If you’ve seen the headlines about Medicare mental health sessions changing again, you’re probably confused. You’re not alone. The messaging around this has been murky at best, and a lot of people are worried about what it means for their access to affordable psychological support.

Let me break it down as clearly as I can.

What’s Actually Changing

The Federal Government announced in late January 2026 that the Medicare Better Access Initiative — the scheme that funds subsidised psychology sessions — is being restructured as part of a broader mental health reform package.

Here are the key changes taking effect from July 2026:

Session allocation is shifting to a tiered model. Instead of a flat allocation of sessions per calendar year, patients will be assessed and placed into one of three tiers based on clinical need. Tier 1 (mild-moderate needs) will receive up to 10 sessions. Tier 2 (moderate-severe) gets up to 16. Tier 3 (complex and ongoing) can access up to 20, with a review pathway for extensions.

GPs will play a larger gatekeeping role. The initial mental health treatment plan from your GP will now include a more detailed assessment tool to determine which tier you fall into. This has been the most controversial part of the announcement, with some clinicians arguing that GPs aren’t always best placed to assess psychological complexity.

Gap fees remain unaddressed. Despite widespread calls for reform, the scheduled fee for psychology sessions under Medicare hasn’t been significantly increased. The rebate still covers roughly a third to a half of what most psychologists charge, which means out-of-pocket costs remain a barrier for many Australians.

Why This Is Happening

The government’s stated reasoning is that the current system doesn’t differentiate well between people with varying levels of need. Under the existing flat model, someone experiencing mild adjustment difficulties receives the same allocation as someone managing complex PTSD. The argument is that a tiered approach allows resources to be directed more effectively.

There’s also an undeniable funding dimension. Mental health service demand has surged since the pandemic, and the system is stretched. Wait times for psychologists in many parts of Australia — particularly regional areas — are still measured in months, not weeks.

Health Minister Mark Butler has framed the changes as “ensuring the right support reaches the right people at the right time.” Critics, including the Australian Psychological Society, have pointed out that restricting access at the lower tiers could mean people don’t get help early enough, potentially leading to worse outcomes down the line.

What This Means If You’re Currently Seeing a Psychologist

If you’re mid-treatment right now, your current plan won’t be affected until it expires. Any sessions already approved under your existing mental health treatment plan will be honoured.

If you’re starting a new plan after July 2026, your GP will use the new assessment framework to determine your tier. If you disagree with the allocation, you can request a review — though the process for this hasn’t been fully outlined yet.

If you’re on a waitlist, the changes don’t directly address wait times. The government has announced additional funding for mental health nurses and peer support workers, but the psychology workforce shortage remains the core bottleneck.

The Gap Fee Problem Nobody’s Fixing

I want to be direct about this, because it’s the elephant in the room. The rebate for a standard 50-minute psychology session under Medicare is currently around $93. Most psychologists in metropolitan areas charge between $200 and $280 per session. That gap of $100 to $190 per session is simply not accessible for many Australians on lower incomes.

Bulk-billing psychologists exist, but they’re rare and their waitlists are often the longest. The practical reality is that for many people, the number of sessions Medicare funds matters less than whether they can afford the gap.

What You Can Do

Talk to your GP. If you’re concerned about how the changes will affect your care, raise it at your next appointment. GPs are still getting across the details too, so don’t assume they’ll bring it up.

Check your private health insurance. Some extras policies cover psychology sessions. It might be worth reviewing your plan to see if it offsets the gap.

Look into community options. Headspace (for under-25s), community health centres, and university psychology clinics often offer low-cost or free sessions.

Stay informed. The details are still being finalised. Consumer advocacy groups like SANE Australia and Beyond Blue are tracking the changes.

The Bigger Conversation

Mental health funding in Australia has always been a patchwork — a bit of Medicare here, a bit of state funding there, private insurance for those who can afford it, and a lot of people falling through the cracks.

These changes are an attempt to make the system more efficient, but efficiency without adequate funding just means rationing. And rationing mental health care has consequences that show up in emergency departments, workplaces, families, and communities.

If you’re struggling right now, please reach out. Lifeline is available 24/7 on 13 11 14, and Beyond Blue can be reached at 1300 22 4636.

Jess Morley is a Brisbane-based wellness writer and yoga instructor. She writes about evidence-based wellbeing at SoulShine.