Medicare provides a rebate for up to 5 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 6 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.
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.
The rebate is $52.95 (indexed on 1st November) per session. Please note that clients cannot claim a Medicare rebate and private health care rebate for the same service.
The information in this pamphlet is a collective summary of potential funding options as at 8.12.2014. For up to date accuracy, please consult your healthcare professional or the appropriate funding mechanism website.