Funding

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 Some children may be eligible to claim Medicare rebates for speech pathology services with a valid referral from their GP, paediatrician or medical specialist.

Medicare rebates do not usually cover the full cost of appointments, so an out-of-pocket gap fee will still apply. Common Medicare pathways include:

GP Chronic Condition Management Plan
This was previously known as a Chronic Disease Management Plan or Enhanced Primary Care Plan. Eligible children may be able to access up to 5 Medicare-rebated allied health sessions per calendar year. These sessions are shared across allied health providers, such as speech pathology, occupational therapy, physiotherapy, psychology or dietetics.

M10 – Complex Neurodevelopmental Conditions and Eligible Disabilities
Some children and young people under 25 may be eligible for Medicare-rebated speech pathology assessment or therapy through the M10 pathway. This may include children with a suspected or diagnosed complex neurodevelopmental condition, such as autism, or an eligible disability.

Eligible disabilities now include stuttering, speech sound disorders, including articulation disorders, phonological disorders, childhood apraxia of speech and dysarthria, as well as cleft lip and/or palate.

This pathway may provide access to Medicare rebates for assessment and treatment sessions, where eligibility and referral requirements are met.

Please speak with your GP, paediatrician or medical specialist to discuss whether your child is eligible and to arrange the required referral paperwork before your appointment.

Medicare claims can be submitted through your Medicare online account via myGov or the myGov app

The NDIS supports people who have a physical, intellectual, cognitive, visual, hearing, psychosocial impairment that either meets the disability or early childhood/early intervention requirements.

Spill The Beans Speech Pathology currently work with plan-managed and self-managed clients under NDIS funding. Please note that we don’t currently accept NDIS clients who are agency-managed.

Spill The Beans Speech Pathology can also support you with an application to the NDIS if appropriate by completing relevant paperwork or by providing assessment findings/reports.

You can contact your private health fund to find out whether you have speech pathology included in your ‘extras cover’ and what rebate you’ll receive for each session, and what your annual limit is. 

An invoice is provided to you following your appointment with all necessary details for you to claim from your health fund.

Initial assessment - item number 320
Therapy session - item number 350