Medicare rebates, and funded programs
Rebates
Medicare Items for Complex and Chronic Conditions Individuals may be eligible for rebates under the Medicare Items for Complex and Chronic Conditions. Clients have complex care needs if they need ongoing care from a multidisciplinary team consisting of their GP and at least two other health care providers, two of which may be an Occupational Therapist, Speech Therapist or Physio Therapist. Residents of aged care facilities may also be eligible for this program, but hospital in-patients are not eligible for the chronic disease management (CDM) program. If you are unsure as to you (or your child’s) eligibility, please discuss with your GP.
Referral process
Session
A session is a face to face consultation with an allied health professional. The consultation must be of at least 20 minutes duration and must be provided to an individual client. The Occupational Therapist, Speech Therapist or Physio Therapist named on the referral form should provide the service. If there is a change in the Occupational Therapist, Speech Therapist or Physio Therapist providing the service the GP should be notified of the change.
Medicare Benefits schedule links for Occupational, Speech and Physio therapies.
We provide face to face occupational, speech and physiotherapy services at your home, school, work, and local community whichever best suits you to achieve your short- and long-term goals.
We also provide telehealth occupational, speech and physiotherapy services which reduces travel time and costs. It also eliminates communicable diseases. Telehealth services can be provided via a desk top computer, tablet/iPad, or a mobile device with a good internet connection. Telehealth services are effective, and your privacy is protected as the therapists must abide by Australian privacy principles.
Medicare rebate
Claims
- Client’s name
- Date of service
- MBS item number
- Allied health professional’s name and provider number
- Referring GP’s name and provider number
- Date of referral
- Amount charged
- Total amount paid
- Any amount outstanding in relation to the service
Other allied health professionals can provide services under the CDM program
- Aboriginal Health Worker
- Occupational Therapist
- Audiologist
- Osteopath
- Chiropractor
- Physiotherapist
- Diabetes Educator
- Podiatrist
- Dietician
- Psychologist
- Exercise Physiologist
- Mental Health Worker
Other allied health programs under Medicare
Up to four (4) Medicare rebate services in total will be available for eligible allied health professionals, to collaborate with the referring practitioner in the diagnosis of a child (aged under 13 years) and/or the development of a child’s PDD treatment and management plan
A further twenty (20) Medicare rebate services in total will also be available for eligible allied health
professionals, to provide treatment to a child (aged under 15 years and who was under 13 years at the time of receiving their diagnosis from the specialist and the development of the PDD treatment and management plan).
The 20 services are for a lifetime, and may apply across a speech pathologist, psychologist and occupational therapist, as determined by the treatment and management plan prepared by the referring specialist.
See the information sheet from the Department of Health about the Medicare items available through this program Department of Health and Aged Care | Autism — Helping Children with Autism program.
Follow-up Allied Health Services for People of Aboriginal or Torres Strait Islander Descent
Additional assistance for people of Aboriginal and Torres Strait Islander descent who have had a health assessment to receive a Medicare benefit for follow-up allied health services. To access these items patients must be referred to an eligible allied health provider by their GP. Eligible patients can receive a maximum of five services -in addition to the five allied health services available each calendar year for patients who have a chronic medical condition and complex care needs. See: Department of Health and Aged Care | Follow-up Allied Health Services for People of Aboriginal or Torres Strait Islander Descent