Private Health Funds

A key part of PACFA's advocacy has been successfully negotiating agreements with some of Australia's largest health funds, who recognise the high level of skill that PACFA members hold. This means more Australians are able to access affordable mental health care.

If you have a client who holds Private Health Insurance with extras cover, they may be able to claim benefits for counselling and psychotherapy services provided by you. Your client will need to check with their health fund as to whether they are eligible for rebates.

Currently, PACFA has agreements with Medibank, ahm, Bupa, HCF, and ARHG (encompassing St Luke's Health, Police Health, GMHBA, Westfund, Emergency Services Health, Phoenix Health, see-u by HBF , AIA Health, and Teachers Union Health.).

Private health Funds requirements for members of PACFA

Insurance requirements

You must hold current Professional Indemnity and Public Liability Insurance. If audited by PACFA or a health fund, a ‘Certificate of Currency’ must be sent within seven days of receiving a written request.

Your practice addresses

When adding a practice address for a second or subsequent location, you must complete a new online application form for each practice address. Practice addresses must be applied for via the online application form, which will be shared with the health funds for approval.

You must notify PACFA to close your provider number when you leave a practice address. When changing addresses, apply for a new practice address prior to the move using the online application form.  Your previous address will then be automatically closed.

Please note:

  • P.O. Boxes are not accepted as a practice location.
  • Your address may be visible on the health fund’s search functions
  • Some health funds limit the number of locations permissible
  • An address labelled ‘telehealth only’ will not be accepted. If your services are provided entirely by telehealth, use the practice address that is used on the client invoice. 

A ‘Provide First Aid certificate HLTAID003/HLTAID011’ is compulsory

The ‘Provide First Aid certificate HLTAID003/HLTAID011’ must be renewed every three years. If audited by PACFA or a health fund, you must provide your current ‘Provide First Aid certificate HLTAID003/HLTAID011 within seven days of receiving a written request.

You are required to send a copy of your ‘Provide First Aid Certificate HLTAID003/ HLTAID011’ via email to [email protected] at least one month before your old certificate expires. Please include name(s) of the health fund(s) and your provider number(s).

If you fail to send an updated certificate at least one month before your old certificate expires, you must notify the PACFA membership team on [email protected] and provide details of an upcoming Provide First Aid Course.

If your ‘Provide First Aid certificate HLTAID003/HLTAID011’ expires, and PACFA has not received a new one, all of your provider numbers will be closed.

NOTE: The ‘HLTAID001 CPR component’ is not sufficient. It covers only the skills and knowledge required to perform cardiopulmonary resuscitation (CPR).

PACFA Membership requirements

Clinical Registration is a requirement of all Private Health funds.

All members who hold a provider number must complete their annual CPD and supervision requirements.  All provider numbers will be cancelled if membership is not renewed by 31 July each year.

PACFA members who take leave will have their numbers closed, or, where possible, their numbers will be put on leave.

PACFA members who have a criminal conviction or who have an ethical complaint upheld against them may have their provider number permanently suspended by the private health fund, at the discretion of the fund(s).

Breach of policy

Failure to meet the listed requirements is considered a breach of policy. It will result in the closure of your provider number without warning or notification.

Health funds have different waiting periods before a new provider number can be issued. They are under no obligation to reissue a provider number.  In some cases, you will not be entitled to reapply.

If closed, you must reapply for a Provider Number by completing the online application form.

PACFA is not responsible for members who have their numbers closed due to a breach of the requirements included in this policy or any policy of the respective health fund(s). PACFA does not take responsibility for incorrect invoicing to a member’s client(s) if a rebate was anticipated but not given by the health funds.

Before applying for a provider number please read the Private Health Fund Policy. 

Health Fund information (including application form and eligibility criteria)  FAQs for existing providers and new applicants
Bupa   Bupa FAQs 
Medibank   Medibank and ahm FAQs 
ahm   Medibank and ahm FAQs 
HCF  HCF Terms and Coditions
ARHG health funds (9 funds total)  ARHG FAQs