Medicare rebates are available in some circumstances. If you are eligible, you must also have a referral plan from your GP or paediatrician. Please note that rebateable sessions can only be provided after the date of the referral.
The following outline the different plans available from Medicare. For more information, please follow the links.
1. Chronic Disease Management Plan (CDM)
The CDM scheme is initiated by your GP and available to children and adults with Chronic Care needs. This Medicare rebate is available for 5 sessions of allied health therapy, including speech pathology, per calendar year. Once the initial plan has been made, the GP will not need to write a new plan each year, but may review the plan.
Please note that CDM plans can only be used for Individual Therapy sessions. It does not allow for Group Therapy sessions to be claimed on Medicare.
2. Helping Children With Autism Medicare Rebates
In July 2008 the Federal Government introduced the Helping Children With Autism Initiative. Under this initiative, it is now possible for families to claim rebates from Medicare for Assessment and Treatment for Children with Autism Spectrum Disorders, providing a referral has been made by a Paediatrician. The Paediatrician can allocate up to 4 sessions for assessment for which rebates are available up until the child turns 13 years of age.
For children with a diagnosis of Autism Spectrum Disorder, a total of 20 therapy sessions (as a one off) can be allocated, including speech pathology, until the child turns 15 years of age.
3. Better Start Medicare Rebates
In July 2011 the Federal Government introduced the Better Start for children with disability Initiative. This initiative assists children with,
- Down syndrome
- cerebral palsy
- Fragile X syndrome, or
- a moderate or greater vision or hearing impairment, including deafblindness
- Prader Willi syndrome
- Williams syndrome
- Angelman syndrome
- Kabuki syndrome
- Smith-Magenis syndrome
- CHARGE syndrome
- Cornelia de Lange syndrome
- ‘Cri du Chat syndrome or
- microcephaly.
It is now possible for families to claim rebates from Medicare for Assessment and Treatment for Children with the above disabilities, providing a referral has been made by a Paediatrician or GP. The doctor can allocate up to 4 sessions for assessment and treatment planning for which rebates are available up until the child turns 13 years of age.
As well a total of 20 therapy sessions can be allocated, including speech pathology, until the child turns 15 years of age.