Should Counsellors Be on Medicare? Why I Say No
🎁 Get the complimentary episode guide 📆 Book a discovery call You've probably seen the debate online asking should counsellors be on Medicare, and because I'm a former psychologist who worked under the Medicare model in medical centres and community hubs, I have some strong opinions about counsellors and psychotherapists on Medicare and why I believe it would be a mistake. I start with how the Better Access initiative began in 2006 and what a mental health care plan requires, including a diagnosis from a GP, psychiatrist or paediatrician, up to 10 individual sessions per calendar year and a short list of approved interventions called focused psychological strategies that eligible providers are audited against. From there I compare that medical model with the way you already work as a private practice counsellor in Australia, where clients can refer themselves, nobody needs a diagnosis on their permanent medical record, and you're free to draw on person-centred, somatic, Gottman, Gestalt, systemic and integrative approaches for as long as the work needs. I also walk you through what happened to psychologists when the two-tier Medicare system arrived, how general psychologists lost referrals and status almost overnight, and why I think history is at risk of repeating for counselling and psychotherapy. You'll hear about the hidden side of holding a Medicare provider number too, from unpaid progress reports and the responsibility of checking that every GP referral is valid, to Medicare audits where the practitioner repays the rebates for every session seen on a non-compliant referral. If you've ever wondered what counselling issues Medicare does not cover, I go through them one by one, including couples and relationship counselling, grief and loss, family dynamics, life transitions, career and workplace stress, self-esteem and identity, and neurodivergence support without a co-occurring condition, which is a big part of the work so many of you do every day. My hope is that you finish this episode seeing the value in the work you're already doing and feeling informed enough to make your own decision about where you stand. If you'd like to see how I'm using AI to support private practice owners, come and join my community at https://www.skool.com/brooklyn/about, and you can find out more about working with me at https://brooklynstorme.com. Keywords used: should counsellors be on Medicare, counsellors and psychotherapists on Medicare, Better Access initiative, mental health care plan, focused psychological strategies, private practice counsellor in Australia, two-tier Medicare system, Medicare provider number, Medicare audits, what counselling issues Medicare does not cover Mini FAQ: Q: Can counsellors provide Medicare rebated sessions in Australia? A: No, counsellors and psychotherapists are not currently eligible providers under the Better Access initiative, which is limited to professions such as clinical and registered psychologists, accredited mental health social workers and endorsed occupational therapists. Q: How many sessions does a mental health care plan cover? A: A mental health care plan gives a client up to 10 individual sessions per calendar year, usually split into an initial six sessions and a further four once the referring doctor has received a review report. Q: What therapies can be used under a mental health care plan? A: Practitioners are restricted to focused psychological strategies such as CBT, interpersonal therapy, psychoeducation, relaxation strategies and skills training, with narrative therapy available only for Aboriginal and Torres Strait Islander clients, so somatic, Gestalt and Gottman work sit outside what Medicare allows. Q: Does Medicare cover couples counselling or grief counselling? A: No, because Medicare only rebates treatment for an individual with a diagnosed mental health condition, so couples counselling, normal grief and loss, life transitions and career stress do not qualify for a mental health care plan. Q: What happens if a Medicare audit finds a problem with a referral? A: The practitioner is held responsible, even when the error was in the GP's referral, and has to repay the rebates for every session seen on that referral, which can add up to thousands of dollars across an audit.
