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How Many Psychology Sessions Can I Get Under NSW Workers Compensation?

Unlike Medicare's 10-session limit, workers compensation psychology does not have a fixed cap. Here is how session numbers are actually determined.

No Fixed Session Cap

One of the significant practical differences between Medicare psychology and workers compensation psychology in NSW is that workers compensation does not impose a hard cap on the number of sessions you can access per year.

Instead, session numbers are determined through a treatment request process:

1. Your psychologist assesses your condition and determines an appropriate treatment plan
2. They submit an Allied Health Treatment Request (AHTR) to the insurer, specifying the proposed number of sessions and clinical rationale
3. The insurer reviews the request and approves or requests modification
4. Approved sessions proceed. If further sessions are needed, the psychologist submits an additional request.

This process means the number of sessions is tied to the clinical evidence your psychologist provides, not a blanket administrative cap.

What SIRA's Clinical Framework Says

SIRA's Clinical Framework for the Delivery of Health Services provides guidance to practitioners and insurers on evidence-based session ranges for different psychological presentations. While these are guides rather than hard limits, they inform the insurer's assessment of treatment requests.

As a general orientation:

• Adjustment disorders and mild to moderate psychological injury: typically fewer sessions are expected to be sufficient
• Complex presentations such as PTSD, major depressive disorder, or anxiety disorders with significant functional impairment: more sessions may be clinically indicated and are routinely approved

Your psychologist will be familiar with the framework and will structure their treatment request appropriately. You do not need to navigate this yourself.

How Treatment Approval Works in Practice

Insurers typically approve treatment in blocks rather than an open-ended number. A common pattern:

• Initial approval for an assessment and early treatment phase (for example, 6 to 8 sessions)
• Ongoing approval if clinical progress and treatment necessity are demonstrated

Your psychologist manages the AHTR submission process. They will typically provide progress notes and clinical justification for ongoing treatment. You may be asked to participate in a treatment review; this is a normal part of the process.

What is an AHTR?

An AHTR (Allied Health Treatment Request) is the formal mechanism your psychologist uses to request and justify psychology treatment under your workers compensation claim. It includes:

• Your diagnosis and functional presentation
• Proposed treatment approach and evidence base
• Number of sessions requested
• Measurable treatment goals and expected outcomes

Your psychologist prepares the AHTR. You do not need to write it. You may be asked to provide some information about your daily functioning and work capacity to help inform it.

What If the Insurer Refuses or Limits Sessions?

Insurers can decline or limit treatment requests. If this happens:

• Your psychologist can provide additional clinical evidence or appeal the decision
• You can request an internal review from the insurer
• SIRA has dispute resolution mechanisms for workers with objections to insurer decisions
• A workers compensation lawyer or the icare recovery team may be able to assist

This directory does not provide legal or insurance advice. For disputes about treatment approval, contact icare directly or consult a workers compensation lawyer.

How This Compares to Medicare

Feature	Workers Comp (icare/SIRA)	Medicare (Better Access)
Session limit	No fixed cap: determined by insurer approval of AHTR	Up to 10 per calendar year
Who determines session count	Psychologist (AHTR) + insurer approval	GP (MHTP) + Medicare rules
Review process	Treatment requests reviewed by insurer; further sessions require new AHTR	GP review required after 6 sessions for additional 4
Out-of-pocket cost	Typically nil for approved sessions	Gap fee applies (rebate is partial)