Spelfabet

Many of our clients are able to access the following funding/rebates for Speech Pathology:

Medicare Chronic Condition Management Program

GPs are increasingly aware that communication and literacy difficulties can lead to health and mental health problems. They may refer for up to 5 Medicare-subsidised sessions with a Speech Pathologist per calendar year. The per-session rebate is about $63, and only applies to individual sessions, not group sessions.

Previous names for this program are Enhanced Primary Care (EPC) and Chronic Disease Management (CDM). Additional rebates may be available to First Nations people. The Item numbers are 10970 (in person), 93000 (online) and 93013 (phone), see MBS Online for more details.

Complex Neurodevelopmental Disorder and Disability Services (M10)

GPs may refer people under the age of 25 to Speech Pathologists or other Allied Health practitioners for up to 8 Medicare-rebatable sessions of assessment, and up to 20 sessions of therapy (lifetime cap of 28 sessions), for the following conditions:

• Severe speech difficulties: Childhood Apraxia of Speech, Dysarthria, articulation or phonological disorder,
• Stuttering,
• Cleft Lip and/or Palate,
• Autism, sight or hearing impairment, Down Syndrome, Cerebral Palsy, Foetal Alcohol Syndrome, Fragile X syndrome and a list of other disabilities you can find here. A Paediatrician referral is usually required for these disabilities, and other conditions may apply (e.g. age of diagnosis). The former Helping Children With Autism and Better Start rebates are now part of this Medicare item.

These rebates are also for individual sessions, not group sessions. The per-session rebate is about $89, see MBS Online for more details. Speech disorders, stuttering and cleft lip or palate are 2026 additions to this group, more information is here. The item numbers are: assessment: 82005 (in person) 93033, (online), 93041 (phone), at least 50 minutes per session; treatment: 82020 (in person), 93036 (online), 93044 (phone), at least 30 minutes per session.

Please note that as a specialist speech-language and literacy service, we don’t have the up-to-date specialist skills needed to work with clients with all the above conditions (e.g. dysarthria, stuttering, cleft lip and palate, AAC users).

National Disability Insurance Scheme

We are able to work with NDIS participants who are self-managed or plan-managed. Please tell us if you intend to use NDIS funding to work with us, so we can focus our intervention on the goals in your NDIS plan, adhere to NDIS reporting schedules and otherwise meet NDIS requirements.

Private health insurance

If you have private health insurance, you may be able to claim rebates for Speech Pathology. Our receipts include the information insurance companies usually require, such as HICAPS item numbers and our Medicare provider numbers.