Can Medicare Help Pay For My Speech Or Occupational Therapy Sessions?

The quick answer is… yes, for some children.

There are some refunds available from Medicare for speech pathology and occupational therapy services, but there are criteria surrounding who may be eligible.

Typically your GP will go through these refunds with you if they deem your child is 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 and Occupational Therapy services.


What type of Medicare funding is available?

  • EPC (Enhanced Primary Care Plan) or CDM (Chronic Disease Management Plan)

This plan does not require your child to have a diagnosis and can be set up by your GP.  Your doctor will determine if your child is eligible and if so, will allocate up to 5 sessions towards speech and/or occupational therapy per calendar year.  Eligibility for this plan is based upon whether your child has a complex, or chronic condition, requiring ongoing care by a multidisciplinary team.  

Does an EPC or CDM cover the full fee for therapy?

An EPC or CDM will entitle you to a refund from Medicare of $54.60 per session from the total fee and does not cover the full amount for a session.  All sessions must be paid for in full prior to processing the plan and we do not bulk bill. The refund for an EPC or CDM is the same for an assessment or a regular therapy session.  

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

After attending a session at Cooee, 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.  Once full payment has been made we will process your medicare card, the GP provider details from the plan and we will then insert or swipe your cheque or savings card to refund the $53.80.

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 either ‘Cooee Speech Pathology’, or your specific therapist’s name written in the Allied Health Professional field.

Please do not hesitate to contact a member of our friendly client care team at reception with any questions, as it can get fairly confusing!  You can contact us via email at [email protected] or call us on (07) 3265 4495.  We would be happy to help! Speech Pathology Australia, our national association also has a fact sheet about Medicare items which you can find here.

Want more information?  

Check out our Funding and Rebates page by clicking here!

We are also a registered NDIS provider and for more information you can contact us here.