Fees and Rebates

Medicare

Your child will be eligible for a Medicare rebate if they are accessing Speech Pathology services. You need to get a Medicare Plan from your GP or Paediatrician prior to your first session in order to claim the rebate. Please note that we charge a gap fee, so you will have some out of pocket expenses.

The following is an outline of the Medicare rebates available when receiving Speech Therapy services:

CDMP – Chronic Disease Management Plan formerly known as Enhanced Primary Care (EPC)

The Chronic Disease Management scheme is initiated by your General Practitioner and available to children and adults with Chronic Care needs. People with Autism are automatically eligible for the CDM because an Autism Spectrum Disorder is a chronic condition.

The Medicare rebate is available for 5 sessions of Allied Health therapy, including Speech Pathology and Occupational Therapy, per calendar year.

Please note that CDM plans are ONLY allowed to be used for Individual Therapy sessions. The CDM Plan does NOT allow for Group Therapy sessions, including Social Skills Groups, to be claimed by Medicare.

For more information about the CDM program you can download the following Information Sheets from Medicare and Speech Pathology Australia or speak to your General Practitioner.

  • Initial Consultations :$90.00 each (30 minutes) into 2 sessions. Medicare rebate per session is $52.50.

 Helping Children With Autism Medicare Rebates 0-13yrs

In July 2008 the Federal Government introduced the Helping Children With Autism H.C.W.A)Initiative. Under this initiative, it is now possible for families to claim rebates from Medicare for Assessment and Treatment for Children with Autism Spectrum Disorders, providing a referral has been made by a Paediatrician.
The paediatrician can allocate up to 4 sessions for assessment for which rebates are available up until the child turns 13 years of age.

For further information on these schemes, links to the following website Information Sheets will be helpful:
Speech Pathology Australia
Amaze (Autism Victoria)
Medicare Australia

There are two separate codes for Speech Pathology services under this code:
  • Autism Assessment Package $630 (7*30 minutes sessions)
This includes:
– formal language and pragmatic and language assessments
– observations
– discussions with parents and educators
– liaison with any additional professionals
– a detailed language and pragmatic language
  • Subsequent Therapy Sessions: $90.00 each (30 minutes). Medicare rebate per session is $74.80 upto 20 sessions (one time use) until 15 years of age.

DSS Funding

There are two types of funding streams under the Department of Social Services (DSS), previously known as FaHCSIA funding:

HCWA  Helping Children with Autism Package

We are registered providers for the Helping Children with Autism Initiative (HCWA), which provides up to $12,000 in funding to children with a diagnosis of autism. This funding can be used to pay for speech therapy services for your child. For more information about HCWA, click here».

BETTER START

We are registered providers for Better Start, for Children with Disability initiative

  • $12,000 available funding for early intervention services and treatments
  • Up to a maximum of $6,000 in any one financial year
  • $2,100 can be used for resources per financial year

For more information about Better Start, click here».

To be eligible your child must:

· Be aged 0 – 7 years
· Have been diagnosed with an Autism Spectrum Disorder (with a written diagnosis)
· Be an Australian resident or meet Centrelink’s Residential Requirements for Carer Allowance.

If you think your child may be eligible for this program, you will need to do the following:

1. Phone Amaze (formerly Autism Victoria) on 1300 308 699 or 9657 1600 to make an appointment with an Autism Advisor. At this appointment the child’s eligibility and needs are discussed.
2. If your child is eligible you will receive a ‘Letter of Introduction’ from the Autism Advisor.
3. Your next step is to contact us at Language for Life Speech Pathology Services and register your child and complete the appropriate paperwork.
4. At your first FaHCSIA funded session you will need to complete FaHCSIA Client Consent Forms and services may then commence.
5. At the completion of each session, FaHCSIA requires you to sign a form that acknowledges provision of the service.
6. Invoices for Speech Therapy services will be sent directly to FaHCSIA for payment.You will be issued with a copy of the invoice.

NDIS

NDIS is a new national funding scheme being rolled out across the disability sector in Australia over the next few years. NDIS offers an information and referral service to any Australian with any level of disability, including access to specialist disability support services.

If eligible for NDIS, your child will receive funding on an annual basis to buy the services and aids your child needs to achieve your goals and achieve optimal independence.

You can decide whether to manage the funds yourself (“self-managed”) or you can ask the NDIS to manage these funds for you.

Language for Life Speech Pathology Services is registered and currently accepting families who are currently receiving NDIS funding. Please note we are registered as “MELBOURNE SPEECH PATHOLOGIST PTY LTD trading as Language for Life”. 

Contact us for more information or visit the NDIS website at http://www.ndis.gov.au/families-carers

Private Health Insurance

Language for Life Speech Pathology Services allows you to claim through your private health extras.

Depending on your private health fund, you may be eligible for a private health rebate from your OT or Speech Pathology sessions. In order to claim a rebate, this can be completed at our clinic at the time of payment, using our HICAPS machine. Alternatively, you can present your receipt to your private health fund and they will organise the rebate to your nominated account.

Your eligibility for a rebate and amount will depend on your specific health coverage. Private health rebates do alter and coverage may be different depending on when you purchased your private health insurance. Coverage also has annual limits that you will need to check with your private health fund.

If you would like to check exactly how much you will get back for therapy services with your specific private health fund, please contact your fund directly and quote one of the following codes:

A121 – Initial Consultation
A022 – 60 minute therapy session (Extended Consultation)

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