Locum psychologists in Australia work across an unusually complex credentialing and billing landscape. Your ability to bill Medicare under the Better Access initiative depends on which AHPRA registration type you hold, and your obligations as a sole trader contractor add a further layer of ABN, GST, and super compliance. This post sets out the key facts so you can take on locum and contracting shifts with confidence.
This post is general information only and is not personal financial, tax, or legal advice.
AHPRA Registration: General Versus Endorsed
All psychologists in Australia must hold general registration with the Psychology Board of Australia (a National Board under AHPRA) before they can practise. General registration is achievable after completing a four-year undergraduate sequence plus a two-year postgraduate pathway, or an equivalent qualification assessed by the Board.
Area-of-practice endorsement is a separate, optional credential available in nine approved areas: clinical psychology, clinical neuropsychology, community psychology, counselling psychology, educational and developmental psychology, forensic psychology, health psychology, organisational psychology, and sport and exercise psychology. Endorsement requires both an approved postgraduate qualification (typically a Master's or Doctoral degree) in that area and completion of a supervised registrar program (generally 1,500 to 3,000 hours). AHPRA notes it currently takes eight years of education and training to become eligible for endorsement, compared with six years for general registration.
Endorsement is not mandatory for general practice, but it matters significantly for Medicare billing. The protected titles attached to endorsement (for example, "clinical psychologist") are enforced under the National Law; using them without endorsement can attract substantial fines.
Medicare Better Access: Item Numbers and Rebate Amounts
The Better Access to Mental Health Care initiative is the primary Medicare pathway for psychology services. Patients access it via a Mental Health Treatment Plan (MHTP) from a GP or psychiatrist, and are entitled to up to 10 individual and 10 group therapy services per calendar year.
Two key item-number streams matter for locum psychologists:
Clinical psychologists (endorsed in clinical psychology):
- Item 80010: Psychological therapy, individual, 50 minutes or more. Medicare rebate: $145.25 per session (from 1 July 2025 MBS schedule).
- Equivalent telehealth item 91167 carries the same $145.25 rebate.
Registered psychologists (general registration, not endorsed):
- Item 80110: Focussed psychological strategies (FPS), individual, 50 minutes or more. Medicare rebate: $98.95 per session (from 1 July 2025 MBS schedule).
- Equivalent telehealth item 91170 carries the same $98.95 rebate.
The gap between the two streams, currently around $46 per session, is a meaningful income differentiator at scale. A locum psychologist completing 20 billable sessions per week in a clinical endorsement position earns approximately $920 more per week in Medicare rebates compared to the registered-psychologist stream, before any out-of-pocket component charged to the patient.
From 1 November 2025, Services Australia updated referral and MHTP management rules under Better Access. Always confirm referring GP paperwork is in order before starting a locum placement, as invalid referrals create billing risk.
GST Treatment of Psychology Services
Psychology is listed at item 16 of the table in subsection 38-10(1) of the GST Act as an "other health service", making direct patient-care services GST-free provided you are registered with the Psychology Board and the service is generally accepted in the profession as necessary for appropriate treatment.
This means that for most clinical sessions you do not charge GST and do not remit GST on that income, even if your total turnover exceeds the $75,000 registration threshold. You must still register for GST once turnover reaches $75,000, and you must lodge a BAS (quarterly for most practitioners, monthly if turnover exceeds $20 million), but your patient-session revenue will largely carry a zero GST liability.
Important exception: third-party report writing (for example, medico-legal reports, WorkCover reports, insurance assessments) is not a health service supplied to the patient. The ATO treats the report recipient as a third party, so GST applies to those fees. If you take on mixed locum work involving both clinical sessions and report writing, your invoicing and BAS must distinguish between GST-free and taxable supplies.
Contractor Admin: ABN, Super, and Mileage
Working locum shifts as an independent contractor requires an ABN. Without one, engaging workplaces are required to withhold 47% of your payments under no-ABN withholding rules.
As a sole trader contractor you pay your own super. The Superannuation Guarantee (SG) rate for 2025-26 is 12%, applying to eligible employees. As a sole trader you are not entitled to SG from your engaging workplaces, but making voluntary concessional contributions to your own fund is tax-effective: the concessional cap for 2026-27 is $32,500 (including any employer contributions if you hold any PAYG roles alongside locum work).
If you drive between workplaces, the ATO cents-per-km rate for 2025-26 is 91 cents per kilometre, capped at 5,000 business kilometres per car. Keep a contemporaneous logbook or GPS record for each locum shift; ad hoc notes added at tax time are harder to sustain under audit.
You should also consider whether the Personal Services Income (PSI) rules apply to your contracting structure. PSI applies when more than 50% of your income is generated from your own skills and effort, which is common for solo psychologist contractors. If PSI applies, certain business deductions are limited and income cannot be split to an associated entity. Seek advice from a registered tax agent if you are unsure.
How Sessional Helps
Sessional is built for exactly this kind of complexity. The psychologist dashboard tracks shifts, invoices, and earnings across multiple workplaces and agencies in one place. The GST and BAS readiness tools categorise each income line as GST-free or taxable, so your BAS figures are ready without spreadsheet sorting. The super tracker monitors your voluntary contributions against the $32,500 concessional cap, and the ATO cents-per-km tool calculates your mileage deduction automatically. AHPRA registration and CPD expiry dates sit in your credential wallet so you never miss a renewal. Explore the plan options or visit the help centre to get started.
Sources
- Psychology Board of Australia - Endorsement pathways
- Psychology Board of Australia - Endorsement overview
- Psychology Board of Australia - Registrar program
- MBS Item 80010 - Clinical psychologist psychological therapy
- MBS Item 80110 - Registered psychologist focussed psychological strategies
- Services Australia - MBS billing rules for mental health services
- APS - Better Access to Mental Health Care initiative under Medicare
- ATO - GST and other health services (s38-10)
- ATO ID 2001/390 - GST and psychology services
- ATO - Working as an independent contractor