Funding
You may be eligible for funding if you meet the criteria. To find out more select from the range of funding options below and consult your healthcare professional.
Private health cover
Speech pathology assessment and therapy sessions can be claimed through private health cover under extras cover. The rebate amount per session and the number of sessions covered is dependent on the individual’s level of cover. The rebate for assessments is usually higher than that for therapy sessions. A typical rebate would be somewhere between $30-$80 per therapy session for 10-16 sessions per calendar year.
Before commencing therapy, please check with your health fund to ensure that speech pathology is included in your cover and the amount you are eligible to claim for each individual assessment and therapy session.
Chronic disease management
Medicare provides a rebate for up to five speech pathology sessions per calendar year for individuals with chronic conditions and complex needs that require a multi-disciplinary approach (treatment from several health professionals). Eligible conditions are those that are likely to be present for six months or longer such as autism, dyspraxia, learning disorders, Down syndrome, ADHD, cerebral palsy, cleft lip and palate, chronic middle ear infections, intellectual disability and severe speech or language impairments. For adults these may also include stroke, traumatic brain injury, progressive neurological diseases (motor neurone disease, Parkinson’s disease), stuttering, vocal cord pathologies and dementia.
The rebate is $52.95 (indexed on 1 November) per session. Please note that clients cannot claim a Medicare rebate and private health care rebate for the same service.
Clients must obtain a CDM referral from their GP who will lodge and complete a GP Management Plan and Team Care Arrangements Plan. Referrals are valid for 12 months and must be in place prior to the commencement of therapy in order to claim. Unused services from the same referral can be used in the following calendar year.
Better Start Medicare (0-13 years)
Children with an eligible disability can be referred by a GP (item number 139), a specialist or consultant physician (item number 137) for the following allied health services.
Up to four diagnostic/assessment services from allied health professionals including speech pathologists to assist the referring practitioner with diagnosis or to contribute to a child’s treatment and management plan (for a child under 13 years of age). (Item number 82005 for speech pathologist.)
Up to twenty treatment services from an allied health professional including a speech pathologist (for a child under 15 years of age, providing a treatment and management plan is in place before their 13th birthday). Note: these are the total number of services available to each child through the Better Start Medicare program – not an annual entitlement. (Item number 82020 for speech pathologist.)
The referral may be a letter or note to the speech pathologist, signed and dated by the referring practitioner. Each referral is valid for a maximum of ten sessions. Following the completion of sessions, the speech pathologist will provide a report to the practitioner who will then decide on the need for further treatment.
Please note that clients require a separate referral for each allied health provider and each separate course of treatment.
HCWA Medicare (0-13 years)
Children undergoing assessment or treatment for autism can be referred by a consultant paediatrician or psychiatrist for the following allied health services:
Up to four diagnostic/assessment services from allied health professionals including speech pathologists to assist the referring practitioner with diagnosis or to contribute to a child’s treatment and management plan (for a child under 13 years of age). (Item number 82005 for speech pathologist.)
Up to twenty treatment services from an allied health professional including a speech pathologist (for a child under 15 years of age, providing a treatment and management plan is in place before their 13th birthday). Note: these are the total number of services available to each child through the Better Start Medicare program – not an annual entitlement (Item number 82020 for speech pathologist).
The referral may be a letter or note to the speech pathologist, signed and dated by the referring practitioner. Each referral is valid for a maximum of ten sessions. Following the completion of sessions, the speech pathologist will provide a report to the practitioner who will then decide on the need for further treatment.
Please note that clients require a separate referral for each allied health provider and each separate course of treatment.
Department of Veterans Affairs (DVA)
Clients (and their dependents) who have gold Department of Veterans Affairs cards are eligible for rebates on speech pathology services.
Clients (and their dependents) who have white Department of Veterans Affairs cards are eligible for rebates on speech pathology services in some circumstances.
The rebate for mobile speech pathology assessment and therapy services is at full cost per session.
NDIS
We are registered to provide Early Intervention Services and Therapeutic Supports under the NDIS.
We welcome clients who are managed via the NDIS, via plan management, or via self managing.
