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 or how the costs compare to seeing a psychologist, 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.
Unlike psychologists, 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.
Prefer to keep their initial mental health discussions private from their regular doctor and the government My Health record.
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 as specified for Medicare under Better Access.
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.
While this might sound like a disadvantage, the "gap fee" reality of 2026 often tells a different story.
The "Rebate Gap" Myth: registered Counsellors vs. Psychologists
Many people assume that seeing a psychologist is cheaper because of the Medicare rebate. However, when you look at the out-of-pocket costs (the "gap fee"), registered Counsellors are often the more affordable long-term option for lower intensity conditions.
The APS National Schedule of Suggested Fees (2025-2026) recommends a standard clinical psychologist consultation fee cost to health consumers at $318.00.
The ACA Workforce Report 2024 indicates registered Counsellors are charging on average $133.33 for a standard consultation.
The Medicare rebate for a 50 minute psychology consultation (as of June 2026) ranges between $98.95 to $145.70 (depending on the registration level of the psychologist, source MBS Online: item 80010, 91167, 80110, 91170)
Health economic research on historic data has verified that the out of pocket costs for psychologists under the Better Access initiative rapidly rose from a median (data middle point) of $74 AUS in 2018-2021 to $94 in 2022 (see Tapp et al, 2026).
In 2026, individual psychology practices are themselves indicating an out of pocket expense ranging between $80.00 to $150.00 in some instances. The cost of a registered Counsellor is often comparable to, or even lower than, the gap fee you pay for a psychologist after your rebate is applied.
The 10-Session Limit: Why It Matters
Under a Medicare MHTP, clients are capped at 10 rebated sessions per calendar year, an initial 6 session and 4 more following an additional GP appointment confirming the necessity for further engagement.
For some, 6-10 sessions may not be enough to address ongoing, multiple and overlapping diagnosed but - lower intensity concerns. Once those sessions are used, you must pay the full psychologist fee out-of-pocket (APS recommendations at $318.00) until the new year begins. Because registered Counsellors maintain a lower flat rate (on average ~$130.00), they offer a sustainable way to access consistent, long-term support without the "rebate cliff."
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 (like a registered Counsellor) 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 that fits within 10 sessions.
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 without government-imposed caps.
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.