Medicare and counselling
Can counsellors bill Medicare in Australia?
Short answer: most counsellors can't — Medicare's Better Access initiative is gated to specific practitioner categories, and general PACFA or ACA registration isn't one of them. Here's exactly who qualifies, how claiming actually works for those who do, and what Zenvia supports today.
Who's actually eligible
The eligibility gate
Medicare Better Access rebates are available for sessions with: GPs, psychiatrists, clinical psychologists, registered (general) psychologists, AASW-accredited mental health social workers, eligible occupational therapists, and mental health nurses. PACFA or ACA registration alone does not qualify a counsellor to bill Medicare. Note that AHPRA doesn't register counsellors or psychotherapists at all — counselling isn't part of the National Registration Scheme — so this isn't a registration a counsellor can add. Eligibility here means being one of the specific professions listed above (an AHPRA-registered psychologist, for example, or an AASW-accredited social worker), not "a counsellor with AHPRA registration."
For eligible practitioners
How claiming actually works
If you do hold an eligible registration, there are two paths:
The client pays nothing. This needs a PRODA account, a Minor ID (issued by your practice-management software vendor and linking the practice to PRODA), and either integrated Medicare Online claiming inside your software or manual submission through HPOS. This is a genuine software-vendor integration, not something an emailed invoice can substitute for.
The client pays your full fee and claims their own rebate afterwards via Medicare Easyclaim or the Medicare app. This is the client claiming from their own Medicare account — it doesn't need anything from your practice software's billing feature at all, just a normal invoice with the right detail on it.
Either way, sessions are capped: 10 individual and 10 group sessions per calendar year under a GP Mental Health Treatment Plan, typically 6 on initial referral before a mandatory GP review unlocks the rest.
What Zenvia supports today
Invoicing, not live claiming — yet
If you're an eligible practitioner, Zenvia lets you invoice a client's Medicare gap payment and track it against their file, the same way NDIS self-managed billing works today. What Zenvia doesn't do yet is submit a live Medicare Online bulk-billing claim on your behalf — that requires the PRODA and Services Australia developer-conformance process real claiming integrations go through, and it's on our roadmap, not built today.
If Medicare support is a deciding factor for your practice, ask us where that stands before you commit.
See what Zenvia handles for you
Bookings, records, invoicing and session notes — for 10% of billings, plus card processing at cost.
Billing another funder? See NDIS, EAP, workers compensation, Victims Services NSW, Victoria's FAS, DVA and Open Arms, or private health fund rebates. Not sure which registration you need? See PACFA vs ACA vs AHPRA.