Medicare rebates for DBT groups
Group psychological therapy is handled differently to individual sessions under Medicare. Here is how it works in practice.
Group therapy is claimed separately
Medicare treats group psychological therapy as its own category, with its own item numbers, separate from individual Better Access sessions. Eligible participants may claim a set number of group therapy mental health services per calendar year, and those services do not consume your individual session allocation.
You need a referral
You do not need a referral to enquire about a program or to complete a suitability screening. You do need an eligible referral if you want to claim a Medicare rebate for the sessions.
That means an appointment with your GP to discuss an eligible referral for group psychological therapy. It is worth telling them which program you are joining.
The rebate depends on who delivers the session
This is the part that surprises people. The applicable item — and therefore the rebate — depends on the registration category of the psychologist delivering the session. A group led by a clinical psychologist attracts a different item to one led by a psychologist with general registration.
The practical consequence is that two DBT groups can have identical fees and different rebates. It is worth asking any provider which item applies to their program.
Claims are made after each session
Even where a program fee is paid upfront, Medicare claims can generally only be made once a session has been delivered and attended. Claims are therefore processed one session at a time across the program, and a rebate cannot be claimed for a session you did not attend.
The Medicare Safety Net
If you have reached, or are close to reaching, your Extended Medicare Safety Net threshold, you may be eligible for a higher Medicare benefit for eligible services for the remainder of the calendar year.
This is particularly worth checking for programs running late in the year, when eligible medical costs have had time to accumulate. The additional benefit depends on your individual Safety Net position, your eligibility, the item applicable to each session and any applicable benefit cap. The Safety Net resets each calendar year.
You can check your current position through Medicare or your myGov account.
What to ask before you enrol
- Which Medicare item applies to this program?
- What is the rebate per session, and across the full program?
- What referral do I need, and by when?
- How are claims processed — by the practice, or by me?
Our fee and rebate details for both programs are set out on the fees and Medicare section.