fees & medicare rebates

 

The ASD Clinic Fee Schedules

The fees charged by The ASD Clinic vary depending on the nature of the psychological services provided - assessment, counselling, report writing, and on which Psychologist provides the service.  A current list of The ASD Clinic fees and services can be downloaded here.

The ASD Clinic will receipt all fees paid using the correct format to enable clients to claim any rebate entitlements.  Some Private Health fund plans provide rebates for psychological services - you should check with your own health fund for their terms and conditions.  Medicare rebates may also available - there are specific eligibility requirements which are outlined below along with some weblinks to more detailed information.  Clients eligible for Private Health fund and Medicare rebates will not be able to claim from both sources for the same fee, ie you cannot top up your Medicare rebate with a Private Health fund rebate.

Medicare rebates for Psychology services

In recent times several Medicare Benefit Schedule (MBS) items have been introduced for certain psychological services, with quite detailed eligibility requirements. Here is an overview of these, with web links to more detailed information.

From 1st November 2006, some Psychological Therapy items became eligible provided they were part of a GP Mental Health Care Plan or a Psychiatric Assessment and Management Plan.

UPDATE - from 1st November 2011 changes to the funding of the Better Access to Mental Health Care program mean there will be a cut in the number of Medicare rebatable sessions with a psychologist. The attached flier outlines these changes. More detailed information about this program is available from the Australian Psychological Society website here.

FURTHER UPDATE - on the 1st February 2012 the government announced that clients deemed by their GP to have 'exceptional circumstances' can continue to access an additonal six Medicare rebatable individual sessions with a psychologist (= a total of 16 sessions for 2012). This is a transitional arrangement and from November 2012 all Better Access clients will be eligible for a total of 10 Medicare rebatable sessions only. You can find out more about this on the attached fact sheet.

To qualify for the rebate for these psychological services the client must have first been seen by a General Practitioner, Psychiatrist or Paediatrician and a written referral obtained. This referral must be given to the Psychologist at the first consultation. We would appreciate that this paperwork is forwarded by post or fax (03 9857 0975) prior to your first consultation to assist with the administration of your billing.  It is also important that the eligible service (see the items above) have been provided and a Medicare claim made by the client prior to consulting the Psychologist.  The rebate for a one hour session with a Clinical Psychologist is $122.15 and a Generalist Psychologist is $83.25.

PLEASE NOTE: This type of referral does not cover the assessment or specific counselling of Autism or Asperger's Syndrome (as they are not defined as mental health disorders), but it does cover frequently observed mental health disorders in our clients such as Anxiety and Depression.

If you would like more detailed information about these Medicare services the Australian Psychological Society has prepared a useful client information sheet - click here to go to their website where you can download an up to date version.

There is also useful information about the Medicare Safety Net on the Medicare website.

Medicare rebates for Autism and Asperger's Syndrome

From 1st July 2008, as part of the Federal Government's Helping Children with Autism package, a number of new Medicare Benefit Schedule (MBS) items were introduced specifically for children with Autism or any other Pervasive Developmental Disorder such as Asperger's Syndrome.  Psychology, Speech Pathology and Occupational Therapy services are eligible for a Medicare rebate if they are provided as part of Diagnosis and/or PDD Treatment plan established only by a consultant Psychiatrist or Paediatrician.

For Diagnosis - the child must be under 13 years old and have been referred by a Paediatrician who has provided any MBS service covering items 110 through to 131, or a Psychiatrist who has provided any MBS service covering items 296 through to 370 (except item 359).  The Psychology, Speech or Occupational Therapy services are to be provided as part of the assessment process, and/or for the development of a Treatment Plan - it is limited to a total of four services per child provided by any combination of these therapists.  The rebate for one session with a Psychologist is $81.60.

PDD Treatment Plan - the child must be under 15 years old and have been referred following preparation of a PDD Treatment Plan prior to their 13th birthday.  This plan can be prepared by a Paediatrician (MBS item 135) or a Psychiatrist (MBS item 289).  A total of 20 services will be eligible for the Medicare rebate - any combination of Psychology, Speech or Occupational Therapy.  The rebate for one session with a Psychologist is $81.60.

We would appreciate that this paperwork is forwarded by post or fax (03 9857 0975) prior to your first consultation to assist with the administration of your billing.

Please Note: Unfortunately some of our clients have attended a session at our clinic for either counselling or an assessment under the impression that their referral from either a Paediatrician or Psychiatrist was valid for this Medicare service.  When you visit your Health Professional please be very clear what you are seeking (see above) and ask them to write a referral letter stating exactly what type of Psychological service is required and to quote the item number so that we are able to bill you accordingly.

If you would like more information about these Medicare services Autism Victoria has prepared a useful client information sheet - click here to be taken to their website.