Can Medicare help pay for any of my Speech Pathology sessions?

Speech Pathology, Occupational Therapy and Medicare

Can medicare help with funding for speech pathology or occupational therapy sessions?

The quick answer is… yes, for some children.

There are some refunds available from Medicare for speech pathology, but there are criteria around which conditions may be eligible.

Typically your GP will go through these refunds with you if they deem you are eligible.  Each refund is associated with a different kind of paperwork, which needs to be set up prior to use.  These referrals are across allied health, so the same rules apply to both Speech Pathology, or Occupational Therapy sessions.

We are also NDIS Registered Providers, for more information about using your NDIS funding – please contact us.

What types of Medicare funding are available?

•  Chronic disease management plans – 5 sessions

This plan does not require your child to have a diagnosis and can be set up by a GP.  Eligibility for this plan is based on whether the child has a complex, or chronic condition, requiring ongoing care by a multidisciplinary team.

A CDM plan entitles the child to 5 sessions per calendar year with a refund of approximately $52.95 from Medicare.

• Better Start for Children with a Disability / Helping Children with Autism – 20 Sessions

Funding through the Better Start or Helping Children with Autism plans does require a diagnosis, typically from a paediatrician. Click here for a list of diagnoses which are covered under the Better Start program.

These plans need to be generated before the child turns 13, and used before the child turns 15.  This plan allows the paediatrician to allocate blocks of 10 therapy sessions at a time, after which the Speech Pathologist or Occupational Therapist will write reports back to ask for further services if needed.

How can we help?  If you want to know more about how therapy can help click here to read more.

Do you have to wait in line at Medicare – No!

At Cooee the parents pay the regular treatment fee, and then if a plan is in place, we can claim the refund for you on the spot, based on the paperwork provided.

We are happy to accept Medicare referrals for families here at Cooee. For us to be able to use any referral for your child, it needs to have ‘Cooee Speech Pathology’, or your specific therapist’s name written in the Allied Health Professional field.

Don’t hesitate to contact Giulia at reception with any questions, as it can get fairly confusing!  Speech Pathology Australia, our national association also has a fact sheet about Medicare items which you can find here.

Our team members are accepting new referrals now!

More information?  Check out our Funding and Rebates page by clicking here!