What Counselling Actually Costs in Melbourne, and What Medicare Does Not Cover

Money is the question people are most reluctant to ask and most likely to be deciding on.

So here it is, including the parts that do not favour me, because a decision made on wrong numbers is worse for everyone.

Figures below were checked on 27 July 2026. Fees and rebates change. The Medicare schedule is indexed every July.

What You Will Actually Pay

The Australian Psychological Society publishes a suggested fee. For 2026 to 2027 it is $330 for a standard consultation of 46 to 60 minutes. It is worth knowing that number exists, and worth knowing that almost nobody charges it. Across published Melbourne clinic fee pages this year, the real market sits well below it.

Typical Melbourne rates, mid 2026:

• Registered or general psychologist: roughly $215 to $245
• Clinical psychologist: roughly $250 to $310
• Provisional psychologist: roughly $130 to $160
• Counsellor or psychotherapist: roughly $90 to $180
• Psychiatrist, initial consultation: several hundred dollars and often well over $600, with reviews substantially less. This one varies enormously, so ask before you book
• University and training clinics: $0 to $90

The counsellor range is the softest number here. Relatively few independent counsellors in Melbourne publish their fees, and several listings that look like counsellors are provisional psychologists.

How Medicare Works, and What Changed in November 2025

Under the Better Access initiative, which covers psychiatrists, psychologists, GPs and some other providers, you can receive up to 10 individually delivered subsidised sessions per calendar year, plus up to 10 group sessions. Not per referral. Not per financial year. If you use all 10 by December, the count resets on 1 January and not before.

The referral comes in two parts. Your GP prepares a Mental Health Treatment Plan covering an initial course of up to six sessions. You return for a review, and a re-referral covers the remainder up to your annual cap of 10.

Three changes took effect on 1 November 2025, and most fee pages online have not caught up.

The first is the one that trips people up. The plan and any referral must now come from a GP at the practice you are enrolled with under MyMedicare, or from your usual medical practitioner, meaning the GP or practice providing the majority of your care. You can no longer walk into any bulk billing clinic to obtain a plan. Referrals direct from a psychiatrist or paediatrician are exempt.

Second, twelve MBS item numbers were abolished: six review items and six ongoing mental health consultation items. Reviews and re-referrals are now billed under standard GP consultation items. If you read anywhere that your GP bills item 2712 for the review, that page is out of date.

Third, referrals dated before 1 November 2025 remain valid for the sessions attached to them.

Current rebates, as at the 1 July 2026 indexation:

• Clinical psychologist, session of 50 minutes or more (item 80010): $149.05
• Registered or general psychologist, session of 50 minutes or more (item 80110): $101.55
• Accredited mental health social worker, standard session: $89.50

Which means, in practice, that a clinical psychologist charging $275 leaves you about $126 out of pocket, and a general psychologist charging $235 leaves you about $133. Preparing the plan with your GP is usually bulk billed, though practitioners set their own fees and are under no obligation to bulk bill anything.

A headline fee tells you almost nothing. The number that matters is the gap, multiplied by the number of sessions you will actually need.

Why Counselling Sits Outside Medicare

I am a PACFA registered counsellor. There is no Medicare rebate for what I do, and I want to explain why rather than leave it as an awkward silence.

Better Access is restricted by legislation to a defined list of providers: psychiatrists, eligible clinical psychologists, registered psychologists, GPs and prescribed medical practitioners with the relevant training, accredited mental health social workers, and occupational therapists. Counsellors and psychotherapists are not on that list. There is no item number I could bill against even if I wanted to.

The reason is structural rather than clinical. Medicare provider recognition is built on AHPRA registration or AASW accreditation. Counselling and psychotherapy in Australia are self-regulated, with no national statutory register and no AHPRA board. Bodies like PACFA and ACA set and enforce their own standards, and those standards are substantial, but they are not statutory.

That may change. National Standards for counsellors and psychotherapists were published in October 2025, and in early 2026 the Nous Group was engaged by government to identify the best regulatory model, with a report expected during the year. PACFA has long argued for statutory regulation of the profession, and has been explicit that rebate access is part of what is at stake. Nothing has been decided, and I would not plan your care on the assumption that it will be.

One consequence is worth stating plainly. Because counselling attracts no Medicare rebate, seeing a counsellor does not use up any of your 10 Better Access sessions. Working with a psychologist under a treatment plan and seeing a counsellor in the same year are separate arrangements, and neither erodes the other. Whether that is a sensible way to structure your care is a question for you and your GP.

Private Health, and the Genuinely Free Options

A number of funds do recognise PACFA registered counsellors, including Medibank, ahm, Bupa, Teachers Health, Police Health and Emergency Services Health. Many smaller funds recognise counsellors through the ARHG accreditation scheme. Several recognise only AHPRA registered psychologists. Three things to check before assuming you are covered: whether counselling is on your specific policy rather than the fund generally, what the waiting period is, since two months is common, and whether the annual limit is shared with extras you have already claimed. Counselling benefits are consistently set lower than psychology benefits on the same policy. Ask about telehealth separately, because the answers are inconsistent.

Free and low cost in and around Carlton:

• University of Melbourne Psychology Clinic, Level 2, 138 to 146 Cardigan Street, Carlton. Sessions are delivered by supervised postgraduate students at substantially reduced fees. Ring (03) 9035 5180 for the current rate.
• Cairnmillar Institute Community Clinic, with sites including North Melbourne and the CBD as well as Hawthorn East. Free, no referral needed, from age 4. 1800 391 393. Sessions are delivered by practitioners in training and placements run 12 to 20 weeks, so continuity is capped.
• Swinburne Psychology Clinic, Hawthorn. Sliding scale from $20 to a maximum of $80, plus a $10 administration fee for the first appointment. Flat $20 if you are unemployed or hold a pension or health care card. (03) 9214 8653.
• Medicare Mental Health, 1800 595 212, weekdays 8:30am to 5pm. A free national phone line that will tell you what free and low cost services currently operate near you. It is not a crisis line.
• headspace for ages 12 to 25. Collingwood is on Lulie Street, Abbotsford, (03) 9417 0150, and is free. Other sites charge a gap, so check the one you plan to attend.
• cohealth, counselling intake (03) 9448 5521. Reduced fees for concession card holders, and bulk billed sessions for some groups including refugees and asylum seekers.
• Mental Health and Wellbeing Locals, free, no referral, no Medicare card, for ages 26 and over. There is no Local in Carlton itself. The nearest is Darebin, 1800 979 545.
• Open Arms, free counselling for current and former ADF members and their families, 1800 011 046.

If you need someone tonight: Lifeline 13 11 14. Beyond Blue 1300 22 4636. 13YARN 13 92 76. Suicide Call Back Service 1300 659 467. NURSE-ON-CALL, Victoria only, 1300 60 60 24. All operate 24 hours.

The Question Underneath the Question

Most people asking about cost are not doing arithmetic. They are asking whether this is a reasonable thing to spend money on when the money could do other things.

I cannot answer that for you. What I can say is that the answer changes depending on what you are buying. Six sessions on something specific is a different financial decision from an open ended arrangement, and it is fair to ask a practitioner which one they think you need before you commit to either.

None of the above is financial or clinical advice, and figures change. If you want to talk it through, a short conversation is the next step. No obligation, just a chance to see if working together feels right.