You're around session six. Things are finally starting to shift. You're beginning to trust your psychologist, you're saying things out loud you've never said before, and then the maths hits you: four sessions left for the rest of the year.
Or maybe you've already hit the wall. The rebate has run out, the next appointment costs the full fee, and you're not sure if you can afford it. You feel priced out of support.
Either way, a quiet worry sets in: what do I do when the rebate runs out and I still need support?
First, you haven't done anything wrong
If you need more than ten sessions, it doesn't mean you're doing therapy wrong, or that you're "too much", or that it isn't working. It means ten sessions was never designed with the therapy process in mind.
If you're attending fortnightly, ten sessions will spread across roughly five months. That's less than half a year, and for complex, long-standing or layered experiences, it's often just the beginning of the work.
Some people take a few sessions to even warm up to someone new. Others go to therapy to work on one thing and realise that something else is beneath the surface that they want to focus on instead.
It's a big ask to achieve your goals in ten hours of work, no matter how legendary the practitioner you're working with is!
What the plan gives you, and what it doesn't
A Mental Health Treatment Plan (MHTP), previously called a Mental Health Care Plan (MHCP), is a valuable initiative in theory. Through your GP, it gives you access to Medicare rebates for eligible psychology services, for up to ten individual sessions per calendar year under the Better Access program.
As of 1 July 2026, the Medicare rebate is approximately $149.05 for a clinical psychologist and $101.55 for a general psychologist. The Australian Psychological Society suggests a fee of $330 for a standard session, although psychologists set their own rates and many charge less.
Even so, most people are left with a gap of around $100 or more per session. Then, after ten individual sessions, you're expected to pay the full fee if you want to continue accessing support.
Accessing Medicare rebates through Better Access also requires a clinically diagnosed mental disorder and a referral from an eligible medical practitioner such as a GP. That pathway works well for some people. For others, particularly those who don't identify with a diagnostic framework or whose experiences don't fit neatly into one, it can feel like an awkward starting point.
The limits are real:
Ten individual sessions often aren't enough.
The full fee is out of reach for many people, so support can end because the money has, not because you're finished.
It's built around a clinical assessment and diagnosis. That helps some people, but it isn't the right fit for everyone.
It goes through your GP. Not everyone wants a mental health plan documented in their GP's clinical records, and not everyone has a GP they feel safe with.
The count resets in January, so timing matters.
There are also up to ten group therapy services available separately under Better Access, although these won't suit everyone's needs.
None of this is a criticism of psychologists or GPs. It's a limit of the system, and knowing the limits helps you plan around them.
If you're still in your sessions: what you can do now
If you know your sessions are running out, there are a few things you can do before you get there.
Tell your psychologist early. Don't wait for the last session. Good clinicians plan endings with you and can help you use the remaining sessions well.
Ask about spacing sessions out. Moving from fortnightly to every three or four weeks can stretch your rebated sessions across more of the year, although it may not be appropriate for everyone's needs.
Decide what you most want covered. What would you like to work through by session ten? What could continue somewhere else?
Ask about lower-cost options. Some psychologists offer reduced fees, or can refer you to lower-cost services.
Think about the January reset. If you're close to the end of the year, a short break might line up with new sessions becoming available.
Decide what you want next. A break, a handover, or a different kind of support are all legitimate choices.
If your sessions have run out: your options
There isn't one right path. These are all valid:
Stay with your psychologist
You can continue seeing your psychologist at the full fee, or less often if that's financially and clinically appropriate. You don't have to stop simply because the Medicare rebate has run out.
Wait for the January reset
Your Better Access individual session allocation resets each calendar year. Depending on your circumstances and treatment needs, you may choose to take a break and return when new sessions become available.
Medicare Mental Health
Medicare Mental Health offers free, confidential mental health and wellbeing support without a referral or Mental Health Treatment Plan.
You can:
Call 1800 595 212 between 8.30am and 5pm on weekdays, excluding public holidays, to speak with someone who can help you find appropriate support.
Visit a Medicare Mental Health Centre if there's one near you. No appointment or referral is needed.
Explore Medicare Mental Health Check In, a free online service for people aged 16 and over experiencing mild mental health challenges. It offers evidence-based online tools, with the option of support from a qualified practitioner via telehealth.
You can find information about available services, support and local centres through Medicare Mental Health.
You can explore the free online service at Medicare Mental Health Check In, which offers evidence-based tools and optional practitioner support.
These services can offer short- to medium-term support and help connect you with other services. They're not necessarily a replacement for ongoing therapy, but they can be a useful place to start.
Community and PHN-funded services
Your GP or local Primary Health Network (PHN) can tell you what's available in your area. Some community services offer free or low-cost counselling and psychology, although eligibility, availability and waiting times vary.
Private health extras
Some private health funds cover part of the cost of counselling or psychology. Cover and eligibility rules vary, including which practitioners your fund recognises. You generally can't claim private health insurance and Medicare for the same session, so check with your fund first.
An Employee Assistance Program (EAP)
If your workplace offers an EAP, you may be able to access a limited number of free counselling sessions. These can be useful for work-related stress and other personal challenges, although session limits and confidentiality arrangements vary.
Other counselling services
Private counselling can be another option if you want ongoing support without needing a Medicare referral or diagnosis. Fees vary between practitioners, and some offer reduced rates or lower-cost places.
Could counselling be a good next step?
Counselling is a form of mental health and emotional support. Unlike psychology sessions accessed through Better Access, private counselling generally isn't Medicare-rebated, so it isn't subject to a Medicare session limit.
You don't need a GP referral or mental health diagnosis to access counselling. This means you can choose to continue working with someone for as long as it feels useful and financially sustainable.
Counselling can be a good fit if you:
Need longer-term support.
Want a relational space that's led by you.
Are looking for support around a particular area of your life or experience.
Aren't looking for a diagnosis, or symptom reduction isn't your main goal.
Want support that looks at the whole picture, including your history, relationships and the systems around you, not only symptoms. This matters especially for neurodivergent and queer people, and for anyone who's felt reduced to a label.
Are working on identity, relationships, life transitions or making sense of your story.
For example, my counselling work often resonates with people who've quietly struggled, felt they don't quite fit the mould, or haven't always felt understood in more traditional clinical settings. I particularly work with queer and gender-diverse people, neurodivergent people and women navigating the complexities of identity, expectations and wellbeing.
My approach makes space for experiences that might sit somewhere between clinical and non-clinical understandings of distress, drawing on therapeutic and non-pathologising ways of supporting wellbeing. I aim to offer a relational, affirming and anti-oppressive space where you can explore what matters to you without feeling the need to fit a conventional mould.
I'll be upfront about the trade-off: counsellors can't offer the Medicare rebate, so counselling is generally paid in full, although some private health extras may cover part of the cost. Counselling fees vary, and some practitioners offer lower-cost options.
It doesn't have to be either/or
Counselling and psychology can sit side by side, or follow one another.
Some people see a psychologist for a block of structured work and a counsellor for ongoing support. Others move between them over time.
If you're exploring counselling while seeing a psychologist, I'd encourage you to tell them. Coordinated care tends to work better, and a good psychologist will want to know what's supporting you. If you come to see me, I'm happy to work alongside your other supports.
When a GP, psychiatrist or psychologist might be the right addition
Counselling is a form of mental health and emotional support, and many people see a counsellor alongside medication, a GP or other treatment.
But some things sit outside what a counsellor can do, and you may want a GP, psychiatrist or psychologist involved if:
You want a formal diagnosis or assessment. For example, for ADHD or autism, including for work, study or funding. Counsellors don't generally provide formal diagnostic assessments or diagnose mental health conditions.
You'd like to explore medication. A GP or psychiatrist can prescribe and review it. If you're already taking medication, you're welcome in counselling, and it's helpful to keep your prescriber in the loop.
Your symptoms are getting worse or affecting your safety. You can still have counselling, and it's worth adding medical support too, so you have more than one person looking out for you.
You want a structured treatment program for a specific condition. For example, a specialised eating disorder or OCD program, which may involve a dedicated clinical team.
Counsellors can work with emotional distress, anxiety, relationships and other mental health concerns, but their training, qualifications and scope of practice differ from those of psychologists and medical practitioners.
If you're experiencing an immediate risk to your safety, you may need urgent or crisis support rather than waiting for a counselling appointment. In an emergency, call 000 or attend your nearest emergency department.
Questions to help you decide
If you're not sure what to do next, these questions might help:
What do I most need more time for?
What can I realistically sustain, financially and for how long?
Would a diagnosis help me (for access, validation or funding), or would it feel like a label I don't want?
Do I want a space where I'm not being assessed?
What would feel like support, rather than just another thing to get through?
There are no right answers. They're here to help you choose.
Frequently asked questions
What happens when my Medicare mental health sessions run out?
You can keep seeing your psychologist at the full fee, wait for the January reset, or look at other options such as Medicare Mental Health services, community services, private health extras, an EAP or counselling.
Can I get more than 10 Medicare psychology sessions?
Under the standard Better Access program, rebates are capped at ten individual sessions per calendar year. There are also up to ten group therapy services available separately.
The temporary increase to 20 individual sessions during the COVID-19 pandemic ended in 2022.
Some other Medicare pathways may provide additional support depending on your circumstances. These include:
Eating Disorder Treatment and Management Plans, which have their own eligibility criteria and treatment arrangements.
GP Chronic Condition Management Plans, which can provide up to five Medicare-rebated individual allied health services per calendar year, shared across eligible providers. Psychologists are among the eligible providers, but these aren't automatically five additional psychology sessions.
Eligibility and session limits differ, so speak with your GP about whether either pathway applies to you.
You can find out more about eligibility and available services through Services Australia – Chronic Condition Management Plans.
Is counselling cheaper than seeing a psychologist?
It depends on the practitioner. Counselling fees vary, but some counsellors charge less than the average private psychology fee.
My standard fee is $130 per session, and I also offer lower-cost counselling from $70 through Rough Patch Counselling.
Counselling generally isn't eligible for the Medicare rebate, although some private health extras may cover part of the cost.
Can I see a counsellor and a psychologist at the same time?
Yes. Many people do. It's a good idea to let both practitioners know so your care is coordinated and everyone understands the support you're receiving.
Can I claim counselling on Medicare?
Generally, no. Private counselling isn't covered under the Better Access program, although some private health extras may cover part of the cost. Check with your fund and counsellor about eligibility.
Do I need a diagnosis to see a counsellor?
No. You don't need a mental health diagnosis or a GP referral to access private counselling.
Can I see a counsellor online anywhere in Australia?
Yes. Many counsellors offer online sessions, which can make support more accessible if you live outside a major city, have limited local options or simply prefer meeting from home.
Check that your counsellor is appropriately qualified and that online sessions are suitable for your needs.
How I work
I'm Liz, an ACA registered counsellor, the founder of Among Puffins Counselling, and I'm passionate about helping people navigate the mental health system and find support that feels right for them.
I offer a warm, collaborative, affirming space that's led by what matters to you. I work with neurodivergent, queer and gender-diverse people, and women carrying heavy expectations, via online sessions available across Australia.
My approach is relational, holistic and integrative. I'm interested in the whole person, not just a list of symptoms or a diagnosis.
I draw on different therapeutic approaches depending on you, your experiences and what you're hoping to get from counselling. Sometimes that might mean practical, action-oriented work focused on specific goals or creating change in your day-to-day life. At other times, it might involve slower, more exploratory work, paying attention to what's happening in your body, exploring patterns and experiences through a somatic, bottom-up approach, or making space for relational work and the experiences that have shaped you.
There's no single way counselling has to look. We can find an approach that feels right for you, and that can change as your needs and goals change.
Fees: $130 per session. I also offer low-cost counselling from $70 through Rough Patch Counselling.
Hours: Tuesdays and Thursdays, 10am–8pm, with limited availability outside these hours upon request.
Booking: You're welcome to book a free 15-minute introductory call. There's no pressure to commit. It's an opportunity to ask questions, get a feel for how I work and decide whether it feels like the right fit.
Book your free 15-minute introductory call or contact me here.
If you're reading this because your sessions have run out, I hope you know that you don't have to have everything figured out right now.
You can take time to consider what kind of support feels right, what you can afford and what you want the next chapter of your care to look like. It’s also okay to be angry, disappointed and frustrated at the limits of our current mental health system.
You deserve support that works for you, not just support that fits within a calendar or a budget.