The Psychiatrist Pathway: ADHD Assessment and Medication
A psychiatrist or paediatrician is the only pathway to ADHD medication in Australia. Here is what a psychiatrist assessment involves, what it costs under Medicare, and how prescribing authority differs by state.
If medication is part of what you are looking for, a psychiatrist (or, for children, a paediatrician) is not optional. A registered psychologist can diagnose ADHD, but only a psychiatrist, paediatrician or neurologist can prescribe stimulant medication for it, and in most states that authority is tightly held: even a diagnosis in hand from a psychologist does not let a GP write the first prescription.
What a psychiatrist assessment covers
A psychiatrist ADHD assessment follows the same core clinical structure as a psychologist's: a detailed interview, standardised rating scales, and collateral information, per the Australian ADHD clinical practice guideline. What a psychiatrist adds is medical assessment: a mental state examination and a broader diagnostic workup that can also flag other psychiatric or physical conditions that overlap with, or get mistaken for, ADHD. Under Medicare item 291, a psychiatrist providing this kind of assessment with a management plan has to send a written report to the referring GP within two weeks, covering the diagnostic findings and a 12-month management plan.
A GP referral is required to access the higher Medicare rebate for a psychiatrist consultation. The referral specifically needs to be for assessment and management-plan development for a mental health condition; a psychiatrist attendance longer than 45 minutes under item 291 carries an 85 percent rebate ($467.45 on a $549.90 fee), while the equivalent first-attendance item without that management-plan framing, item 296, rebates 85 percent of a $316.30 fee ($268.90).
Prescribing authority varies by state
Once diagnosed, who can actually write the prescription depends on where you live. In New South Wales, psychiatrists, paediatricians and neurologists hold a class authority to prescribe up to set maximum doses without individual approval; GPs only gained a continuation-prescriber pathway for stable existing patients from 1 September 2025. Victoria keeps prescribing tightest: only paediatricians (under 18) and psychiatrists (any age) can prescribe without a state permit, and GPs need a permit tied to a documented specialist diagnosis and review. Queensland has gone furthest the other way: from 1 December 2025, any Queensland GP can initiate, modify and continue stimulant medication for adults, no extra accreditation required, though a formal DSM-5 assessment still has to happen first. Western Australia and South Australia both sit closer to the NSW and Victorian model, with an approved specialist required to make the first prescription and a GP able to continue it under shared care once that happens.
This is the practical reason the psychiatrist pathway matters even in a state where GPs can eventually take over prescribing: someone still has to make the diagnosis and, in most states, write that first prescription, and in every state except Queensland (for adults) that someone is a psychiatrist, paediatrician or neurologist.
Cost and what to expect
Psychiatrist consultations tend to have a higher up-front session cost than a psychologist's but often need fewer total sessions to reach a decision on medication, since a psychiatrist can move from assessment straight into a prescribing decision in the same practice. Nationally, total ADHD assessment costs average close to $1,400 across both pathways, according to 2026 University of Wollongong reporting, though a psychiatrist-only pathway is not separately broken out in that figure. On top of the assessment, PBS-subsidised ADHD medication costs a general patient up to $25.00 per prescription, or $7.70 with a concession card, from 1 January 2026.
Common questions
Can a psychologist prescribe ADHD medication?
No. Only a psychiatrist, paediatrician or neurologist can prescribe ADHD stimulant medication in Australia, and in most states that authority sits specifically with a psychiatrist or paediatrician rather than a neurologist in practice.
Do I need a GP referral to see a psychiatrist for ADHD?
For the Medicare rebate to apply, yes. A referral from a GP or a participating nurse practitioner is required for the psychiatrist assessment items that carry the higher rebate.
Source: Medicare Benefits Schedule, item 291.
Sources
- Medicare Benefits Schedule: item 291
- NSW Health: Prescribe a psychostimulant medicine
- Victorian Department of Health: permit requirements
- RACGP newsGP: Queensland GPs to diagnose and treat ADHD
- PBS: current patient fees and charges
Related reading
- The psychologist pathway to ADHD assessment
- ADHD medication prescribing rules by state
- What ADHD medication costs under the PBS
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