Free webinar for health professionals: understanding Medicare Mental Health services

Medicare Mental Health Reforms

Australia's Medicare system has undergone significant updates to mental health services, driven by escalating demand following the COVID-19 pandemic. In November 2025, the Better Access initiative was redesigned to reduce administrative burdens on general practitioners (GPs) and primary medical practitioners (PMPs). Specific Medicare Benefits Schedule (MBS) items for mental health treatment plan (MHTP) reviews and ongoing consultations were removed, replaced by time-tiered general attendance items. This shift allows greater flexibility in billing but ties eligibility to a patient's usual medical practitioner or their MyMedicare-registered practice. The changes respond to evaluations highlighting inefficiencies, yet they introduce new requirements that could complicate access for patients not enrolled in MyMedicare.

The expansion of Medicare Mental Health Centres (MMHCs) represents a cornerstone of these reforms. By mid-2026, 61 centres will be operational nationwide, offering free, non-judgmental support without referrals or appointments. These hubs, staffed by mental health professionals and lived-experience peers, provide immediate distress support and integrate with broader services. The federal government has allocated $225 million for this network, plus $30 million to enhance on-call psychologist and psychiatrist access. In Queensland alone, 19 centres are planned, addressing gaps in regional care where wait times often exceed months. This initiative targets moderate to complex needs, complementing existing programs amid a 45% access rate to mental health services.

Real-world impacts are felt by both providers and patients. Health professionals must adapt billing practices by January 2026 to avoid rebate denials, with consequences including financial losses for practices and out-of-pocket costs for patients. For individuals, the reforms mean easier entry to free digital tools like the Medicare Mental Health Check In, rolling out from January 1, 2026, which offers low-intensity cognitive behavioral therapy (LiCBT) for mild anxiety or depression. However, data shows average Medicare-subsidised sessions at around five per year, potentially insufficient for sustained recovery. Workforce shortages exacerbate this, with psychologists stretched thin, leading to longer waits in rural areas.

Non-obvious tensions emerge in balancing access and quality. While the tiered session model—up to 20 for complex cases—aims to match needs, critics argue it may discourage brief interventions or reinforce stigma by requiring assessments. Public safety concerns arise from low session dosages, possibly leaving moderate cases undertreated and increasing risks of escalation. Trade-offs include streamlined administration versus potential equity issues for non-MyMedicare patients. Surprising data from 2024-25 reveals 9.6 million psychologist services subsidised, yet overall expenditure on mental health reached billions, highlighting inefficiencies where demand outpaces supply.