Funding Options for Therapy Services

Below is a summary of the most common options available.

Medicare 

Chronic Disease Management (CDM) Plan

Also known as a GP Management Plan or EPC, this referral is provided by your GP and allows your child to access up to 5 Medicare-subsidised sessions per calendar year with eligible allied health professionals, including speech pathologists and occupational therapists.

• A rebate of around $58 per session (subject to current Medicare rates)
• Referral is needed from your GP
• You pay the full session fee upfront, and claim the rebate back through Medicare

We are happy to help you understand how many sessions are left on your plan or provide receipts to support your rebate claim.

M10 Item Group

• Are under 25 years of age

• Have a referral from a GP, consultant physician or specialist

• Have a diagnosis (or suspected diagnosis) of an eligible condition.

• Autism Spectrum Disorder (ASD)

• Attention-Deficit/Hyperactivity Disorder (ADHD)

• Cerebral palsy

• Down syndrome

• Fragile X syndrome

• Moderate to severe intellectual disability

– Speech & communication conditions (expanded March 2026)

• Stuttering

• Speech sound disorder, including:

  • Articulation disorder

  • Phonological disorder

  • Childhood apraxia of speech

  • Dysarthria

• Cleft lip and/or palate

• Up to 8 allied health assessment sessions (lifetime limit)

• Up to 20 allied health treatment sessions (lifetime limit)

Medicare provides a rebate per session of around $80. Depending on session fees, there may be a gap payment.

M11 – Health Services for Aboriginal and Torres Strait Islander People

First Nations Australians may be eligible for Medicare rebates for Allied Health Services. This referral is provided by your GP or Health Service and allows your child to access up to 10 Medicare-subsidised sessions per calendar year with eligible allied health professionals, including speech pathologists and occupational therapists.

• A rebate of around $60 per session (subject to current Medicare rates)
• Referral is needed from your GP
• You pay the full session fee upfront, and claim the rebate back through Medicare

We are happy to help you understand how many sessions are left on your plan or provide receipts to support your rebate claim

Defence 

ADF Family Health Program

Families of current ADF members may be eligible for therapy support through the ADF Family Health Program.

• Full or partial rebates for allied health services
• No GP referral required
• We can provide invoices and supporting documentation to assist your claim

Check with your Defence health administrator or visit www.adffamilyhealth.com to see what’s available to you.

Private Health Insurance

If you have extras cover, your child may be able to claim rebates on speech pathology or occupational therapy.

• Rebate amounts depend on your health fund and level of cover
• No referral needed
• We can provide on-the-spot claims with HICAPS or detailed receipts for you to submit

Contact your fund to confirm what’s included in your policy.

Self-Funded / Out-of-Pocket

No funding plan? No problem!

Families are always welcome to access our services privately without needing a referral.

• Choose the frequency and type of service that suits your child
• Invoices can be provided for tax or record-keeping purposes
• We’re happy to discuss a therapy schedule that works for both your goals and your budget.