What is this Medicare item?

This psychology service (Medicare Item 81000) offers pregnancy support counselling to assist females who have any personal concerns related to a current or recent pregnancy within the past 12 months, whether it has been full-term or part-term (including a planned termination). The pregnancy support counselling Medicare Item covers up to three 30 minute+ sessions with a psychologist per pregnancy.

What is pregnancy support counselling?

Pregnancy support counselling offered by psychologists is supportive, non-judgmental, confidential and unbiased.

Psychologists using this Medicare item are trained to support a female through pregnancy-related issues, and to provide information about the options and services relevant to her pregnancy concerns.

Psychologists who provide pregnancy support counselling are specifically trained in:

  • Non-directive counselling skills
  • Pregnancy-related counselling issues
  • Pregnancy-related information resources

Am I eligible to receive pregnancy support counselling?

Pregnancy support counselling through the Medicare scheme is available for females with a current or recent pregnancy (within the last 12 months) who have any concerns, such as decisions about the future, adjustment following the pregnancy, or general issues related to a pregnancy. Partners can also attend the counselling session, if appropriate.

How do I organise to receive pregnancy support counselling?

A referral to this service results from a GP assessing that a female has concerns that would benefit from sessions with a psychologist who is eligible to provide pregnancy support counselling services. The referral may consist of a letter or note to the psychologist. Please note that GPs are not required to use a specific form or plan. To find a psychologist in your area who is eligible to provide pregnancy support counselling, click on the following link: How can I find a pregnancy support counselling psychologist?

When is pregnancy support counselling helpful?

Females find pregnancy support counselling helpful for a number of pregnancy-related issues, such as:

  • Making decisions and exploring possible options about her pregnancy
  • Coming to terms with unexpected outcomes (e.g., stillbirth, miscarriage, genetic conditions, problems at birth, cot death)
  • Dealing with a variety of feelings related to her pregnancy, birth or early months of being a parent
  • Discussing her pregnancy with others (e.g., partner, children, parents, religious or cultural groups)

What is the difference between the pregnancy support counselling item and mental health Medicare items?

There are important differences between pregnancy support counselling and mental health psychological services under Medicare.

  • The pregnancy support counselling referral is not specifically for a mental health disorder, but can be for parenting, health or relationship concerns.
  • The pregnancy support counselling rebate only covers 3 sessions, although you may continue working with the psychologist as a private patient, or be referred again under another appropriate initiative.

Specifically, females who use the pregnancy counseling services can also receive a rebate for psychological services under Medicare for mental health disorders or chronic diseases, following a GP referral and care plan.

Pregnancy support counselling may also help a female identify issues for which she may need help from professionals other than a psychologist. For example, it might be identified that the female needs to see medical, social services, legal or financial professionals to address concerns about pregnancy care, living arrangements, leaving/returning to work, childcare arrangements, or finances. The psychologist may help you develop strategies or identify services to access relevant supports.

Find a pregnancy support counselling psychologist

The Australian Psychological Society has three options for finding a psychologist who can provide pregnancy support counselling services.

  1. Psychologist Medicare provider register

  2. APS Find a Psychologist Service at: www.findapsychologist.org.au
    (N.B. You need to tick the Pregnancy Support Counselling option)

  3. Phone the APS Find a Psychologist Service on: 1800 333 497 (Freecall)

Can I access any/all psychologists?

Under Medicare, to receive pregnancy support counselling, you must be referred by your GP to a registered psychologist who has a Medicare Provider Number and who has completed training in pregnancy support counseling.

What is a Medicare Provider Number?

Medicare is Australia's universal public healthcare system. Medicare Provider Numbers are issued by Medicare Australia to practitioners who are able to provide services for which a Medicare rebate can be claimed.

What is a registered psychologist?

All psychologists are legally required to register with the Psychologist Registration Board in their State or Territory, in the same way medical practitioners must be registered. This means that they must be competent and follow a strict Code of Conduct.

Not all counsellors or therapists are registered psychologists. Seeing someone who is registered ensures you receive high quality ethical treatment.

If I am already seeing a psychologist, can I access Medicare benefits?

In order to receive this Medicare rebate, you must be referred by your GP to a registered psychologist who has a Medicare Provider Number. If you are already seeing a psychologist, discuss this with your doctor.

What will I have to pay for psychology services?

The cost to you, above the rebate available from Medicare, will vary depending on the fee being charged by the psychologist. If the psychologist decides to bulk bill you will not have to pay anything. However if the psychologist does not use the bulk billing method then you would pay the difference between what the psychologist charges you (which may be the Government-determined schedule fee or a fee set by the psychologist) and the Medicare rebate. This will vary and you must check this out with the psychologist before commencing your treatment.

Does the Medicare Safety Net apply to my out-of-pocket expenses under this initiative?

Yes. You are responsible for paying any charges in excess of the Medicare rebate for items under this initiative. However, these out-of-pocket expenses will count towards both the original and the extended Medicare Safety Nets. Once you or your family reach the relevant threshold in the calendar year, Medicare benefits will increase to 100 per cent of the Government-determined schedule fee under the original Safety Net, and 80 per cent of your total out-of-pocket expenses for out-of-hospital services under the extended Medicare Safety Net. The Medicare Safety Nets are designed to protect high users of health services from large out-of-pocket expenses.

What about my private health insurance?

You cannot use your private health insurance ancillary cover to top up the Medicare rebates for these services.

You need to decide if you will use Medicare or your private health insurance ancillary cover to pay for psychological services you receive. That is, you can either access rebates from Medicare by following the claiming process or claim where available on your insurer's ancillary benefits.