National Disability Insurance Scheme (NDIS)

 

Clients who have NDIS funding that is self-managed or plan-managed, may be able to use their funding to cover/partially cover the fees for a psychological assessment. Check with your support coordinator or plan manager about using your NDIS funds for a psychological assessment. 

 

The funding category that can be used to claim psychology services is 'Capacity Building – Improved Daily Living'.  For a child under 7 years of age: Item Number: 15_001_0118_1_3 and Item Name: Early Childhood Intervention Supports – Psychologist. For a child over 7 years of age: Item Number: 15_054_0128_1_3 and Item Name: Assessment, Recommendation, Therapy, or Training – Psychologist.

 

Medicare

 

Medicare Rebates for psychological sessions for the purpose of assessment, diagnosis and creation of a treatment and management plan, can be claimed through the following programs:

 

Helping Children with Autism Program

This program is for a child under 13 years of age. A referral letter from a paediatrician or psychiatrist is required which specifically requests an assessment of autism spectrum disorder under the Helping Children with Autism Program. Medicare rebates can be provided for up to 4 assessment sessions. For more information, click here.

 

Better Start for Children with Disability Initiative

This initiative is for a child under 13 years of age. A referral letter from a GP, specialist, or consultant physician is required which specifically requests the type of assessment required under the Better Start for Children with Disability Initiative. Medicare rebates can be provided for up to 4 assessment sessions. For more information, click here.

 

Complex Neurodevelopmental Disorder and Eligible Disabilities Scheme

This scheme is for individuals under 25 years of age. A referral letter from a paediatrician or psychiatrist is required which specifically requests an assessment of a complex neurodevelopmental disorder under the Complex Neurodevelopmental Disorder and Eligible Disabilities Scheme. Medicare rebates can be provided for up to 8 assessment sessions. For more information, click here.

 

The Medicare item code for ‘psychologist assessment and diagnosis’ is 82000.

 

The current Medicare rebate per single session is $96.65 (as at 1 July 2024).

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GP Mental Health Care Plan

 

A GP Mental Health Care Plan does not cover the cost for psychological assessments. This plan is designed to cover counselling / therapy for mental health issues such as anxiety, depression, and sleep problems.

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Private Health Insurance

 

Some private health funds provide rebates for psychological assessments under extras cover. Please check with your private health provider to confirm your eligibility for rebates. 

 

Clients must determine whether they are going to claim the assessment fee through Medicare or Private Health Insurance. You are unable to use Medicare and Private Health Insurance for the same consultation.

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