Cost is the most common reason people put off making the first appointment, and it is made worse by how hard the real number is to find. Practices publish a fee, Medicare publishes a rebate, and you are left to work out the bit in the middle. So here it is, plainly.

The number that matters is the gap

You pay the full fee on the day and Medicare refunds part of it, usually within a day or two. The gap is what it actually costs you.

My fee is $225 for a standard fifty-minute consultation, in person or by telehealth. The Medicare rebate for a session with a clinical psychologist is currently $141.85. So the gap is $83.15 per session.

For context, the Australian Psychological Society's recommended consultation fee is currently $315. Mine sits deliberately below it.

Before you have a plan

Without a Mental Health Treatment Plan there is no rebate, and you pay the full $225.

That is worth knowing rather than being surprised by, and it is also worth knowing that you can start without one. If seeing your GP is going to take three weeks and you would rather begin now, you can, and sort the paperwork out after.

How many rebated sessions you get

A Mental Health Treatment Plan covers six sessions. After those, a review with your GP can release another four. Ten in a calendar year is the maximum, and it resets on 1 January rather than twelve months after you start.

At a gap of $83.15, ten sessions costs $831.50 across a year, assuming the rebate stays where it is.

If you have a diagnosed eating disorder the arithmetic changes substantially, because an Eating Disorder Management Plan covers up to forty psychological sessions and twenty dietetics sessions over twelve months.

Private health

If your policy includes extras with psychology cover, you may be able to claim there instead. What you cannot do is claim Medicare and private health for the same session.

Which is better depends entirely on your policy. Some extras cover pays more per session than the Medicare rebate but caps the annual total quickly. Ring your fund, ask what they pay per psychology session and what the annual limit is, and compare it against $141.85 across ten sessions. It takes one phone call and can be worth a few hundred dollars.

Costs people forget

The GP appointment to write the plan. It needs to be a long consult and may not be bulk billed.

The review appointment after session six, same again.

Late cancellations. Mine is $100 for a cancellation with under 24 hours' notice. In a solo practice that appointment usually cannot be refilled, which is why the fee exists. If your roster is unpredictable, factor it in.

Travel, if you are coming in from out of town. A round trip from Ararat or Maryborough is a real cost in fuel and hours, and it is one reason telehealth works out cheaper for a lot of people. It is rebated identically.

How many sessions will you actually need

The honest answer is that it varies enormously, and be sceptical of anyone who gives you a confident number before meeting you.

A specific anxiety problem or a single depressive episode often responds within the ten rebated sessions. Complex trauma, long-standing patterns and eating disorders generally take longer. I will give you my honest estimate after the first session, and revise it if I am wrong.

If money is the barrier

Say so. It is not an awkward thing to raise and I would much rather know. Sometimes the answer is spacing sessions further apart, sometimes it is a different service better suited to your budget, and occasionally it is a referral somewhere with lower-cost options.

What is worst is quietly not booking. Full current fees are on the fees page, there is more on how treatment plans work, and you can always ask a question before committing to anything.

Fees and rebates are current at the time of writing. Medicare rebates are indexed annually, so check the fees page for the latest figures.