🇦🇺 ADHD Diagnosis in Australia: 2025/2026 Update
Australia has historically had a massive cost barrier for ADHD diagnosis, but the landscape is changing fast. As of late 2025, there are now two cost-effective pathways depending on which state you live in: the new Direct GP Diagnosis (available in select states) and the national "Item 291" Assessment (available everywhere).
Quick Summary
- Best Pathway (QLD): Direct diagnosis by your regular GP (Starting Dec 1, 2025)
- Best Pathway (VIC, NSW, WA, SA, TAS): Telehealth Item 291 Assessment (e.g., Fluence Clinic or Nexia Healthcare)
- Cost: ~$647 (Item 291) vs. Standard GP fees (Direct GP Diagnosis)
- Key Change: GPs in Queensland can now diagnose adults independently. GPs in NSW, WA, and SA are entering pilot programs in 2026.
Pathway 1: The "Direct GP Diagnosis" (New for late 2025)
Current Availability: Queensland (Dec 1, 2025), with NSW/WA/SA pilots starting 2026.
This is the new "holy grail" of access. Recent state reforms are removing the requirement to see a psychiatrist entirely, allowing trained GPs to make the diagnosis and prescribe stimulants themselves.
How it works
You book a long consultation with a GP who is comfortable managing ADHD. They assess you, diagnose you, and write the prescription on the spot.
The "Gotcha"
This is currently state-dependent.
- • Queensland: Live as of Dec 1, 2025
- • NSW & WA: Pilot programs rolling out early-to-mid 2026
- • Victoria: No current announcement for independent GP diagnosis
Pathway 2: The "Item 291" Assessment (National Standard)
Current Availability: Nationwide (Best for VIC, TAS, NT, ACT, and non-pilot areas).
If you are not in Queensland, you generally still need a psychiatrist's authority to get medication. The "hack" here is using MBS Item 291—a one-off assessment where a psychiatrist diagnoses you and immediately delegates prescribing rights to your GP.
How it works
- • One-off assessment: A psychiatrist completes a comprehensive one-off assessment and writes a report authorizing your GP to prescribe meds
- • Cost: ~$647 AUD (Out of pocket after Medicare rebates)
- • Wait Time: 1–4 weeks (via telehealth) vs 6+ months for local specialists
Recommended Item 291 Providers
If you cannot access a diagnosing GP in your state, these telehealth providers focus specifically on Item 291 reports to get you back to your affordable GP quickly.
Fluence Clinic
- • Focus: High-volume telehealth assessments for Item 291
- • Speed: Fast turnaround for reports to GPs
Nexia Healthcare
- • Focus: Comprehensive telehealth assessments eligible for Item 291 rebates
- • Advantage: Specialists in "GP-delegated" care
Cost & Wait Times Comparison
| Pathway | Cost (Net) | Wait Time | Notes |
|---|---|---|---|
| Direct GP Diagnosis | Lowest (Standard GP Gap) | Fastest (Days/Weeks) | Only available in QLD (Dec 1, 2025) and pilot areas |
| Item 291 Assessment | ~$647 AUD | Fast (1–4 Weeks) | The standard route for VIC, NSW, WA. Requires 1 psych visit |
| Traditional Psychiatrist | $1,500+ AUD | Slow (6+ Months) | Full private care. Often unnecessary for standard ADHD management |
Step-by-Step Process (Revised)
Step 1: Check Your Location
If you are in QLD: Call local clinics to find a "GP who manages adult ADHD." You may not need a referral at all.
If you are elsewhere: You likely need the Item 291 pathway. Proceed to Step 2.
Step 2: Get a Referral
See your regular GP. Ask for a referral to a telehealth psychiatrist (like Fluence or Nexia) specifically for an "Item 291 Assessment."
Note: This referral is strictly required for the Medicare rebate.
Step 3: Book Assessment
Contact the telehealth provider. Upload your referral and book the next available slot (usually within a few weeks).
Step 4: The Report
The psychiatrist sends a "Management Plan" to your GP.
Step 5: GP Prescribing
Your GP receives the plan and can now legally prescribe your medication.
What to Do Next
Recommended Action
Residents of QLD: Wait for December 1 reforms and book a long consult with a knowledgeable GP.
Residents of VIC/NSW/WA: Ask your current GP for an "Item 291 referral" to a telehealth clinic. This remains the fastest way to bypass the 6-month waitlists in your state.
Related Resources
Important Reminder
This information is for educational purposes only and should not replace professional medical advice. Always consult with qualified healthcare professionals for diagnosis and treatment decisions. Medicare rebates, provider availability, and costs may change over time.