorders

Medicare Eating Disorder Plan

Up to 40 rebated psychological sessions in twelve months, plus up to 20 dietetic sessions. Reviewed by your GP at sessions 10, 20 and 30; the review at 20 also needs a psychiatrist or paediatrician.

Written by a GP, paediatrician or psychiatrist against set eligibility criteria. Accredited Mental Health Social Workers are eligible providers.

You can begin on a Mental Health Treatment Plan and move to an Eating Disorder Plan later if you become eligible. Starting one does not lock the other out.

What you actually pay.

A standard session is $200 for 55 minutes. Your first session is 60 minutes, same fee.

  • With a plan and referral: Medicare returns $89.50 — about $110.50 out of pocket. We claim it for you at the session, so there is nothing to lodge.
  • Without a plan: $200. You do not need a referral to be seen — the referral changes what Medicare pays, not whether you can start.
  • Aboriginal and Torres Strait Islander clients: bulk-billed with a valid referral. No out-of-pocket cost, and we will help you sort the referral. A standing commitment, not a limited offer.
  • Concession places: a limited number for people experiencing financial hardship — just ask.
  • Quick Chair (25 minutes): bulk-billed for eligible clients with a plan and current referral. Fully covered, nothing to pay.
  • Veterans and families: DVA-funded sessions billed directly to the Department of Veterans’ Affairs with a valid referral, at no cost to you.

The item numbers, if you or your GP want to check them:

  • 80160 — in the rooms, 50 minutes or more. Benefit $89.50.
  • 91176 — by video, 50 minutes or more. Benefit $89.50.
  • 82379 / 93103 — the eating disorder equivalents, in the rooms and by video. Benefit $89.50.
  • 91175 — by video, 20 to under 50 minutes. Benefit $63.40. This is the Quick Chair.

All four of the $89.50 items require a session of at least 50 minutes. That is a Medicare threshold, not a session length — ours run 55.

What to ask your GP for.

Booking a longer appointment helps — a mental health plan takes more than a standard consult. Then, in your own words or these:

“I’d like to talk about a Mental Health Treatment Plan. I’ve found an Accredited Mental Health Social Worker I’d like to see — Lauren Lynch at Body Belonging Clinic in Nedlands. She’s a Medicare provider under Better Access, and she also works by telehealth.”

If eating, food or body image is part of it, add:

“Could we also look at whether I’m eligible for an Eating Disorder Plan? She’s an ANZAED Credentialed Eating Disorder Clinician, so she can work under one — that’s up to 40 rebated sessions a year instead of 10, plus dietitian sessions.”

Two things worth knowing before you go. The plan has to come from your MyMedicare-registered or usual GP practice for the rebate to apply. And plenty of GPs have not been told that Accredited Mental Health Social Workers are eligible providers under both schemes — if it comes up, that is the sentence to say, and we are happy to send your GP the details directly.

Take this with you. A two-page PDF: page one is yours — what to ask for and what it costs. Page two is for your GP — the item numbers, both plan structures and the review points, so nothing rests on you remembering it.

What Medicare doesn’t cover.

Gender-affirming surgery letters

A private service — $450 for one 90-minute session, letter included. How the letter works →

ADHD and autism assessments

We don’t diagnose, and formal assessments carry no Medicare rebate anywhere. You do not need a diagnosis to start therapy. Start here instead →

Private health extras

Some funds recognise mental health social work under extras cover, as an alternative to a Medicare rebate rather than on top of it. Worth checking your level of cover.

The rest of it.

Do I need a referral before I book?

No. You can start as a private client with no referral and no diagnosis. The referral only changes what Medicare pays. If you want the rebate, we will help you sort the plan — plenty of people book the first session first.

Does the 10 reset every year?

Yes, on 1 January — it is a calendar year, not twelve months from when you started. If you began in November you do not lose the balance; the new year’s ten becomes available. Your referral may still be current, so check before assuming you need a new one.

Is the rebate different by telehealth?

No. $89.50 either way, as long as the session is 50 minutes or more.

Do I have to claim it myself?

No. We process the Medicare claim at the session, so the rebate goes back to your nominated bank account without you lodging anything.

What if I can’t afford the gap?

Say so. There are concession places and bulk-billed places, and Aboriginal and Torres Strait Islander clients are bulk-billed with a valid referral. Belonging shouldn’t depend on what you can pay.

Can I see you and a dietitian on the same plan?

Under an Eating Disorder Plan, yes — it carries up to 20 dietetic sessions alongside the 40 psychological ones. Under a Mental Health Treatment Plan, dietetics sits outside it.

Medicare figures on this page are current as at 3 September 2026 and are indexed each 1 July. This is general information about the Medicare schemes, not financial or medical advice — your GP assesses eligibility.