Medicare Rebates:
Your child may be eligible to receive a Medicare rebate when they access services through Speech Pathology. Some common questions are answered below:
Do you need a referral from your GP/paediatrician to use the Medicare rebates?
Yes you do. We cannot process your claim without one.
Can I claim the gap on my private health fund?
No you cannot. You need to choose whether you will claim through Medicare or private health funds. You can use your Medicare sessions and then use private health funds for remaining sessions.
Can you process our Medicare payment in the clinic or over the phone?
No I can’t. You pay me at the time of intervention and take the invoice to a Medicare office where you will be refunded.
Do you speak with our GP?
Yes, at the first and final sessions, your therapist may report back to the GP.
Out of pocket expenses The gap must be paid for by the family, however any out of pocket costs will count toward the Medicare safety net for that family. You cannot claim the gap through your private health fund.
Enhanced Primary Care Programme (EPC) or Chronic Disease Management
Who is eligible?
- Children who have complex and chronic health needs needing support from at least three health care providers (e.g. GP, Occupational Therapy, Speech Pathology)
- Children who have a GP management plan and Team Care arrangements in place (as determined by your GP)
What do you receive?
A person can claim a maximum of 5 allied health and dental care services in each 12 month period. The rebate for each session is $50.05. These can only be used for individual services.
Helping Children with Autism
Who is eligible?
Assessment: Children with Autistic Spectrum Disorders (including Asperger’s Syndrome and Pervasive Developmental Delay) under 13 years of age, for the purposes of assisting with diagnosis.
Intervention: Children with a pervasive developmental disorder (including ASD) aged under 15 years
What do you receive?
Assessment: Up to 4 assessment sessions, shared between a range of health professionals as discussed with your child’s paediatrician.
Intervention: A maximum of 20 sessions in total until 15 years of age, across all services. These may be used for individual sessions only.
Follow Up Allied Health
Who is eligible?
People of Aboriginal and Torres Strait Islander descent (with a referral from their GP) are eligible for this plan. This is in addition to the 5 Enhanced Primary Care Plan sessions.
What do you receive?
A person can have a maximum of 5 allied health sessions each calendar year. The Medicare rebate for these services is $50.90 per session. These can only be used for individual services.