Navigating Mental Health Support in Australia: Registered Counsellors, Medicare, and Your Rights
Finding the right mental health support is a personal journey, but the "business side" of therapy—referrals, rebates, and regulations—can add stress to the issues you’re seeking help for.
If you are wondering whether you need a GP referral to see a registered Counsellor and the relative costs, I will break down the 2026 landscape in Australia.
Do I need a GP referral to see a registered Counsellor?
The short answer is no.
You do not need a Mental Health Treatment Plan (MHTP) or a referral letter from a GP to book an appointment with a registered Counsellor. You have the freedom to find a practitioner who resonates with you and start therapy immediately. This path is often preferred by those who:
Value expedited access without the additional cost and time waiting for a GP appointment.
Are seeking support for life transitions, grief, or relationship issues that may not meet the criteria of a "diagnosable mental disorder" requiring higher intensity support.
Registered Counsellors can and do work with GPs through referral and collaborate integrated person-centred care. This is aligned on the goals and therapeutic objectives detailed in a MHTP, but it won’t be eligible for a Medicare rebate.
If your experiences and conditions do require higher intensity support than the scope of practice of a registered Counsellor, they will refer you to your choice of GP with their own therapeutic assessment. Some clients with a wide range of issues of varying severity may have a Counsellor, Psychologist and GP working in collaboration as a care team to provide support.
Are registered Counsellors subsidised by Medicare?
Currently, registered Counsellors are not subsidised by Medicare.
Under the Australian Government’s "Better Access" initiative, Medicare rebates are exclusively reserved for registered psychologists, clinical psychologists, and accredited mental health social workers.
What sort of costs might be involved?
While a Mental Health Treatment Plan (MHTP) provides Medicare rebates for psychologists, many individuals still face out-of-pocket ‘gap fees’ ranging from $80 to $150 per session, alongside waiting list times. For those who do not qualify for bulk-billing services (where Medicare covers 100% of the cost) or cannot wait for an appointment, seeing a registered Counsellor at a standard flat rate (industry average rates being around ~$130) can be a highly accessible and predictable financial alternative.
For lower intensity mental health concerns—such as mild anxiety, work stress, or life adjustments—counselling is just as appropriate and effective as seeing a psychologist. Registered Counsellors focus on an evidence-based person-centred approach that treats you as an individual, not a diagnosis.
Your Rights: Autonomy and Choice
Under the Australian Charter of Healthcare Rights, you have the fundamental right to choose the healthcare services that feel right for you. This includes:
Right to Partnership: You are a partner in your own care. You have the right to ask questions and make decisions with your healthcare provider.
Freedom of Choice: Even if a GP suggests a specific psychologist on a referral, you are not legally bound to see that specific person if there are other valid options that better suit your financial or personal needs. The therapeutic relationship and collaboration between the selected professional and client is an important consideration in effective recovery.
Informed Consent: You have the right to be informed about the costs and benefits of different treatment paths—including the option of seeing a private registered Counsellor instead of a Medicare-rebated psychologist.
You cannot be directed or forced to use a specific service if you believe another professional is more appropriate for your situation. If your presentation develops to require higher level intervention, a registered Counsellor will facilitate that referral with your GP in a collaborative approach. We are all part of the same health service seeking to balance your autonomy of choice and your therapeutic needs.
Summary: Which path is right for you?
Choose a Psychologist if you have higher intensity support needs and require specialised clinical intervention within the Better Access framework.
Choose a registered Counsellor if you have lower intensity support needs and you want timely, affordable, and flexible support for life’s challenges, with the autonomy to continue therapy as long as you need on a consistent budget.
If you believe your circumstances are appropriate to seek Counselling as an initial intervention - take the next step and book for a 15 minute exploratory conversation.