Medicare Rebates

  • Why are there two different rebates for psychologists under Medicare?

    When Better Access was introduced 10 years ago the Government initially proposed to rebate only services delivered by clinical psychologists. The APS lobbied the Government to include all psychologists. In response, the Government included services delivered by all registered psychologists in a tier with a lower rebate. This is consistent with the tiered structure of the MBS system that was developed for medical practitioners (specialists and general practitioners). For further information please see Ten years of Better Access

  • What impact does the tiered system have on the overall Medicare funding allocated to psychologists?

    There is no fixed allocation of funds by Medicare to psychologists. Medicare provides rebates to eligible clients. The cost varies each year contingent on a range of factors such as the number of individuals accessing services, the availability of psychologists and the number of sessions that clients access.

  • Is the two-tier structure equitable?

    Better Access has increased accessibility to psychological services for the community; however the APS is aware of the equity issues raised across the profession. In February 2017, the APS College, State and Branch Chairs attended discussion groups to generate potential alternatives to the current Medicare structure. Each group proposed a number of possible alternatives. The APS has distributed a survey for members to understand individual’s views on the issue and to maintain its commitment to securing fair access for psychology services provided under Medicare.

  • Why are practitioners with decades of experience receiving a lower rebate?

    The differences in Medicare rebates were established by the Government based on recognition of both training and experience, that is, formal postgraduate training and supervised experience as the means of gaining specialist knowledge and skills. The APS has always argued for competency-based rebates. For example, in 2010-13 the APS was successful in developing bridging programs that led to additional psychologists being recognised as eligible for the higher rebate. 

  • Should new graduates receive a higher rebate than experienced psychologists?

    The APS does not recommend that new graduates enter into private practice arrangements as they are relatively inexperienced. Psychology graduates are not eligible for the higher Medicare rebate as a period of supervised practice after postgraduate training is required to confer Medicare eligibility for the higher rebate.

  • How is the APS responding to inequity in the Medicare funding structure?

    The APS has continually argued for including more psychologists in the higher tier. It is also working on developing bridging programs to enable psychologists in the lower tier to reach area of practice endorsement (AoPE) in clinical psychology and hence get into the higher tier.

  • What rebate structures have been proposed by or to the Government in the past?

    The Federal Government initially planned to rebate only clinical psychology services under Medicare but the APS successfully lobbied for the inclusion of other psychological services. The Government chose to do this through a lower tier of rebate.

    As a part of the 2015 Mental Health Reforms, the National Mental Health Commission recommended retaining clinical psychology services under Medicare’s Better Access program, and reallocating all other psychological services to Primary Health Networks. The APS was successful in lobbying to retain all psychologists as service providers under Better Access. 

  • With government cost cutting what is the APS doing to protect Better Access?

    The APS’ priority in recent years when the government has been cutting funding has been to protect Medicare’s Better Access program from funding cuts and to ensure psychology services continue to be funded through Medicare rather than moving to Primary Health Networks, where local funding buckets are capped. In 2016, the Government was clear that there would be reforms in health and mental health. The APS is therefore focussed on protecting access for consumers, and opportunities for reform within the current funding constraints. 

  • Is Medicare affecting training pathways for psychologists?

    Yes it is - there has been an increase in the number of clinical courses and a reduction in other specialty courses during this period. The APS is very concerned about this and has expressed this to the Heads of Departments and Schools of Psychology Australia (HoDSPA) on many occasions.

MBS Review

  • Will there be changes to the two-tier structure as a part of the MBS Review?

    The MBS Review Taskforce has stated that the purpose of the review is to align MBS items with best practice and that the Review is not being conducted as a cost saving measure. APS members are encouraged to review the MBS website to remain up to date with the most recent information regarding the MBS Review.

  • What other issues is the APS raising during the MBS item review?

    The APS opposes the annual session limits imposed on consumers referred under the Chronic Disease Management (CDM) plans and also the session limits in Better Access.

The APS Board

  • What steps have taken place to ensure that the APS Board represents the diversity of the profession?

    In 2015 the APS Board recommended that a major Governance Review of the structure, composition and processes of the Board be conducted. This has been done and the revised structure will be put to the membership soon. The new structure would help ensure that the Governance of the Society supports the APS to achieve its aims. For further information please see Governance Review- Better reflecting our diverse membership

  • What issues and topics are discussed at APS Board meetings?

    The Board provides updates on key issues discussed after each Board meeting within the context of the Strategic Objectives contained in the APS Strategic Plan. Read the updates here