You may be surprised to learn that the work of counsellors is not currently covered by Medicare.
It’s been a source of frustration and confusion for both counsellors and their clients. After all, counsellors are well placed to provide some of the Medicare funded services provided by psychologists, mental health social workers and credentialled mental health nurses.
The good news is that a change in the Medicare provisions for counsellors could arrive sooner than you think.
The Australian Counselling Association and other advocates in the counselling industry have been working hard to bring counselling services under the Medicare umbrella and provide better outcomes for all Australians.
How does the Medicare rebate work?
Medicare is the national health insurance scheme in Australia, and it subsidises a broad range of medical services. Medicare can be used by patients with private health insurance, and there are situations where they can both be used at the same time.
The Medicare subsidy is paid directly to the patient when they pay for a qualifying medical service, or it can be paid to the practitioner if they are bulk billing.
Practitioners that bulk bill don’t charge any co-payment or additional fee to patients – instead they bulk bill the Department of Human Services directly.
Services that are covered by Medicare are listed in the Medical Benefits Schedule (MBS). These services are generally accepted to be clinically relevant services by their respective profession and there are 5,754 of them.
New services are added, and obsolete services are removed under the assessment of the Medical Services Advisory Committee, which advises the Minister for Health.
Medical services that require a referral qualify for a Medicare benefit of 85% of the MBS listed fee, while non-referred services such as a general practitioner (GP) get 100%.
Are counsellors covered by Medicare?
Counsellors are not currently covered by Medicare for counselling sessions. However, counselling is a practice that occurs across multiple professions – including some that are covered by Medicare. The Better Access initiative is a specific program that gives Medicare rebates for mental health services.
Allied health professionals including mental health nurses, occupational therapists, psychologists and social workers provide services that are covered by Medicare.
This means that counsellors whose scope of practice, knowledge and skills overlaps with those of the allied health professionals covered by Medicare are being under-utilised.
Meanwhile, waiting lists for psychologists continue to grow, while a quarter of registered counsellors would like to be working more hours.
There’s another good reason to improve patient access to counsellors through Medicare. A third of registered counsellors live in regional, rural and remote areas, compared to around 15 per cent of psychologists and psychiatrists.
If counsellors could claim Medicare, then it’s likely that more people living in regional areas would have better access to mental health care.
The Australian Counselling Association has been advocating for changes
The Australian Counselling Association (ACA) is the peak body for counsellors and psychotherapists. They provide a range of services for over 9,000 members and advocate on their behalf.
For over 15 years, the ACA has prioritised the issue of Medicare rebates for its members with petitions, lobbyists, and meetings with government.
In 2022, the ACA had a win in its campaign.
The Queensland Mental Health Select Committee was charged with the task of scrutinising Queensland’s mental health care system – which they did over a six-month period. The ACA provided a submission to the Committee and then appeared before the committee to deliver additional information and evidence.
Specifically, the ACA advocated for the Queensland Government to recommend to the Federal Government that Registered Counsellors be included within the Medicare Benefits Schedule to offer rebateable services.
When the Committee delivered its final report, it made an explicit recommendation that the Queensland Government collaborate with the Australian Government to ensure Medicare rebates are available to patients for all mental health support and alcohol and other drug practitioner services.
“This is significant in that this is the first time that a state or territory government has formally recognised and endorsed counsellors through submission to the government. It is also important because it is a state Labor government making the recommendation to the federal Labor government,” says Georgina Akers, Course Coordinator for ECU’s online Master of Counselling.
“These changes represent a step forward for the counselling profession throughout Australia. It will significantly increase employment opportunities and put the Federal Government to open up MSB item numbers to ACA Members.”
Changes have not yet been enacted, but this is still a win for the counselling profession.
Changes in Victoria have also created more opportunities for counsellors to work in schools
The recommendations in Queensland are not the only recent win for the counselling profession.
The definition of a mental health practitioner in Victoria has been expanded to include counsellors.
That definition was part of a new Mental Health and Wellbeing Bill and by quietly changing that description, politicians have provided more counselling support for kids at school.
In fact, from 2023, Victorian school students will have access to an additional 2000 counsellors.
“This is important as it opens up a whole range of access to counsellors in both the public and private settings,” says Akers.
“This will lead to the inclusion of counsellors in multidisciplinary teams and also significantly open up employment opportunities for Victorian ACA members. It also adds counsellors into schools and ensures that our profession has equal standing with the others.”
This change follows a pilot program that put additional counsellors into 100 schools across the state. More than $200 million has been budgeted to expand the program so that young people can experience better mental health outcomes.
Read more about becoming a school counsellor in Australia on our blog.
It’s an exciting time to be a counsellor
At the moment, we have around 38,000 counsellors in Australia according to the government's Labour Market Insights who are earning an average weekly wage of $1652, or around $85,000 annually.
Over the next five years, the Australian Government’s National Skills Commission expects the number of counselling roles to increase by 14.2 per cent.
Akers is excited and sees these recent developments as just the beginning.
“In the future, we hope to see other states and territories add counsellors to legislation and join the Queensland government in lobbying the federal government to add counsellors to the MBS.”
Expand your opportunities as a counsellor with ECU’s Master of Counselling
You can upgrade your counselling skills with an accelerated and online Master of Counselling with ECU in as little as 24 months.
Accredited by the ACA, this course allows you to continue working while you learn, and you don’t have to wait until next year to begin – there are six intakes throughout the year.
You’ll develop job-ready skills that you can apply immediately, and you can also put them to the test during supervised practice in an agency setting. During your 220 hours of professional field placement, you’ll have the opportunity to work with clients and strengthen your practice.
Want to know more about placement? We answer your counselling placement FAQs here.
This course has been designed for students preparing to become a counsellor as well as those in other roles such as social work, career coaching and other allied health positions.
Whether you are already working as a counsellor or want to join this rewarding field, ECU’s Master of Counselling will give you the tools you need to make a difference to individuals, families and communities.