Rosebery Healthcare, Rosebery, NSW
Myhealth Rockdale, Rockdale, NSW
EDUCATION
This Education page is designed for psychologists new to private practice. It contains information about professional matters and relevant topics.
This page may also include my own reflections on what I have learnt in my practice. Such reflections are my own views based on my experience and should not be taken as definitive for psychologists in every situation. They are designed to be thought-provoking and interesting.
Included at the end of this page are some pictorial clues to a happy life that are characteristic of my approach to therapy. I invite you to browse through them.
Information on this page is current as at 14 August 2022. Copyright Jan Roberts 2022.
PROFESSIONAL PRACTICE INFORMATION
Medicare Mental Health Care Plans:
The treating doctor will assess the patient to determine if that patient needs a Medicare Mental Health Care Plan. The doctor needs to be assured that the client has a definite mental health problem that will benefit from sessions with a psychologist. The doctor may ask the patient to complete a paper-based test to assess the patient's mental state. When the doctor has confirmed the need for psychological treatment, he or she will write out a Mental Health Care Plan for the patient's records with a copy to take to the psychologist.
All plans and renewals of plans need to be approved by Medicare before Medicare will pay for the client's sessions. The way that happens is that the doctor's clinic submits the bill to Medicare for the consultation where the doctor has written out a plan or renewed a plan. The doctor uses a billing code to indicate he or she has written a mental health care plan or renewed a mental health care plan for the patient. When Medicare processes the bill for the doctor, that is when the plan or renewal of a plan takes effect and the psychologist's clinic can charge for sessions under that plan. Medicare approval can take between 5 and 10 working days using electronic billing.
Medicare will pay for a specified number of sessions to a psychologist in a calendar year (January to December). Any unused sessions lapse at the end of the year and the specified number of new sessions begin on 1 January of the new year. This is a permanent entitlement. The government changes the total number of sessions occasionally. Currently (mid 2022) Medicare pays for a maximum of 10 sessions per year. If clients have private health insurance and extras cover, they may be able to pay for extra sessions and claim back from their fund. Usually sessions are bunched up at the start at a rate of about one visit per fortnight, and stretch out as people make progress.
Psychology sessions come in groups of 6. At the end of 6 psychology sessions, a doctor approves another set of 6 sessions. Whether those sessions take place in one clinic or in multiple clinics, after a total of 6 sessions a doctor's approval is needed for further sessions. The groups of 6 sessions do not include sessions paid through the client's health fund or other source. Mental health care plans must be renewed by a doctor at the end of a year's duration. Renewals do not need to be done immediately upon the renewal date but must be done before the client attends further sessions.
If the client needs to find out how many sessions they have left before they are due for a 6-visit renewal or whether their plan is due for renewal, they can enquire directly through Medicare. Alternatively, the clinic staff can consult the client records and let them know.
Under Medicare Mental Health Care Plans, the psychologist is required to write back to the referring doctor after the client's first visit to confirm that the client has attended. The letter also contains a brief description of the client's background and identifies issues to be addressed, such as depression or post-traumatic stress disorder. The letter should be short and concise, ideally one page maximum as a general rule. If there are special issues to describe that the doctor needs to be aware of or the doctor has specifically flagged with the psychologist, then the letter can be up to 2 pages, but preferably no more. The psychologist should retain a copy of the doctor's letters for their records.
All plans and renewals of plans need to be approved by Medicare before Medicare will pay for the client's sessions. The way that happens is that the doctor's clinic submits the bill to Medicare for the consultation where the doctor has written out a plan or renewed a plan. The doctor uses a billing code to indicate he or she has written a mental health care plan or renewed a mental health care plan for the patient. When Medicare processes the bill for the doctor, that is when the plan or renewal of a plan takes effect and the psychologist's clinic can charge for sessions under that plan. Medicare approval can take between 5 and 10 working days using electronic billing.
Medicare will pay for a specified number of sessions to a psychologist in a calendar year (January to December). Any unused sessions lapse at the end of the year and the specified number of new sessions begin on 1 January of the new year. This is a permanent entitlement. The government changes the total number of sessions occasionally. Currently (mid 2022) Medicare pays for a maximum of 10 sessions per year. If clients have private health insurance and extras cover, they may be able to pay for extra sessions and claim back from their fund. Usually sessions are bunched up at the start at a rate of about one visit per fortnight, and stretch out as people make progress.
Psychology sessions come in groups of 6. At the end of 6 psychology sessions, a doctor approves another set of 6 sessions. Whether those sessions take place in one clinic or in multiple clinics, after a total of 6 sessions a doctor's approval is needed for further sessions. The groups of 6 sessions do not include sessions paid through the client's health fund or other source. Mental health care plans must be renewed by a doctor at the end of a year's duration. Renewals do not need to be done immediately upon the renewal date but must be done before the client attends further sessions.
If the client needs to find out how many sessions they have left before they are due for a 6-visit renewal or whether their plan is due for renewal, they can enquire directly through Medicare. Alternatively, the clinic staff can consult the client records and let them know.
Under Medicare Mental Health Care Plans, the psychologist is required to write back to the referring doctor after the client's first visit to confirm that the client has attended. The letter also contains a brief description of the client's background and identifies issues to be addressed, such as depression or post-traumatic stress disorder. The letter should be short and concise, ideally one page maximum as a general rule. If there are special issues to describe that the doctor needs to be aware of or the doctor has specifically flagged with the psychologist, then the letter can be up to 2 pages, but preferably no more. The psychologist should retain a copy of the doctor's letters for their records.
Movement of clients between psychologists:
As part of issuing a Mental Health Care Plan, a GP will write a referral letter nominating a particular psychologist for their patient. However, if individuals with a Mental Health Care Plan want to attend a different psychologist or change psychologists, they must obtain a referral letter addressed to that other psychologist. The Mental Health Care Plan remains the same, but the referral letter must be re-issued. Psychologists may refer a client back to the doctor to obtain a referral letter to another psychologist if they believe the client will benefit, such as referring a male client to a male psychologist if the client would feel more comfortable discussing specific issues with a male psychologist.
Medicare conducts audits to ensure that Medicare Mental Health Care Plans and referral letters are in place for all of the psychologist's clients. Where clients move between psychologists, a copy of the client's original mental health care plan, along with the referral letter, must be sent to the new psychologist or their clinic because of potential Medicare audits.
Mental Health Care Plans can transfer to any State of Australia. If the client moves interstate, a copy of the original plan is sent to their new psychologist or clinic and then the client can commence sessions in the new location.
Medicare is fine with clients moving between psychologists and clinics as long as (i) an original plan has been approved, (ii) any necessary renewals have been done, (iii) a copy of the client's Mental Health Care Plan is provided to the new psychologist, and (iv) a referral letter is provided addressed to the new psychologist.
Mental Health Care Plans can transfer to any State of Australia. If the client moves interstate, a copy of the original plan is sent to their new psychologist or clinic and then the client can commence sessions in the new location.
Medicare is fine with clients moving between psychologists and clinics as long as (i) an original plan has been approved, (ii) any necessary renewals have been done, (iii) a copy of the client's Mental Health Care Plan is provided to the new psychologist, and (iv) a referral letter is provided addressed to the new psychologist.
Billing under Medicare:
Some psychologists bulk bill, i.e. they charge only the Medicare rebate amount and the client is not required to pay anything. Some psychologists do not bulk and the client is required to pay the whole cost of the session, which will be higher than the rebate, and then claim the rebate amount back from Medicare. It is up to the client to enquire if there is a gap charge before attending any psychologist.
There is often a charge where appointments are missed without notice. This charge is not subject to a Medicare rebate. Any letters or forms that the client requests the psychologist to complete are chargeable and not subject to a Medicare rebate.
There is often a charge where appointments are missed without notice. This charge is not subject to a Medicare rebate. Any letters or forms that the client requests the psychologist to complete are chargeable and not subject to a Medicare rebate.
Counselling not covered by Mental Health Care Plans:
Mental Health Care Plans do not cover relationship counselling, life coaching, career counselling and stop-smoking counselling. Stop-smoking counselling may be covered under Medicare Health Care Plans that apply to long-term physical health conditions. For relationship counselling, see Relationships Australia website: https://www.relationships.org.au.
Psychiatric conditions:
Occasionally, a psychologist may encounter a client who presents with a psychiatric condition, such as schizophrenia or bipolar disorder. It may be that the illness is in the initial stage or that the client has had it over time but has not revealed their symptoms to a doctor. If the psychologist suspects the client may have a psychiatric condition, then the psychologist refers the client back to the referring doctor, requesting a psychiatric review by the doctor and/or for referral to a psychiatrist for assessment.
Remember to be respectful about making any review requests. The doctor is primarily responsible for the patient's treatment. The doctor will usually consider the psychologist's advice but it is up to the doctor whether to act on that advice or not.
Remember to be respectful about making any review requests. The doctor is primarily responsible for the patient's treatment. The doctor will usually consider the psychologist's advice but it is up to the doctor whether to act on that advice or not.
Insurance:
Psychologists need to have current Professional Indemnity Insurance. Included in this insurance is coverage for (i) malpractice claims and (ii) public liability. Costs of coverage vary widely. Compare insurers online to obtain the most appropriate coverage for your psychology practice. I have found Insurance House (IH Group) to be reliably good value.
GST:
Practising psychologists must have an Australian Business Number (ABN). In order to claim back GST paid on business expenses, psychologists must register for GST. Registration for ABN and GST is done through the Australian Taxation Office. See the ATO website: www.ato.gov.au. A quarterly GST return is completed by the psychologist. This can be done by a paper return or online. Keep all documentation together with a copy of each quarterly GST return. Psychological services provided by the psychologist are GST-free. Services such as writing letters and completing forms attract GST.
Claiming GST: The psychologist pays GST on the services fees charged by their clinic. The psychologist will also pay GST on office furniture, computer equipment, books, stationery, postage, business cards, professional memberships, etc, used by the psychologist in their work. All the GST paid by the psychologist on these expenses will be listed on tax invoices or receipts and is claimed back through the quarterly GST return.
Charging GST: The psychologist charges GST on any letters, forms, reports, etc, that the client may request. A tax invoice should be provided to the client including the psychologist's GST number. The GST charged to the client is paid to the ATO through the psychologist's quarterly GST return.
Claiming GST: The psychologist pays GST on the services fees charged by their clinic. The psychologist will also pay GST on office furniture, computer equipment, books, stationery, postage, business cards, professional memberships, etc, used by the psychologist in their work. All the GST paid by the psychologist on these expenses will be listed on tax invoices or receipts and is claimed back through the quarterly GST return.
Charging GST: The psychologist charges GST on any letters, forms, reports, etc, that the client may request. A tax invoice should be provided to the client including the psychologist's GST number. The GST charged to the client is paid to the ATO through the psychologist's quarterly GST return.
Confidentiality:
All discussions with a psychologist are confidential. The psychologist does not report back to Medicare or anyone else, apart from writing letters to the referring doctor as required by Medicare. What a client says to a psychologist stays between them.
Children are aware of confidentiality and need to trust the psychologist not to report everything they say to the parent. As a general rule, psychologists may discuss a young child's issues with the custodial parent but should respect confidentiality with older children. In my practice, I use about 9 years old as the cut-off point. With older children, I discuss the child's issues with the parent only if the child asks me to discuss something with the parent.
There are some exceptions to confidentiality. In cases where clients of any age reveal to the psychologist that they have a plan to kill themselves or another person, and the psychologist believes they are serious, then the psychologist is required to report that the client may be a danger to themselves or another person. Any instance of ongoing child abuse must be reported to the relevant authority. In either instance, the psychologist needs to document both their involvement and the outcome should there be any subsequent investigations.
Children are aware of confidentiality and need to trust the psychologist not to report everything they say to the parent. As a general rule, psychologists may discuss a young child's issues with the custodial parent but should respect confidentiality with older children. In my practice, I use about 9 years old as the cut-off point. With older children, I discuss the child's issues with the parent only if the child asks me to discuss something with the parent.
There are some exceptions to confidentiality. In cases where clients of any age reveal to the psychologist that they have a plan to kill themselves or another person, and the psychologist believes they are serious, then the psychologist is required to report that the client may be a danger to themselves or another person. Any instance of ongoing child abuse must be reported to the relevant authority. In either instance, the psychologist needs to document both their involvement and the outcome should there be any subsequent investigations.
Court letters:
On occasion, the psychologist may be asked to provide a letter to the court in relation to a client. These letters should be concise and contain no psychological jargon. They should address the client's mental state and motivations for their behaviours only. They should not comment on the events leading up to the matter before the court as those are matters of fact of which the psychologist does not have direct knowledge.
In any court letters, where a definition of the client's condition may be helpful, quote the relevant section from the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) compiled by the World Health Organization. The ICD-10 can be obtained free from the internet.
See website: https://www.cdc.gov/nchs/icd/icd10.htm
It is courteous practice when writing court letters to use "Yours respectfully" in the signature.
In any court letters, where a definition of the client's condition may be helpful, quote the relevant section from the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) compiled by the World Health Organization. The ICD-10 can be obtained free from the internet.
See website: https://www.cdc.gov/nchs/icd/icd10.htm
It is courteous practice when writing court letters to use "Yours respectfully" in the signature.
Business cards:
Obtain business cards for your practice. Make sure the print is large enough for people whose sight is not as good as others! Include your name, address and relevant contact details.
Suggested websites for business cards:
Other psychology referrals:
Psychologists may receive clients through the federal Department of Veterans Affairs (DVA) for treatment for depression. These sessions are billed direct to DVA. Referrals may also come through Services NSW (formerly Road Traffic Authority) in the case of motor vehicle accidents. These sessions are billed direct to Services NSW.
Work and Development Orders:
Revenue NSW provides a program, Work and Development Orders (WDO), under which people with State court fines or traffic fines can eliminate their debt by working for a charity or developing themselves by attending an approved course or engaging in counselling with a registered counselling provider. Some ther States have similar programs. Sponsors record the person's attendance on the WDO website. In NSW, if attending counselling, the WDO participant reduces their debt by $1,000 per month. If the person attends monthly, their State debt will eventually be eliminated. If they fail to attend, their WDO is cancelled.
Psychologists who register to provide counselling are known as "Sponsors". They are listed on the Revenue NSW webpage list of sponsors. Registered psychologists receive referrals either through individuals who find their contact details on the Revenue NSW website or through organisations such as Legal Aid or Lifeline. If the person obtains a Mental Health Care Plan from their doctor, that person will be entitled to the Medicare rebate for their counselling sessions. Under the WDO program, the psychologist is paid for the counselling session, but is required to do some extra online recording of WDOs and client attendances. Sponsors do this extra work without pay to help people who have State debts.
Through this program, I have found multiple WDO clients with undiagnosed Attention Deficit Disorder. Their condition has contributed to the cause of their fines in the first place. I referred them back to their GP for review and referral to a psychiatrist for assessment and medication. They have been able to obtain appropriate treatment for their condition, changing their lives for the better, including reducing the likelihood of further fines. Other WDO clients have benefitted from counselling because they have family traumas, such as a sibling with cancer or a daughter addicted to drugs. WDO clients may never have otherwise considered counselling, but have found huge benefits from their sessions apart from the reductions in their fines. Some clients find their sessions so helpful they continue to attend even when their State debt has been eliminated.
In NSW, to register as a sponsor for WDO, see the Revenue NSW website for instructions. In other States, see the equivalent department website.
Psychologists who register to provide counselling are known as "Sponsors". They are listed on the Revenue NSW webpage list of sponsors. Registered psychologists receive referrals either through individuals who find their contact details on the Revenue NSW website or through organisations such as Legal Aid or Lifeline. If the person obtains a Mental Health Care Plan from their doctor, that person will be entitled to the Medicare rebate for their counselling sessions. Under the WDO program, the psychologist is paid for the counselling session, but is required to do some extra online recording of WDOs and client attendances. Sponsors do this extra work without pay to help people who have State debts.
Through this program, I have found multiple WDO clients with undiagnosed Attention Deficit Disorder. Their condition has contributed to the cause of their fines in the first place. I referred them back to their GP for review and referral to a psychiatrist for assessment and medication. They have been able to obtain appropriate treatment for their condition, changing their lives for the better, including reducing the likelihood of further fines. Other WDO clients have benefitted from counselling because they have family traumas, such as a sibling with cancer or a daughter addicted to drugs. WDO clients may never have otherwise considered counselling, but have found huge benefits from their sessions apart from the reductions in their fines. Some clients find their sessions so helpful they continue to attend even when their State debt has been eliminated.
In NSW, to register as a sponsor for WDO, see the Revenue NSW website for instructions. In other States, see the equivalent department website.
Workcover:
Psychologists may register with Workcover. Only psychologists who have completed the Workcover course (paid for by the psychologist) can take Workcover clients. The client must have an approved Workcover claim, with a claim number, before psychology services are provided.
Psychologists working with Workcover are permitted to talk with the client only about the accident/incident and its immediate aftermath. Sessions are not designed to cover further-ranging issues such as the client considering going to university or TAFE to retrain, the impact the accident/incident has had on the client's family, any other issues from the past that may have been brought up, etc.
Workcover require lengthy reports. They will audit a psychologist if they think too many sessions have been provided. They require occasional conferences between the doctor, the psychologist, the client and Workcover representatives where they focus on their return-to-work priority. I do not accept Workcover clients.
Psychologists working with Workcover are permitted to talk with the client only about the accident/incident and its immediate aftermath. Sessions are not designed to cover further-ranging issues such as the client considering going to university or TAFE to retrain, the impact the accident/incident has had on the client's family, any other issues from the past that may have been brought up, etc.
Workcover require lengthy reports. They will audit a psychologist if they think too many sessions have been provided. They require occasional conferences between the doctor, the psychologist, the client and Workcover representatives where they focus on their return-to-work priority. I do not accept Workcover clients.
Psychologists' professional development:
AHPRA requires psychologists, as part of their registration, to undertake a specified number of hours of professional development on an annual basis. Medicare also requires psychologists to complete specified hours of professional development annually. Professional development hours undertaken for one will count against the other, but there may be more required by Medicare than by AHPRA. For audit purposes, keep a spreadsheet detailing all hours spent undertaking professional development activities during the year.
Peer reviews are required as part of professional development. Peer reviews comprise discussions between psychologists about their cases, seeking opinion and advice on how to improve their casework. Peer reviews are useful and can provide new insights into understanding client cases. Record the number of hours spent doing peer reviews as part of professional development records.
Accrue professional development hours by attending relevant conferences, seminars and other training. These activities broaden your knowledge while giving you the opportunity to meet other people working in your field.AHPRA requires psychologists, as part of their registration, to undertake a specified number of hours of professional development on an annual basis. Medicare also requires psychologists to complete specified hours of professional development annually. Professional development hours undertaken for one will count against the other, but there may be more required by Medicare than by AHPRA. For audit purposes, keep a spreadsheet detailing all hours spent undertaking professional development activities during the year.
If you wish to engage in research and writing as part of your professional development, residents of New South Wales can join the State Library of New South Wales. Membership of the State Library is free and entitles you to access their extensive academic Databases which include the psychology databases used by universities. To use the Databases from your home computer, you need to enter the membership number provided on your State Library membership card. State Library staff are happy to assist you over the phone to learn about using the Databases. Residents of other States or Territories can enquire about accessing this valuable service through their own State or Territory Library. For NSW residents see website: www.sl.nsw.gov.au. See Join for membership. Go to Research and Collections where you enter your library membership number for access.
Peer reviews are required as part of professional development. Peer reviews comprise discussions between psychologists about their cases, seeking opinion and advice on how to improve their casework. Peer reviews are useful and can provide new insights into understanding client cases. Record the number of hours spent doing peer reviews as part of professional development records.
Accrue professional development hours by attending relevant conferences, seminars and other training. These activities broaden your knowledge while giving you the opportunity to meet other people working in your field.AHPRA requires psychologists, as part of their registration, to undertake a specified number of hours of professional development on an annual basis. Medicare also requires psychologists to complete specified hours of professional development annually. Professional development hours undertaken for one will count against the other, but there may be more required by Medicare than by AHPRA. For audit purposes, keep a spreadsheet detailing all hours spent undertaking professional development activities during the year.
If you wish to engage in research and writing as part of your professional development, residents of New South Wales can join the State Library of New South Wales. Membership of the State Library is free and entitles you to access their extensive academic Databases which include the psychology databases used by universities. To use the Databases from your home computer, you need to enter the membership number provided on your State Library membership card. State Library staff are happy to assist you over the phone to learn about using the Databases. Residents of other States or Territories can enquire about accessing this valuable service through their own State or Territory Library. For NSW residents see website: www.sl.nsw.gov.au. See Join for membership. Go to Research and Collections where you enter your library membership number for access.
Professional association:
It is good practice for psychologists to obtain membership in a professional association. I am an international affiliate member of the American Psychological Association. International affiliate membership costs about $A200 at present. See their website: www.apa.org.
![]()
Accept that you will not like everyone and not everyone will like you.
![]()
Rejoice in being yourself.
![]()
Be unpredictable!
![]()
Embrace change - it is the only constant in the universe.
![]()
Discard the chains of resentment and disappointment.
![]()
Know when to stay and when to go.
![]()
Love being the unique creature you are!
![]()
Learning is a life-long process.
![]()
Life is not a rehearsal - you get only one chance.
![]()
Value all that you are.
![]()
Enjoy the little treats in life.
![]()
The only person you need to be better than is who you were yesterday.
![]()
The world is a cold place - rug up!
![]()
The journey is as important as the destination.
![]()
You need no permission to be who you are!
.png)
.png)
.png)
.png)
