The short answer
Yes, if you want a Medicare rebate. You need a valid referral, usually from your GP, to claim the specialist rebate for a psychiatrist, whether you're seen in person or by telehealth. You can see a psychiatrist privately without one, but any Medicare benefit is lower and you'll pay more. A GP referral can lead to ongoing care with the psychiatrist, or a one-off assessment and management plan that your GP then follows.
On this page
Do I need a referral to see a psychiatrist?
To get money back from Medicare, yes. You need a valid referral to claim the specialist rebate for a psychiatrist, and that applies whether you're seen in person or by telehealth [1][2].
Most referrals come from a GP. Under Medicare rules, a nurse practitioner can also refer you, and specialists can refer to each other, ideally with your GP kept in the loop [1][3]. A psychiatrist doesn't have to accept a referral, so check they're taking new patients when you call to book [1].
If you need help now: if you're in crisis or thinking about suicide, call Lifeline on 13 11 14 or text 0477 13 11 14. If a life is in danger, call 000 [4].
GP referral vs a psychiatrist assessment and management plan (item 291)
A GP referral to a psychiatrist usually leads to one of two things under Medicare.
Ongoing care with the psychiatrist. The psychiatrist assesses you and keeps seeing you to manage your treatment. A long first appointment (more than 45 minutes) for a new patient is billed as item 296 [5].
A one-off assessment and management plan (item 291). The psychiatrist sees you once, for more than 45 minutes, does a full diagnostic assessment and mental state examination, and decides your GP can look after your care from there. Within 2 weeks, they send your GP a written report with the assessment and a management plan for the next 12 months. Where it's appropriate, they explain it to you and give you a copy [6]. The idea is that you get specialist input while your GP keeps managing your care [7].
| Ongoing care | Assessment and management plan | |
|---|---|---|
| Main Medicare item | 296 for the first long appointment [5] | 291 [6] |
| Who can refer | A referring practitioner, usually your GP [5] | A GP (or another doctor in general practice) or a participating nurse practitioner only [6][7] |
| Who manages you afterwards | The psychiatrist, working with your GP | Your GP, following the psychiatrist's plan [6] |
| How often | As many appointments as you need | Once in 12 months. Your GP can ask for one review of the plan in that time [6][7] |
A few practical points:
- If another specialist, such as a paediatrician or neurologist, thinks you need an item 291 assessment, the referral should go through your GP [7].
- If the psychiatrist decides your needs are too complex for your GP to manage, they can take on your ongoing care under other items instead [7].
- After an item 291 assessment, the psychiatrist may see you once or twice more for short-term help, for example to monitor a new medicine before handing your care back to your GP [7].
Can I see a psychiatrist without a referral?
Yes, as a private patient. Without a valid referral, the psychiatrist can only bill a different Medicare item, so any benefit is lower and you'll likely pay more out of pocket [1][3].
Two other things affect what you pay:
- Public mental health services. If you see a psychiatrist in a public hospital or public community health service, you generally won't have to pay [8].
- Private health insurance. Appointments with a private psychiatrist outside a hospital stay aren't covered. Insurance can cover psychiatrist consultations while you're admitted to hospital [8].
How much does a psychiatrist cost with a referral?
Psychiatrists set their own fees. With a valid referral, Medicare pays a rebate and you pay any difference, often called the gap fee [8]. As at the 1 July 2026 fee update (checked November 2026):
| MBS item | What it covers | Schedule fee | Medicare benefit |
|---|---|---|---|
| 291 | Assessment and 12-month management plan for your GP | $549.90 | $467.45 [6] |
| 296 | First consultation over 45 minutes, new patient | $316.30 | $268.90 [5] |
Ask the psychiatrist's rooms what they charge, and what you'll get back from Medicare, before your first appointment.
Can I see a psychiatrist by telehealth?
Yes. Medicare has ongoing telehealth items for psychiatry, and video is the preferred option, with phone used where it's clinically appropriate [9]. Item 291 and the first long consultation for a new patient both have video versions but no phone versions. Some shorter follow-up consultations can be done by phone [9].
You'll usually still need a GP referral to see a psychiatrist by telehealth. Some things, such as a physical check-up or prescribing certain medicines, may still need a face-to-face visit [2].
The GP referral itself can come from a telehealth consult. Medicare rules require the GP to have attended you and considered whether you need a referral, and the referral to be written, signed and dated [3]. They don't say that consult has to be in person, and electronic referrals are allowed [1]. Read more in can you get a referral online.
What should a psychiatrist referral include, and how long does it last?
A valid referral includes the reason for referring you, the date and the referring practitioner's signature. It should also include relevant clinical information about your mental health [1]. It doesn't have to name a particular psychiatrist [1]. Our guide to referral letters covers what's usually in one.
| Who wrote it | How long it lasts |
|---|---|
| Your GP | 12 months, unless they write another period or make it indefinite for ongoing care [1] |
| Another specialist | 3 months, unless you're an admitted hospital patient [1] |
The period starts at your first appointment with the psychiatrist, not the date it was written [1]. Once you've started with one psychiatrist, switching to another needs a new referral [1]. There's more in how long a referral lasts.
Psychiatrist or psychologist?
Seeing a psychologist under Medicare is a separate pathway with its own referral rules. If that's what you're after, read do I need a referral for a psychologist. Your GP can talk through which kind of support suits your situation.
Getting a referral
Referral GP offers telehealth consultations by phone or video with AHPRA-registered Australian GPs. If your GP agrees a psychiatrist is the right next step, they can write a referral, including for an assessment and management plan where that fits your situation.
A consultation doesn't guarantee a referral. Your GP decides what's clinically appropriate.
Bulk billed for eligible patients. If you're not eligible, a consultation fee may apply, and we'll confirm it with you before your consult.
We're not an emergency service. If you're in crisis, call Lifeline on 13 11 14, or 000 if a life is in danger [4].
Start a mental health referral consult
This page is general information, not medical or legal advice.
Common questions
Can I see a psychiatrist without a referral?
What is a psychiatrist assessment and management plan (item 291)?
It's a one-off appointment of more than 45 minutes where the psychiatrist does a full assessment and decides your GP can manage your care. Within 2 weeks they send your GP a written report with your diagnosis and a 12-month management plan [6]. The referral must come from a GP or participating nurse practitioner [7].
Can my GP refer me to a psychiatrist after a telehealth consult?
Can I see a psychiatrist online with a Medicare rebate?
How long does a referral to a psychiatrist last?
A GP referral lasts 12 months from your first appointment unless the GP writes a different period or makes it indefinite. A referral from another specialist lasts 3 months [1].
References
- MBS Online. Factsheet: Referrals for specialist services. Last updated August 2026. Accessed November 2026. mbsonline.gov.au/internet/mbsonline/publishing.nsf/650f3eec0dfb990fca2
- Royal Australian and New Zealand College of Psychiatrists, Your Health in Mind. Seeing a psychiatrist online (telepsychiatry). Last reviewed November 2024. Accessed November 2026. yourhealthinmind.org/psychiatry-explained/seeing-a-psychiatrist-online
- MBS Online. Explanatory note GN.6.16: Referral of patients to specialists or consultant physicians. Accessed November 2026. www9.health.gov.au/mbs/fullDisplay.cfm?type=note&q=GN.6.16&qt=noteID
- Lifeline Australia. Crisis support. Accessed November 2026. lifeline.org.au
- MBS Online. Item 296: Consultant psychiatrist, referred, new patient, more than 45 minutes. Schedule fee updated 1 July 2026. Accessed November 2026. www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=296&qt=item
- MBS Online. Item 291: Consultant psychiatrist, referred patient assessment and management plan. Schedule fee updated 1 July 2026. Accessed November 2026. www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=291&qt=item
- MBS Online. Explanatory note AN.0.30: Consultant psychiatrist, referred patient assessment and management plan (items 291, 92435, 293, 92436). Accessed November 2026. www9.health.gov.au/mbs/fullDisplay.cfm?type=note&q=AN.0.30&qt=noteID
- Royal Australian and New Zealand College of Psychiatrists, Your Health in Mind. Cost to see a psychiatrist. Last reviewed November 2024. Accessed November 2026. yourhealthinmind.org/psychiatry-explained/cost-to-see-a-psychiatrist
- MBS Online. Explanatory note AN.40.1: Specialist and consultant physician MBS telehealth (video and phone) attendance items. Accessed November 2026. www9.health.gov.au/mbs/fullDisplay.cfm?type=note&q=AN.40.1&qt=noteID
Published by Referral GP. Last updated 6 November 2026. This page is general information only and isn’t a substitute for advice about your own situation. If you or someone else is in danger, call 000.