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icare Psychology NSW: What icare Covers, How Billing Works, and How to Access Treatment

Last reviewed: June 2026 • Sources: SIRA NSW, icare NSW, Workers Compensation Act 1987 (NSW)

If you have a NSW workers compensation claim and need psychological support, you may have been told that icare covers it—but not had a clear explanation of what that means in practice. This guide explains what icare funds for psychology, how the payment process actually works (including who pays the psychologist, and when), how to get sessions approved, and how telehealth fits in.

For the full step-by-step pathway from injury to first session, see our psychological injury guide. For help choosing a SIRA-approved psychologist, see our practitioner choosing guide.

What is icare and how does it relate to workers compensation psychology?

icare (Insurance and Care NSW) is the NSW Government agency that acts as the insurer for most workers compensation claims in NSW. It was established in 2015 when WorkCover NSW was divided into two bodies: icare (the insurer) and SIRA (the regulator). When people talk about "WorkCover" in NSW today, they usually mean the icare/SIRA system.

In workers compensation, icare's role for psychology is to:

• Receive and assess Allied Health Treatment Requests (AHTRs) submitted by your treating psychologist
• Approve or decline treatment funding for psychology sessions
• Pay the psychologist directly at the SIRA gazetted rate once sessions are approved
• Coordinate with your employer and return-to-work coordinator where relevant

SIRA (the State Insurance Regulatory Authority) is the separate body that sets the rules icare must follow, maintains the SIRA health provider register (including approved psychologists), and sets the fee schedule (gazetted rates) that icare pays providers. You do not deal with SIRA directly in most claims—icare is your main point of contact as the insurer.

What does icare cover for psychology?

icare funds psychological treatment that is reasonably necessary as a result of a compensable workplace injury. "Reasonably necessary" is a defined standard under the Workers Compensation Act 1987 (NSW) and involves clinical assessment by the treating practitioner and, in some cases, review by the insurer's own advisors.

Types of psychology sessions funded

icare funds individual psychological treatment sessions provided by a SIRA-approved psychologist. The SIRA fee schedule uses the following billing items for psychology:

Telehealth and in-person sessions are funded at the same rate. There is no financial penalty for choosing telehealth under the NSW workers compensation scheme.

Is there a session cap?

Unlike Medicare's Better Access scheme, which limits you to 10 psychology sessions per calendar year, icare does not impose a fixed annual cap on psychology sessions. The number of sessions funded depends on:

• The clinical recommendations in your treating psychologist's AHTR (Allied Health Treatment Request)
• The insurer's assessment of whether further treatment is reasonably necessary
• Your diagnosis and progress toward your return-to-work or recovery goals

As a rough guide, SIRA's Clinical Framework indicates that adjustment disorders often need 8–16 sessions, and trauma/PTSD presentations typically require 16–24 sessions, though individual needs vary significantly. Your treating psychologist will specify the number requested in the AHTR and provide clinical reasoning.

What icare does not cover

icare does not fund:

• Psychology sessions that are not related to the workplace injury (for instance, pre-existing conditions unconnected to work)
• Sessions with a psychologist who is not SIRA-approved
• Sessions that commence before an AHTR is approved (unless there is an exceptional urgent situation—discuss with your insurer)
• Psychology for a psychological injury that has been deemed non-compensable (e.g., injury caused solely by reasonable management action under section 11A of the Workers Compensation Act 1987)
• Group therapy or couples therapy under SIRA psychology items

How billing and payment actually work

One of the most common points of confusion is who pays, and when. Here is how it works:

Step 1: AHTR approval

Your treating psychologist submits an Allied Health Treatment Request (AHTR) to icare specifying the diagnosis, proposed number of sessions, treatment approach, and return-to-work goals. icare must respond within statutory timeframes (10 business days for routine; 3 business days for urgent). If approved, icare issues an approval letter that specifies the number of sessions and the period covered.

Step 2: Sessions are delivered

You attend your psychology sessions (in person or via telehealth). You do not pay anything at the point of service for approved sessions. The psychologist keeps clinical notes and records the billing item (e.g., PSY301 for a 60-minute telehealth session).

Step 3: Psychologist invoices icare

After each session (or in batches), the psychologist submits an invoice to icare at the SIRA gazetted rate. The invoice references your claim number, the relevant SIRA billing item, the date of service, and the number of sessions delivered.

Step 4: icare pays the psychologist

icare processes the invoice and pays the psychologist directly. Standard payment terms vary, but providers typically invoice electronically via the icare provider portal. You are not involved in this step and do not receive a bill.

If sessions run out before treatment is complete

When the approved number of sessions is nearly exhausted, your treating psychologist should submit a new AHTR (renewal) requesting additional sessions with updated clinical notes and progress information. Plan ahead: aim to submit the renewal AHTR at least 2 sessions before the approved number is exhausted to avoid a gap in treatment while waiting for approval.

Getting psychology treatment approved through icare

The pathway to approved icare psychology is:

1. Report your injury to your employer and make sure it is formally registered.
2. See your GP. Your GP issues a workers compensation certificate of capacity (Form 2888) and can refer you to a psychologist for psychological injury support.
3. Find a SIRA-approved psychologist. This is essential: only SIRA-approved providers can bill icare. See our directory of SIRA-approved psychologists in Sydney or check sira.nsw.gov.au/information-search/health-care-providers.
4. AHTR is submitted. Your treating psychologist submits an Allied Health Treatment Request to icare. This can happen before or at your first session in some cases—confirm with your psychologist. In some situations, the first one or two sessions can proceed pending AHTR approval.
5. Wait for approval. icare responds within 10 business days (routine) or 3 business days (urgent). Follow up with icare on 13 44 22 if you have not heard back within this timeframe.
6. Attend sessions. Once approved, you attend sessions. No payment is required from you for the approved sessions.

Telehealth psychology under icare

Telehealth psychology is covered under NSW workers compensation at the same rate as in-person sessions. This matters for two reasons: it expands your choice of treating psychologist (you are not limited to practitioners within commuting distance), and it removes a practical barrier for people who find travelling difficult during recovery.

The relevant SIRA billing items for telehealth are PSY301 (initial session) and PSY302 (subsequent sessions). Both are 60-minute sessions conducted by video or phone. The gazetted rates (from 1 February 2026) are approximately $271.60 for PSY301 and $226.80 for PSY302.

If your AHTR specifies telehealth delivery, your psychologist will document this in the AHTR. Some insurers may ask for a brief justification of why telehealth is clinically appropriate in your case (for example, difficulty travelling due to your injury, or the broader choice of available SIRA-approved practitioners). In practice, telehealth requests are routinely approved.

For more detail on using telehealth specifically under the SIRA scheme, see our SIRA-approved psychologist telehealth guide.

If icare declines or disputes your treatment

If icare declines your AHTR or disputes your psychological injury claim, you have rights. The dispute resolution pathway in NSW is:

1. Request an internal review from icare in writing, specifying the reasons you believe the decision is incorrect.
2. If unsatisfied with the internal review outcome, lodge a dispute with the Personal Injury Commission (PIC), which handles workers compensation disputes in NSW. The PIC replaced the Workers Compensation Commission in 2021.
3. Seek legal advice from a workers compensation lawyer. Many offer free initial consultations.

icare's contact number is 13 44 22. SIRA can be reached at 13 10 50. The Personal Injury Commission is at pic.nsw.gov.au.

Frequently asked questions