Medicare-subsidised services

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Summary

Key points

  • 11% of Australians (2.9 million people) accessed 14 million Medicare-subsidised mental health-specific services in 2020–21. This is an increase from 7% of Australians in 2010–11.
  • 14% of Australian females accessed Medicare-subsidised mental health-specific services compared to 9% of Australian males in 2020–21.
  • 48% of Medicare-subsidised mental health-specific services were provided by psychologists (including clinical psychologists), 29% were provided by GPs and 19% were provided by psychiatrists in 2020–21.
  • 26% of Medicare-subsidised mental health-specific services were delivered via telehealth in 2020–21.
  • In 2020–21, the number of people receiving Medicare-subsidised mental health-specific services was highest in the April–June period and lowest in the October–December period, while the number of services being delivered was highest in the July–September period and lowest in the January–March period.

Medicare-subsidised mental health‑specific services are provided by psychiatrists, general practitioners (GPs), psychologists and other allied health professionals. The services described here are provided in a range of settings – for example, hospitals, consulting rooms, home visits, telephone and videoconferencing – as defined in the Medicare Benefits Schedule (MBS). Information is presented on both patient and service provider characteristics and is limited to Medicare-subsidised services only. These data relate only to mental health services that are claimed under specific mental health care MBS item numbers. Therefore, the reported number of patients who receive mental health-related services is unlikely to represent all patients who receive mental health care. It is unclear how many additional people receive GP mental health-related care that is billed as a consultation against generic GP MBS item numbers. For further information on the MBS data, refer to the data source section on this website.

During 2020–21, the Medicare-subsidised mental health-specific service rate was 545 services per 1,000 population in Australia. Of these, the highest rate was provided by general practitioners (158 services per 1,000 population), and the lowest rate by other allied health providers (23).

Additional mental health-specific items are included in the MBS periodically. There were a number of new items introduced during the 2020–21 collection period including:

  • August 2020: additional items for mental health services in response to the COVID-19 pandemic, such as face-to-face and telehealth items for focussed psychological strategy treatment services.
  • December 2020: additional items for allied health and mental health services in Residential Aged Care Facilities, such as items for the creation and review of a mental health treatment plan.

Has the provision of Medicare-subsidised mental health-specific services increased over the past 10 years?

The top half of the dashboard is a line chart showing the number of Medicare-subsidised mental health services, the number of services per patient, and the service rate (per 1,000 population) by provider type from 2010–11 to 2020–21. The bottom half of the dashboard is a map of Australia showing the year on year change of the number of services per 1,000 population by provider type and state or territory, from 2016–17 to 2020–21. The figure shows a higher increase from 2019–20 to 2020–21 compared to previous years. During the COVID-19 pandemic, the Australian Government introduced additional services to the Medicare Benefits Schedule to support provision of health care via telehealth. The second page of the dashboard is a vertical stacked bar chart showing the proportion of Medicare-subsidised mental health-specific services delivered via telehealth and face-to-face in 2020–21. Over 1 in 4 services (3.6 million, 25.7%) were provided via telehealth (phone or video) in 2020–21.

People receiving services

In 2020–21, 2.9 million Australians (11.2% of the population) received Medicare-subsidised mental health-specific services. Both Victoria and Queensland had the highest proportions of the population receiving services (11.7%), followed by New South Wales (10.9%). The Northern Territory had the lowest proportion of the population receiving services (5.9%) (Figure MBS.1).

Figure MBS.1: Percentage of the population receiving Medicare-subsidised mental health-specific services, by states and territories, 2020–21

Vertical bar chart showing the proportion of each state and territories population who received Medicare-subsidised mental health-specific services, by state or territory in 2020–21. Victoria (12%) and Queensland (12%) had a higher proportion of the population accessing services than the national proportion (11%). New South Wales, Western Australia, Tasmania and South Australia had about 11% of their populations receiving services, followed by the Australian Capital Territory (10%) and the Northern Territory (6%). Refer to Table MBS.4.

Source data: Medicare-subsidised mental health‑specific services tables 2020–21

People aged 18–24 years were most likely to receive Medicare-subsidised mental health-specific services (17.7% of people aged 18–24 years), followed by 25–34 years (15.7%) and 35–44 years (14.4%) (Figure MBS.2). A higher proportion of the female population (13.7%) accessed services compared with males (8.6%). The proportion of the Australian population receiving services varied according to the remoteness area of patient’s residence. The proportion of people receiving services was highest for those living in Major cities and Inner regional areas (11.5%), with the proportion of the population receiving services decreasing with increasing remoteness to 3.3% of people living in Very remote areas.

Figure MBS.2: Percentage of the population receiving Medicare-subsidised mental health-specific services, by demographic group, 2020–21

Horizontal bar chart showing the percentage of specific demographic populations who received Medicare-subsidised mental health-specific services during 2020–21, by key demographics. In 2020–21, patients aged 0–4 years were the lowest users of services (0.9% of people aged 0–4 years). Usage increased with age to 6.6% for people aged 5–11 and to 14.3% for 12–17 years. Patients aged 18–24 years were the highest users of services (17.7%), followed by 25–34 years (15.7%) and 35–44 (14.4%); and then gradually decreasing for older age groups 45–54 years (12.6%), 55–64 years (9.9%), 65–74 years (6.7%), 75–84 years (5.0%) and 85 years and over (3.3%). By sex, a greater proportion of the female population (13.7%) accessed services compared with males (8.6%). For remoteness area, the same proportion of people living in Major cities and Inner regional areas (11.5%) accessed services, and the percentage of the population accessing services decreased as remoteness increased: Outer regional (9.0%), Remote (6.2%) and Very remote (3.3%). Refer to Table MBS.2.

Source data: Medicare-subsidised mental health‑specific services tables 2020–21

In 2020–21, 9.3% of the Australian population received Medicare-subsidised mental health-specific services from a general practitioner; 1.8% received services from a psychiatrist; 2.2% received Psychological Therapy Services from a clinical psychologist; 3.0% received psychology services other than Psychological Therapy Services, from a psychologist (clinical psychologist or other psychologist); and 0.5% received services from other allied health professionals, noting that an individual may receive services from more than one provider type. The General Practitioners section provides further information about mental health-related GP care.

Over time

The number of people receiving Medicare-subsidised mental health-specific services increased from 1.5 million (6.9% of Australians) in 2010–11 to 2.9 million (11.2% of Australians) in 2020–21. Increases were seen for all provider types, with the greatest percentage point increase occurring for general practitioners (from 5.4% to 9.3%). The proportion of Australians accessing clinical psychologist MBS services increased from 1.1% in 20210–11 to 2.2% in 2020–21, exceeding psychiatrist MBS services (Figure MBS.3).

Figure MBS.3: Percentage of the Australian population receiving Medicare-subsidised mental-health specific services, by provider type, 2010–11 to 2020–21 

Line chart showing the percentage of Australians receiving Medicare-subsidised mental health services by provider from 2010–11 to 2020–21. The percentage of Australians receiving services from psychiatrists increased from 1.3% in 2010–11 to 1.8% in 2020–21, GPs increased from 5.4% to 9.3%, clinical psychologists 1.1% to 2.2%, other psychologists 1.9% to 3.0%, and other allied health providers 0.2% to 0.5%. The percentage of Australians receiving services from all providers increased from 6.9% in 2010–11 to 11.2% in 2020–21. Refer to Table MBS.4.

Source data: Medicare-subsidised mental health‑specific services tables 2020–21

Mental health-specific services

Services

There were 14.0 million Medicare-subsidised mental health-specific services provided to 2.9 million Australians in 2020–21. Victoria (629.3 services per 1,000 population) had the highest rate of services, and the Northern Territory (185.5) had the lowest, which was considerably lower than the national rate (544.9) (Figure MBS.4). 

Figure MBS.4: Rate (per 1,000 population) of Medicare-subsidised mental health-specific services, by state and territory, 2020–21

Vertical bar chart showing the Medicare-subsidised mental health-specific service rate (per 1,000 population), by states and territories in 2020–21. Victoria (629.3) and Queensland (558.2) had the highest rate of services per 1,000 population, greater than the national rate (544.9). In the other states and territories, New South Wales had 518.0 services per 1,000 population, followed by Western Australia (491.0), Tasmania (489.1), the Australian Capital Territory (479.1), South Australia (477.4), and the Northern Territory had the lowest rate of 185.5. Refer to Table MBS.12.

Source data: Medicare-subsidised mental health‑specific services tables 2020–21

In 2020–21, Australians aged 18–24 years had the highest rate of Medicare-subsidised mental health-specific service use (87.9 services per 100 people aged 18–24 years), and people aged 0–4 years had the lowest usage rate (2.1 services per 100 people aged 0–4 years). Females had a higher rate of service usage than males (70.5 and 38.1 services per 100 females and males, respectively). People living in Major cities had the highest rate of service use (58.8 services per 100 people living in Major cities), with rates decreasing with increasing remoteness to 10.6 for Very remote (Figure MBS.5).

Figure MBS.5: Rate (per 100 population) of Medicare-subsidised mental health-specific services, by demographic group, 2020–21

Horizontal bar chart showing the rates of Medicare-subsidised mental health services per 100 population by demographics in 2020–21. Service use in 2020–21 was lowest among patients aged 0–4 years (2.1 services per 100 population), and increased with age to 25.8 for 5–11 years, to 69.9 for 12–17 years and was highest for those aged 18–24 years (87.9), and gradually decreased for older age groups: 25–34 years (78.1), 35–44 years (71.6); 45–54 years (62.9), 55–64 years (50.6), 65–74 years (31.8), 75–84 years (20.7), and 85 years over (11.5). By sex, females accessed a greater number of services per 100 population than males (70.5 compared with 38.1 respectively). For remoteness area, the highest service rate was seen in Major cities (58.8 per 100 population) with service rates decreasing as remoteness increased: Inner regional (49.8), Outer regional (34.2), Remote (21.2) and Very remote (10.6). Refer to Table MBS.10.

Source data: Medicare-subsidised mental health‑specific services tables 2020–21

Average number of services per patient

In 2020–21, patients in Victoria had the highest average number of Medicare-subsidised mental health-specific services per patient (5.4), compared to the national average of 4.9 services per patient. The Northern Territory had the lowest number of services per patient at 3.1. The average number of services per patient for all other states and territories ranged between 4.8 and 4.5 services per patient. For the age groups analysed, people aged 55–64 had the highest average number of services per patient (5.1) and patients aged 0–4 years had the lowest (2.4). Females had more services per patient than males (5.1 and 4.4, respectively).

Over time

The total number of Medicare-subsidised mental health-specific services increased from 7.7 million in 2010–11 to 14.0 million in 2020–21; increasing from 349.5 services per 1,000 population to 544.9 in 2020–21 (Figure MBS.6). The increase in the rate of services was mainly due to increases in services provided by GPs (increase of 1.9 million from 2010–11 to 2020–21), followed by Psychological Therapy Services provided by clinical psychologists (1.8 million), and other psychological services provided by clinical psychologists and other psychologists (1.5 million). From 2010–11 to 2020–21 there was a relatively small increase in the rate of Medicare-subsidised mental health-specific services delivered by psychiatrists (0.7 million). In 2020–21 new Better Access items were added, including additional mental health-related items in response to the COVID-19 pandemic (next section) (DoH 2020). These new items are included in the data.

Figure MBS.6: Rate (per 1,000 population) of Medicare-subsidised mental health-specific services, by provider type, 2010–11 to 2020–21

Vertical bar chart showing the rate of Medicare-subsidised mental health services per 1,000 population by provider type from 2010–11 to 2020–21. The number of services per 1,000 population provided by psychiatrists increased from 90.6 in 2010–11 to 104.9 in 2020–21, GPs increased from 96.1 to 158.2 per 1,000 population, clinical psychologists 57.3 to 119.0, other psychologists 95.0 to 139.8 and other allied health professionals 10.4 to 23.0. Refer to Table MBS.12.

Source data: Medicare-subsidised mental health‑specific services tables 2020–21

Services provided via telehealth during the COVID-19 pandemic

During the course of the pandemic the Australian Government introduced a wide range of additions to the MBS to support the provision of care via telehealth, to help reduce the risk of community transmission of COVID-19 and provide protection for both patients and health care providers. These items include mental health services provided by GPs, psychiatrists, psychologists and other allied health workers.

Over 1 in 4 services (3.6 million, 25.7%) were provided via telehealth (phone or video) in 2020–21. Psychiatrists and clinical psychologists provided a higher proportion of Medicare-subsidised mental health-specific services via telehealth than other types of providers (31.0% and 29.8% respectively), and GPs provided the lowest proportion of mental health MBS services via telehealth (19.2%). More detail about the use of telehealth services during the pandemic, can be found in the Mental health impact of COVID-19 section.

Use of services during the COVID-19 pandemic

Analyses of the Medicare-subsidised mental health-specific services by quarter have been included to show seasonal variations in service use and provide more insight into the impact of events such as the pandemic. These include service and person counts reported by provider type, age group and sex.

From 2012–13 to 2018–19 the number of people receiving Medicare-subsidised mental health-specific services and the number of services being delivered was consistently highest in the April–June period and lowest in the October–December period. Note that reduced service usage is typical during public holidays and particularly over the Christmas/New Year period.

In 2019–20, an unseasonably low number of people used services in April–June (1.2 million), likely due to movement restrictions during lockdown periods. However, a relatively high number of services were still used (3.2 million), meaning more services were used per person in April–June (2.7) than in other quarters (2.4). In 2020–21, the number of people who used services was again highest in the April-June period (1.4 million), and lowest in the October-December period (1.3 million), consistent with years before 2019–20.

Providers show different patterns of activity over the year. Psychiatrists provide services to a relatively stable number of patients, while GPs and psychologists showed more seasonal variations. The number of patients accessing psychologist provided services typically peak in the April–June period; this pattern was observed in 2020–21 but not in 2019–20. For GP providers, the number of patients accessing mental health services typically peak in the January–March period; however, in 2020–21 the peak was observed in the July–September period.

Key concepts

Key concept Description
Medicare-subsidised general practitioner (GP) services Medicare-subsidised general practitioner (GP) services are services provided by medical practitioners who are vocationally registered under Section 3F of the Health Insurance Act 1973, or are Fellows of the Royal Australian College of General Practitioners or Fellows of the Australian College of Rural and Remote Medicine and meet the requirements for the relevant Quality Assurance and Continuing Medical Education program or trainees for vocational registration. GP mental health services include services provided by medical practitioners, including general practitioners, but excluding psychiatrists (DOH 2019: 107–166, 190, 218, 276–278, 456, 782 1219–1223).
Medicare-subsidised other allied mental health services Medicare-subsidised other allied mental health services are services provided by other allied mental health professionals such as occupational therapists, social workers and mental health nurses. These services cover focussed psychological strategies – allied mental health (occupational therapist and social worker items) and enhanced primary care – allied health (mental health worker item). Mental health workers include Aboriginal health workers, mental health nurses, occupational therapists and some social workers as well as psychologists. Although some psychologists are covered by this item they cannot be readily separated from the other mental health workers covered, so this item is counted under the heading of other allied mental health services. The data source section lists these item groups and MBS item numbers. For Medicare payments to be made on these items the provider (occupational therapist, social worker or other appropriate provider) must be registered with Medicare Australia as meeting the credentialing requirements for provision of the service (DOH 2019: 1225–1231, 1294,–1299 1314–1315).
Medicare‑subsidised psychiatrist services Medicare-subsidised psychiatrist services are services provided by a psychiatrist (or, for electroconvulsive therapy, by either a psychiatrist or another medical practitioner together with an anaesthetist) on a fee-for-service basis that are partially or fully funded under the Australian Government’s Medicare program. These services cover patient attendances (or consultations) provided in different settings as well as services such as group psychotherapy, telepsychiatry, case conferences and electroconvulsive therapy. These item groups along with the relevant MBS item numbers are listed in the data source section. Note that for items in the range 291 to 370 (MBS Group A8) and 855 to 866 (Case conference – consultant psychiatrist) only medical practitioners who are recognised as psychiatrists for the purposes of the Health Insurance Act 1973 are eligible to provide services attracting an MBS subsidy (DOH 2019: 69–72, 117–119, 227–237, 260–261,323, 456).
Medicare-subsidised psychologist services

Medicare-subsidised psychologist services are services provided by psychologists that are rebateable by Medicare through psychological therapy services, focussed psychological strategies and enhanced primary care items. The data source section lists these item groups with the relevant MBS item numbers. For these items to be eligible for Medicare rebates, the provider must meet the following eligibility requirements and be registered with Medicare Australia.

Medicare rebates for psychological therapy services are only available for services provided by clinical psychologists who are fully registered in the relevant jurisdiction and are members of, or eligible for membership with, the Australian Psychological Society’s College of Clinical Psychologists. Clinical membership is only available for registered psychologists who have completed the standard 4 years of study in psychology and attained an accredited doctorate degree in clinical psychology or master’s degree in clinical psychology with 1 year of supervised post-masters clinical psychology experience.

Medicare rebates for focussed psychological strategies and enhanced primary care are available for services provided by psychologists who are fully registered in the relevant jurisdiction regardless of any specialist clinical training. Registered psychologists must complete the standard 4 years of study in psychology with an additional 2 years of supervised practice, postgraduate coursework or a research degree, and meet any other jurisdiction-specific requirement for registration (DOH 2019: 77–78, 1219–1222, 1288–1291).
Psychologist (other)

Clinical psychologist includes psychological therapy services provided only by clinical psychologists. Psychologist (other) includes services provided by both clinical psychologists and other psychologists (DOH 2019: 77–78, 1286–1287, 1225–1231, 1239–1244, 1291–1294, 1305–1308, 1337).

 

Data presented covers the time period 1984–85 to 2020–21. This section was last updated in August 2022.