Policy Updates and Fee Increases
Changes commencing 1 June 2022
Unfortunately, due to a variety of circumstances including ongoing diary congestion, limited ability to take on new clients, late notice cancellations, and a blow out in the number of people requesting bulk billing, I have come to the difficult decision to make a number of policy changes and fee increases which will begin on 1 June 2022.
CANCELLATIONS – 48-hours notice required to avoid increased cancellation fee:
Changes are being made to requirements for notice to avoid a cancellation fee due to an increase in late-notice cancellations which can be difficult to fill as there is insufficient time for the people waiting for an earlier appointment to make arrangements for babysitting, time off work, etc. As a result, the notification time required will increase from 24 to 48 hours prior to the appointment, and only three advance appointments can be scheduled in order to reduce unneeded bookings.
Due to the time required to attempt to fill these vacancies, and the uncertainty this will be successful, the cancellation fee (which has not increased in nearly 15 years) will be increased to 50% of the session fee plus GST but with additional early discounts and late charges (see fee schedule below). Further appointments will not be available while fees remain outstanding.
BULK BILLING – no longer available as default to all Pension and Health Care Card holders:
‘Bulk billing’ is the term for when a clinician accepts the Medicare rebate as the whole of their fee for service. The Australian Psychological Society currently recommends that the fee for a 46-60min Clinical Psychology session is $267, while the current Medicare rebate is less than half this amount at $129.55. The difference between these two fees is expected to continue to increase as the Medicare rebate has only increased minimally in the past ten years.
I value supporting people regardless of their ability to pay, so in my 15 years in Private Practice I have charged a rate considerably below that recommended, and offered bulk billing for those on a Pension or Health Care Card when they have a Mental Health Care Plan, or an equivalent fee without the Medicare rebate when they do not. In addition, I have covered bank charges, provide an extended first session, complete a session summary after each appointment, write GP MHCP review letters, respond to emails, phone calls, communicate with schools and other support services, accept requests for delayed payments, and go beyond the standard 60min session when required. All of these things take additional time but have been provided at no additional cost to clients.
I will continue to provide these additional services, however, a recent blowout in the proportion of my caseload that is bulk billed has made it unsustainable to continue to offer this as an option to all who were previously eligible. Those who have previously accessed Bulk Billing will need to reapply for a reduced fee. After providing your Pension or Health Care Card details and a brief financial statement, you may be approved for either:
Continued Bulk Billing (however the proportion of clients accepted for this option will be capped),
A Discounted fee but now with a small gap payment (see fees below), or alternatively
Transfer to another Psychologist who may continue to offer more flexible Bulk Billing.
MASKS – still required for all face-to-face appointments:
Face-to-face sessions continue to be available but will still require masks and full vaccination. Telehealth is available for those who do not meet these requirements or are unable to attend in person for other reasons.
I appreciate that masks can be uncomfortable and make it harder to see each other’s facial expressions, and several people have queried the ongoing need for wearing them. However, I need to minimise the risk of becoming sick as if I became unwell I may be unable to provide support to anyone for up to a week, and as I am self-employed I only receive an income when I am working.
APS Recommended Fee
Medicare Rebate (MHCP only)
5% Early Payment Discount (same day)
5% Late Payment Charge (>7 days)
<48hr Notice Cancellation Fee (50%+GST)
Discounted Fee (on application)
Bulk Billing (on application)
NEW FEE ARRANGEMENTS – fee increases, additional fee levels and types:
As of 1 June 2022 there will be three fee levels: Standard, Discounted and a more limited proportion of Bulk Billed clients. First sessions will continue to be 90 minutes at no additional cost compared to the ongoing 50-60min sessions. Psychological therapy is exempt from GST.
Standard Fee: The Standard Fee is increasing from $200 to $220, however, to reduce the time spent on chasing unpaid accounts, and to assist with managing the increased cost to clients, I have also introduced a 5% discount for payment on the day of the appointment, making the increase only $9 per session.
Discounted Fee: The Discounted fee of $160 will be available on application to those on a Pension or Health Care Card and/or with significant financial challenges, a brief statement of financial position will be required. For those with a Mental Health Care Plan this will mean a gap of $30.45 which reduces to $22.45 if paid the same day. Unfortunately, Medicare does not allow the payment of the gap only so the full fee must be paid and then the Medicare rebate claimed, it is usually deposited in your account within 24 hours of claim. Some other Medicare or Private Health rebates may be available with appropriate referrals, or suitable extras cover, but these are usually lower thus leaving larger gap fees. The Discounted fee can also be used if you are approved for a reduced fee but are not eligible for any rebates, however you will be responsible for the total amount of $160 (plus 5% late fees or minus early 5% discounts shown in the table above).
Bulk Billing: The Bulk Billing rate of $129.55 will only be available to a fixed proportion of clients, and will require provision of Pension or Health Care Card details and a brief written statement of financial position to apply. For those on a Mental Health Care Plan, the fee will be billed directly to Medicare and the rebate will cover the whole fee. However, similar to the Discounted fee, those without a MHCP will be responsible for paying the $129.55 fee (plus 5% late charge, see table above) unless eligible to claim other Medicare or Private Health rebates.
Cancellation Fees: Cancellation fees will be increased to 50% of the usual fee plus GST if notified less than 48 hours prior to the appointment. When relevant, an invoice will be provided the day the cancellation is made, but 45% plus GST will be accepted if paid by the day of the appointment, and will increase to 55% plus GST if outstanding after 7 days.
The fee paid will now depend on when it is paid, with 5% early discount for same day payment and a 5% late fee for any fees unpaid after 7 days. All fees (including cancellation) must be paid prior to the next session, or the session may be reallocated to someone else.
EFTPOS is the preferred payment option at the time of the session, but invoices with electronic payment options will be provided at the time of the session for those who attend via telehealth. Receipts will be provided for those wishing to claim from a private health fund, or on request.
Exemptions from early discounts and late charges will be made if the fee is being paid by a third party which is outside the control of the client. Accounts will continue to be submitted directly to Open Arms, Workers Compensation, NDIS managers, DPFEM, etc but any fees not covered by these services, for example resulting from cancellations or expired referrals, will be the billed directly to the client.
NEW FEE TYPES
Extended Sessions: Two additional fee options are being offered for those who wish to schedule an extended session of 90 or 120min duration. This will likely be of most use to those seeking couple or family therapy. Unfortunately, the Medicare rebate for those with a Mental Health Care Plan remains the same as for a 60min session.
Reports: Although I will continue to complete GP MHCP review letters at no additional cost, any other documentation required for purposes such as Courts, Centrelink, Workers Compensation or NDIS will be charged at 30min, or part thereof, increments depending on the time required for preparation. A minimum of 48 hours notice for brief reports, longer for those requiring more detail, is requested but completion by a preferred due date cannot be guaranteed if insufficient time is allowed. No discounts or rebates are available for report writing.
In summary, from 1 June 2022:
48 hours notice will be required to avoid a cancellation fee of 50% of the session fee plus GST
Only three advanced appointment bookings will be permitted at a time
Fees are increasing but there will be three fee levels: Standard (full fee), Discount (fee with reduced gap), and Bulk Billed ((no gap with a MHCP))
Bulk Billing will be capped at a proportion of case load and will no longer be automatically available to all Pension and Health Care Card holders
You will need to reapply in writing prior to May 15th 2022 for approval for reduced fees at either the Discount or Bulk Bill fee levels
When eligible, Medicare and Private Health rebates may reduce the fee, but these are generally claimed after the bill has been paid in full (except when Bulk Billing has been approved). Remember that a Medicare Rebate is only available if you have a valid Mental Health Care Plan from your GP.
Clients funded by third parties (eg Open Arms, DVA, DPFEM, NDIS or Workers Compensation) are generally charged the Standard Fee but this is billed directly to the funding body. These clients will thus only need to be aware of the changes to cancellation and advanced booking requirements (see above), unless appropriate funding authorisation has not been approved prior to the session as then they are liable for the full fee themselves.
Applications for reduced fees (Discounted or Bulk Billing) can be emailed to email@example.com, or provided using the Online Form emailed to current clients, or the Online Intake form sent to new clients. Please include a brief financial statement and your current Pension or Health Care Card number. Applications will be processed as quickly as possible to give you prompt clarity regarding ongoing fees. Priority will be given to existing clients but timely applications will be an advantage given the limited availability. It is unlikely at this time that new clients will be approved for the Bulk Billing option given the limited proportion of clients who can be accepted.