EXPLAINER: Valid referrals for psychology sessions

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Compliance with Better Access referrals: what GP’s and clients need to know.

Here is an explainer on how we can support each other to ensure that the paperwork required for client rebates is correct and in place.

When you see your GP for a mental health care treatment plan (MHCTP or sometimes just MHCP) they need to provide two things:

  1. The MHCP
  2. A referral letter

While the MHCP itself allows Medicare to start providing you with rebates, it’s the referral letter that is most important to me – as without a compliant one I will not be able to process your rebate.

If I am audited and do not have a compliant referral letter I am legally liable to pay back every rebate of $88.25 that has been paid to you!  As you can imagine I am not willing to take that risk, therefore this blog explains the GP’s responsibility when preparing a MHCP.

Features of a compliant referral as per official ServicesAustralia.gov.au information:

  • Client name
  • Client DOB
  • Presenting issue and diagnosis
  • Number of sessions being prescribed (up to 6 initial sessions, subsequent 4 sessions or 10 additional covid-19 sessions – it cannot say 20, even that the is the total number available at present per calendar year until June 30, 2022).
  • GP name and provider number.

If I receive incomplete paperwork (often the referral letter will not include the number of sessions) I will email the GP to request it (if the practice is email is available – I can’t call, it’s too time-consuming and I often do this admin outside of business hours), outlining what is required/missing.  I may request clients to help me with this as often medical centres will not talk to me without permission and I am not paid to chase this up!

Until I receive a compliant referral letter you are not able to receive a Medicare rebate for the service.

The referral letter must be dated prior to your first appointment for that session to be rebated. So, if your GP did not prepare a letter and you go back to get one and they date it after your session, you cannot use it for that initial session. Please discuss this with your GP.

The Information for GP’s on this can be found here.

If you have a referral letter in another psychologist’s name, I can use it as long as it states that it is for psychology sessions under the Better Access to Mental Health Initiative.

For more information on MHCP’s for consumers/patients/clients read this

Apologies for the long post about bureaucracy, but I do not make the rules and do my best to support making your claiming as easy as possible by doing it for you through Halaxy.