Should I use workers compensation (SIRA/icare) or Medicare for psychology sessions?

If your psychological injury was caused or significantly contributed to by your employment, you should claim through your workers compensation insurer (icare or a self-insurer) under the SIRA scheme. Workers compensation covers the full cost of approved sessions with no gap fee, and there is no 10-session annual cap equivalent to Medicare's Better Access scheme. Medicare (via a Mental Health Treatment Plan from your GP) is appropriate when your mental health condition is not related to work injury. You do not need to choose permanently: some workers use workers comp for their work-injury treatment and Medicare for unrelated mental health support. However, you cannot claim the same session under both schemes.

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SIRA vs Medicare: Which Should You Use for Psychology in NSW?

Q: How much do I pay out of pocket under workers compensation vs Medicare?

Under approved NSW workers compensation claims: sessions with a SIRA-approved psychologist are billed directly to your insurer at the gazetted SIRA fee rate (PSY002 subsequent session rate is $237.60 for 60 minutes from 1 February 2026). For approved claims, there is typically no out-of-pocket gap for you. Under Medicare Better Access: you pay your psychologist's full fee and receive a Medicare rebate. From 1 July 2025, the Medicare rebate for a registered psychologist (50+ minute session) is $98.95 per session. The rebate for a clinical psychologist is $145.25 per session. Typical Sydney psychologist fees are $230-$300 per session, so a gap of $85-$200 is common. Workers compensation is generally more cost-effective than Medicare for work-related psychological injury.

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If you have been dealing with a workplace psychological injury, you may be wondering whether to access psychology through your workers compensation claim (SIRA/icare) or through Medicare's Better Access scheme. Both can fund psychology sessions, but they are designed for different situations, have different costs, and work very differently in practice.

This guide explains the key differences so you can choose the right pathway for your situation.

General information, not legal or medical advice. Every workers compensation claim is assessed on its own facts. If you are unsure which pathway applies to your situation, speak with your GP, your employer's HR team, or icare (1800 737 822).

Side-by-side comparison

Feature	SIRA / icare (workers comp)	Medicare Better Access
Who it is for	Workers injured or made ill through employment (NSW private/state sector, most industries)	Anyone with a diagnosable mental health condition, regardless of cause
Who pays	Your insurer (icare or self-insurer) pays the psychologist directly for approved sessions	You pay the psychologist, then claim the Medicare rebate back
Out-of-pocket cost	Usually nil for insurer-approved sessions	Gap fee (full fee minus rebate). Typical Sydney gap: $85-$200 per session
Medicare rebate	Not applicable (cannot claim both for same session)	$98.95 (registered psychologist, from 1 Jul 2025) or $145.25 (clinical psychologist)
Annual session cap	No fixed annual cap; sessions determined by Recovery Plan and clinical need	Up to 10 individual sessions per calendar year
GP referral required	Yes: Certificate of Capacity and workers comp psychology referral (not a Medicare MHTP)	Yes: a Mental Health Treatment Plan (MHTP) from your GP
Psychologist requirement	Must hold a SIRA provider number (not all AHPRA-registered psychologists qualify)	Any AHPRA-registered psychologist
Session rate paid to psychologist	SIRA gazetted rate: PSY002 $237.60 per 60-min session (from 1 Feb 2026). Source: SIRA NSW Workers Compensation (Psychology and Counselling Fees) Order 2026	Psychologist's own fee (typically $230-$300 in Sydney); rebate offsets part of this
Telehealth available	Yes, telehealth sessions are accepted under SIRA/icare	Yes, same rebate as in-person under Better Access
If claim is disputed	You may continue treatment while dispute is resolved. Seek legal advice from a workers comp lawyer.	No dispute mechanism (Medicare is not a claim against an employer)

Which pathway is right for you?

Use workers compensation (SIRA/icare) if:

Your psychological injury was caused or substantially contributed to by your employment (e.g. workplace bullying, traumatic incident at work, work-related stress that led to a diagnosable condition)
You want no out-of-pocket cost for your psychology sessions
You expect to need more than 10 sessions per year
Your employer is a NSW private or state sector business (not a Commonwealth Government agency -- if so, see our Comcare guide)

Use Medicare (Better Access) if:

Your mental health condition is not related to a workplace injury
You do not want to involve your employer or make a workers compensation claim
You work for a Commonwealth Government agency (Comcare applies, not SIRA)
Your workers compensation claim has been finalised or discontinued

Can you use both?

You can use both SIRA and Medicare -- but not for the same sessions. For example, if your workers compensation claim covers treatment for your work-related anxiety, you could separately see a different psychologist under Medicare for an unrelated issue (e.g. a phobia that pre-dates your workplace injury). You cannot claim the same session under both schemes, and you cannot claim a Medicare rebate on a session that was billed to your insurer under workers comp.

How to start a workers compensation psychology claim in NSW

See your GP. Get a Workers Compensation Certificate of Capacity (sometimes still called a WorkCover certificate) and a referral for psychological treatment under workers compensation. This is a different document from a Medicare Mental Health Treatment Plan.
Notify your employer. You are required to report a psychological injury to your employer as soon as practicable. Your employer's insurer will be notified.
Find a SIRA-approved psychologist. Your chosen psychologist must hold a current SIRA provider number. Use this directory to find telehealth-available, SIRA-registered psychologists in NSW: view directory →
Insurer review. icare or your insurer will assess liability. While the claim is being reviewed, your insurer may fund initial treatment on a provisional basis.
Recovery Plan. Your psychologist will prepare a Recovery Plan that sets out proposed treatment, goals, and a timeline. This is submitted to your insurer and guides the approval of further sessions.

For more detail on the claim process, see our full guide: Psychological injury under NSW workers comp: a step-by-step guide.

How to start a Medicare Better Access claim

See your GP. Ask for a Mental Health Treatment Plan (MHTP). Your GP assesses your mental health, prepares the plan, and gives you a referral to a psychologist.
Book with an AHPRA-registered psychologist. Any AHPRA-registered psychologist can bulk-bill or charge a gap fee under Better Access. You do not need a SIRA-approved provider for Medicare.
Claim your rebate. After each session, claim the Medicare rebate via the Medicare app or your psychologist may bulk-bill (meaning Medicare pays them directly and you pay nothing if bulk-billed).
Review at 6 sessions. Your GP reviews your progress after your 6th session and can refer you for up to 4 more in the same calendar year (total 10).

Frequently asked questions

Should I use workers compensation or Medicare for psychology sessions?

If your psychological injury was caused or significantly contributed to by your employment, you should claim through workers compensation (SIRA/icare) in NSW. Workers compensation covers the full cost of approved sessions with no gap fee, and there is no 10-session annual cap. Medicare's Better Access scheme is appropriate when your mental health condition is not related to a work injury. You do not need to choose permanently -- some workers use workers comp for their work-injury treatment and Medicare for unrelated mental health support, but you cannot claim the same session under both schemes.

How many psychology sessions do I get under SIRA workers compensation compared to Medicare?

Under Medicare's Better Access scheme, you can access up to 10 individual sessions per calendar year with a psychologist after getting a Mental Health Treatment Plan from your GP. Under NSW workers compensation (SIRA/icare), there is no equivalent hard annual cap. Sessions are determined by your insurer based on your psychologist's Recovery Plan and clinical needs. Workers with significant psychological injuries often receive more than 10 funded sessions per year under workers comp.

How much do I pay out of pocket under workers compensation vs Medicare?

Under approved NSW workers compensation claims, sessions with a SIRA-approved psychologist are billed directly to your insurer at the SIRA gazetted rate (PSY002 subsequent session rate is $237.60 for 60 minutes from 1 February 2026). For approved claims, there is typically no out-of-pocket gap for you. Under Medicare Better Access, you pay your psychologist's full fee and receive a Medicare rebate. From 1 July 2025, the Medicare rebate for a registered psychologist is $98.95 per session and $145.25 for a clinical psychologist. Typical Sydney psychologist fees are $230 to $300 per session, so a gap of $85 to $200 per session is common. Workers compensation is generally more cost-effective than Medicare for work-related psychological injury.

Can I switch from Medicare to workers compensation if I realise my condition is work-related?

Yes. If you began treatment using Medicare but have since identified that your psychological condition was caused or substantially contributed to by your employment, you can make a workers compensation claim. Your GP will need to issue a Workers Compensation Certificate of Capacity and a referral for psychological treatment under workers compensation. You cannot retrospectively reclaim Medicare rebates already paid, but future sessions can move to workers compensation funding if your claim is accepted. Speak with your employer or icare (1800 737 822) about the process.

Do I need a GP referral for psychology under workers compensation?

Under NSW workers compensation (SIRA/icare), you typically need a Workers Compensation Certificate of Capacity from your GP and a referral for psychology services. This is a workers comp referral -- not a Medicare Mental Health Treatment Plan (MHTP). The MHTP is a Medicare-specific document and is not used for workers compensation claims. Your treating psychologist will then provide a Recovery Plan to your insurer, which sets out the proposed treatment and goals.

What is the difference between a SIRA-approved psychologist and any AHPRA-registered psychologist?

Any AHPRA-registered psychologist can see patients under Medicare. But for NSW workers compensation (SIRA/icare) claims, the psychologist must hold a current SIRA provider number. This is a separate registration. Not all AHPRA-registered psychologists hold a SIRA provider number. When searching for a workers comp psychologist, always confirm they hold a current SIRA provider number before booking. You can verify via the SIRA health care provider register at sira.nsw.gov.au.

Find a SIRA-approved psychologist in NSW

If your condition is work-related, workers compensation funding (SIRA/icare) covers the full cost with no gap fee and no annual session cap. Listed psychologists include registered psychologists who accept workers comp referrals and offer telehealth across NSW.

Browse the directory

Free to use. We are a directory, not a clinical service.

Sources: SIRA NSW Workers Compensation; SIRA Workers Compensation (Psychology and Counselling Fees) Order 2026 (PSY002 rate from 1 February 2026); Services Australia Better Access (Medicare rebates from 1 July 2025); icare NSW. General information only, not legal or medical advice. Last reviewed June 2026.