Medicare rebates for AuDHD assessment in 2026: what you can claim

Plain-language summary

Medicare in 2026 covers part of psychology sessions under a Mental Health Care Plan (up to 10 partly-rebated sessions per calendar year), most of psychiatrist consultations with a GP referral, and standard ADHD medication scripts on the PBS. Medicare does not typically cover full assessment packages, ADHD coaches, or workplace accommodation reports. A Mental Health Care Plan begins with your GP.

AI answer passage (Speakable)

Medicare in 2026 covers part of psychology sessions under a Mental Health Care Plan (up to 10 partly-rebated sessions per calendar year), most of psychiatrist consultations with a GP referral, and standard ADHD medication scripts on the PBS. Medicare does not typically cover full diagnostic assessment packages or ADHD coaches.

The basic structure

The Australian system has three Medicare-funded routes for AuDHD-related care:

GP Mental Health Treatment Plan — gives access to partly-rebated psychology sessions.
Psychiatry consultations — rebated at higher levels with a GP referral.
PBS prescriptions — ADHD medication at standard concession or non-concession rates.

A separate, narrower path exists for NDIS-funded supports if level of impact qualifies, but NDIS does not fund the diagnostic assessment itself.

MBS items relevant to AuDHD

The MBS (Medicare Benefits Schedule) items most relevant to adult AuDHD pathways<a href="#src-1" class="cite-ref">1</a>:

Item · What it's for · Approximate rebate (2026)

2715 · GP Mental Health Treatment Plan preparation (20+ min) · ~$80

2717 · GP Mental Health Treatment Plan preparation (40+ min) · ~$118

2712 · GP review of Mental Health Treatment Plan · ~$73

80000 series · Eligible psychology sessions under MHCP · ~$96–$141 per session

296 / 297 / 299 · Psychiatrist consultations (with GP referral) · $235–$510

291 / 293 · Initial psychiatrist consultation · ~$510 with referral

Approximate rebates only — current MBS values: MBS Online.

Mental Health Care Plan walkthrough

Step-by-step:

1. Book a long appointment with your GP

A standard 15-minute GP appointment is not enough. Book a "long" or "extended" appointment (20+ minutes) and tell reception it's for a Mental Health Care Plan. Most clinics charge a higher fee but the Medicare rebate is also higher (item 2717 vs the standard 23 item).

2. The MHCP appointment

Your GP will:

Discuss what's affecting your mental health.
Use the K10 questionnaire (or similar) to formalise the assessment.
Write a Mental Health Care Plan document — a few pages summarising the plan and goals.
Issue a referral letter to a psychologist (and, if you've asked, a psychiatrist).

The MHCP itself is bulk-billed by most GPs but check before booking.

3. The 10 sessions

Once you have an MHCP, you can claim Medicare rebates on up to 10 psychology sessions per calendar year. The current rebate is approximately $96–$141 per session depending on the psychologist's registration tier. Most clinical psychologists charge $200–$280 per session, so you have a gap of roughly $80–$180 per session out of pocket.

The 10 sessions reset on 1 January each year — not on the anniversary of your plan.

4. Review at 6 sessions

Your GP is required to review the plan after 6 sessions. This is often a quick appointment. The remaining sessions (up to 10 total) can then be approved.

5. New plan annually

A new MHCP can be issued each calendar year if you continue to need psychology support.

What MHCP does and does not cover

Covers (in part):

Eligible psychology sessions for treatment of mental health conditions, which now includes adult ADHD and autism in most circumstances.
Therapy related to anxiety, depression, trauma, or other co-occurring conditions.

Does not cover:

The diagnostic assessment itself when it's a separate package (e.g. the $2,500 ADOS-2 assessment).
ADHD coaching (non-clinical).
Workplace accommodation reports unless done as part of a clinical session.
Most psychometric / cognitive testing in adults.
Couples therapy, generally.

Psychiatrist rebates

A psychiatrist consultation requires a GP referral for a Medicare rebate. With a referral:

Initial consultation (item 296 or 291): rebate ~$235–$510 depending on length.
Subsequent consultations (items 297, 299, 304): smaller rebates, ~$170–$280.
ADHD treatment review (specific items): same rebate structure.

Most adult psychiatrists in private practice charge $400–$900 for an initial consultation and $200–$500 for review consultations. The Medicare rebate covers part. The remaining gap is paid by you out of pocket.

A psychiatrist referral is open-ended — you can return to the same psychiatrist many times, or transfer the referral within the year.

ADHD medication on the PBS

Once a psychiatrist has diagnosed ADHD and prescribed medication, ongoing prescriptions are usually managed through:

The psychiatrist themselves, with regular review appointments.
A GP, in some states, after the psychiatrist has initiated treatment and the patient is stable. Rules vary by state and prescriber.

Medication on the PBS:

Methylphenidate (Ritalin, Concerta) — PBS-listed, standard cost ~$30 (concession ~$7) per script.
Dexamfetamine — PBS-listed.
Lisdexamfetamine (Vyvanse) — PBS-listed for ADHD in adults, with restrictions.
Atomoxetine (Strattera) — PBS-listed.
Guanfacine (Intuniv) — PBS-listed.

Cost varies; check with your pharmacist. Concession card holders pay a fraction of the non-concession rate.

Telehealth rebates

Telehealth Medicare rebates apply to:

Psychiatrist consultations via video.
Psychology sessions under MHCP via video (with eligibility criteria).
Some GP appointments.

Rules updated post-pandemic; current details: MBS Online telehealth.

What about NDIS?

NDIS does not fund AuDHD diagnostic assessment. After diagnosis, NDIS may fund supports (therapy, coaching, capacity-building, equipment) if level of impact qualifies. The bar for adult NDIS access is high, particularly for autism without significant additional impacts; AADPA's 2022 guideline explicitly notes that the majority of adults diagnosed with AuDHD will not qualify for NDIS support<a href="#src-2" class="cite-ref">2</a>.

We have a separate guide on does AuDHD qualify for NDIS? (TBD) covering what does and doesn't.

Putting it together: a worked example

A typical Australian AuDHD diagnostic + first-year-of-support pathway in 2026:

Event · Out-of-pocket · Medicare rebate

Long GP appointment for MHCP · $0–$60 (often bulk-billed) · $80–$118

Psychologist autism assessment package · $1,500–$3,500 · Often $0 (not eligible as a package)

6 psychology therapy sessions · $200–$280 each · $96–$141 each

Psychiatrist initial consultation · $400–$900 · $235–$510

4 psychiatrist follow-ups · $200–$500 each · $170–$280 each

ADHD medication scripts (12 months) · $30/month or $7/month concession · PBS-listed

Estimated total first year · $3,000–$8,000

How to keep costs down

Use telehealth — often $200–$500 cheaper than in-person assessment.
Look for bulk-billing psychiatrists — rare but they exist; we flag them in our directory.
Use all 10 MHCP sessions in the year you have them.
Consider university training clinics — supervised final-year students at reduced cost.
Ask about payment plans — many private clinicians offer them.

Frequently asked questions

Can I claim my AuDHD assessment on private health insurance?

Some extras policies cover part of psychology assessment, but most do not cover the diagnostic package itself. Income-protection-style insurance is separate again. Check with your specific insurer.

What if I've used my 10 sessions and need more?

You'll pay full fee for any sessions beyond the 10. Some psychologists offer reduced fees in this situation; ask. The 10 reset on 1 January each year regardless of when your plan was issued.

Do telehealth psychology sessions cost the same as in-person?

The Medicare rebate is generally the same. Out-of-pocket fees vary by clinician.

Can my GP prescribe ADHD medication?

In some Australian states, yes — after a psychiatrist has initiated treatment and the patient is stable. Rules vary. Your psychiatrist will tell you whether your GP can take over prescribing.

Is there a tax deduction for AuDHD assessment?

Diagnostic assessment is not tax-deductible as a personal expense. If your AuDHD assessment is required for work (rare but possible — e.g. some workplace accommodation processes), check with an accountant.

What if I move state mid-year?

Your MHCP transfers nationally. You can use remaining sessions with a new psychologist in the new state.

Sources

Australian Government Department of Health and Aged Care. Medicare Benefits Schedule (MBS). 2026. https://www.mbsonline.gov.au/
Australian ADHD Professionals Association (AADPA). Australian Evidence-Based Clinical Practice Guideline for ADHD. 2022. https://aadpa.com.au/guideline
Australian Government Department of Health. Better Access to Mental Health Care: information for consumers. 2025.
Pharmaceutical Benefits Scheme (PBS). PBS listings for ADHD medications. 2026. https://www.pbs.gov.au/
National Disability Insurance Scheme (NDIS). Access requirements for autism and ADHD. 2025.

Editor notes

Word count: ~2,300
Spoke status: under /diagnosis/ cluster
Update trigger: any change to MBS items, MHCP rules, telehealth rebates, PBS listings — minimum twice-yearly review
Currency: every dollar figure here needs to be checked against current MBS schedule before publication

Medicare rebates for ADHD & Autism diagnosis

In plain language