Speech Pathology services are supported through alternative options including Commonwealth FaHCSIA and Medicare Funding, and private health insurance rebates, school funded programmes. There are specific requirements regarding eligibility and claiming of rebates. Children can be assisted in the earliest years when initially attending Maternal and Child Health checks or once attending Kindergarten, Childcare and Early Intervention Programs. Later concerns may arise during their school readiness and transition phases. Whilst at school, speech pathology services can supplement individualised learning programs.
Private Health Insurance Rebates
Private Health Insurance rebates vary depending on your level of cover. Contact your Health Fund directly for a current schedule. Check both the initial consultation and subsequent visits, as they can vary. Accounts are payable to Healesville Speech Pathology and the rebate claimed afterwards. Present the receipt to your Health Fund.
The Department of Families, Housing,Community Services and Indigenous Affairs: FaHCSIA.
FaHCSIA provides assistance through the Helping Children with Autism (HCWA) and Better Start Funding Packages. Children must be deemed eligible for these funding packages.
For further information regarding eligibility go to:
Better Start Funding and Helping Children with Autism Packages
For more information about the Better Start initiative, contact the Better Start Helpline on 1800 778 581. This helpline operates from 9:30am to 12:30pm and 1:30pm to 5:00pm Monday to Fridays.
For more information about the Helping Children with Autism package, Call the ASD Support Helpline on 1800 778 581 This helpline operates from 9:30am to 12:30pm and 2pm to 5pm (EDST) Monday to Friday.
Eva Harrold represents Healesville Speech Pathology as a registered member of the ‘Early Intervention Service Provider Panel’ Irabina Childhood Autism Services Consortium. As such, all claims for payment are arranged by Healesville Speech Pathology through Irabina. Fees for service relate to the type of setvice provided whether in the clinic, as outreach to a school or kindergarten or home. Service delivery options and the subsequent cost can be discussed directly with the Speech Pathologist, Eva Harrold.
A fee schedule table for Service Providers (Speech Pathology, Occupational Therapy,Physiotherapy and Psychology) within the Consortium: Irabina Childhood Autism Services can be found here.
Medicare - Allied Health Services For Complex and Chronic Conditions
(Chronic Disease Management CDM formerly known as Enhanced Primary Care EPC)A chronic condition is one that has been present for six months or longer.
Patients are considered eligible if their GP has completed the following prerequisite Chronic Disease Management items in the previous two years:
• a GP management plan (GPMP)—item 721 (or item 732 for a review of a GPMP)
• Team care arrangements (TCAs)—item 723 (or item 732 for a review of TCAs).
GP assesses patient’s eligibility for Chronic Disease Management (CDM) Items (previously known as EPC) plan and makes referral to speech pathologist
GP recommends a speech pathologist (or the patient requests a referral to a known speech pathologist)
Speech pathologist must be registered with Medicare Australia
Up to maximum of five services can be claimed per calendar year
The five services may be with one allied health professional or a number of allied health professionals
Patient claims rebate using receipt provided by speech pathologist
Speech pathologist reports to GP at the end of the first and last service
The speech pathologist must be registered with Medicare to be part of the CDM program.
The speech pathologist provides a written report to the GP on the first and last service only or more often if clinically relevant.The report will outline the speech pathologists assessment findings or treatment outcomes and future therapy plan or involvement with the patient.
How much is the Medicare rebate?
The rebate is currently $52.95. Medicare rebates are indexed on 1 November each year.
The out-of-pocket expense (gap) will count towards the Medicare safety net.
The client may not claim a Medicare rebate and a private health insurance rebate for the same service. The client must choose which rebate they are going to claim for a service.
Phone: 132 011
Medicare funded assessment and treatment of children with Autism Spectrum Disorder
Refer to fact sheet here.