Speech Pathology Funding

Speech pathology funding and rebate packages

Rebates for speech therapy

There are a variety of rebates and funding available for speech pathology consultations. At ENT Clinic patients can claim rebates for their consultations and treatment from a variety of sources including medicare and private health insurance. To access a Medicare rebate, a referral from the GP or relevant medical specialist will be necessary. A specific GP referral will also be necessary to access speech pathology services under the Department of Veterans Affairs and Motor Accident and Workcover Authority programs.

Medicare

The Chronic Disease Management Plan or Enhanced Primary Care Program from Medicare provides a rebate for up to 5 sessions per year. This rebate is available with a referral from your general practitioner.

Who is eligible for an EPC plan?

• Clients who have a chronic condition and complex care needs that are being managed by their GP under an Enhanced Primary Care (EPC) plan may be eligible. Up to 5 Medicare Allied Health Treatment services can be provided by certain allied health professionals including speech pathologists
• A chronic condition is one that has been present for six months or longer. 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, one of which may be a speech pathologist.
• Residents of aged care facilities may also be eligible for this program.
• Medicare rebates are available to assist in the diagnosis and initial allied health treatment of children with autism and other disorders, where the child is under 13 years of age at the time of diagnosis and under 15 years of age when receiving treatment. Up to 20 Medicare Allied Health Treatment services can be provided by certain allied health professionals including speech pathologists.

If you are unsure as to you (or your child’s) eligibility please discuss with your GP.

“Helping Children With Autism” FaHCSIA funding

If your child is under the age of 6 and has a diagnosis of Autistic Spectrum Disorder, you are eligible to apply to FAHCSIA to receive funding for therapy and resources until your child turns 7. For more information, or to apply for this funding, see: www.fahcsia.gov.au

The Helping Children with Autism Package is an initiative to assist families with children diagnosed with Autism Spectrum Disorder (ASD). There are a number of components to this package.

FaHCSIA funding summary:

• The GP refers the child to a Paediatrician or Psychiatrist who makes the referral to the speech pathologist for assessment, and following diagnosis, for treatment consultations
• Where the child has received a diagnosis of ASD and has been approved as eligible by an Autism Advisor, they may access funding for an Early Intervention program
• The child must be under 6 years of age when eligibility is approved and under 7 years when receiving the service
• The total funding package for Early Intervention is $12,000 ($6,000 per financial year for 2 years)

Families, carers and teachers may also benefit from specific autism related education workshops and website resources

“Better Start” funding

Children who have a diagnosis of cerebral palsy, Fragile X syndrome, Down syndrome, or moderate or greater hearing or vision impairment may receive funding for therapy and resources until your child turns 7.

What does the Better Start initiative include?

The Better Start for Children with Disability (Better Start) initiative includes:

• The GP refers the child to a Paediatrician or Psychiatrist who makes the referral to the speech pathologist for assessment, and following diagnosis, for treatment consultations
• The child must be under 6 years of age when eligibility is approved and under 7 years when receiving the service

• Up to $12,000 in funding for early intervention services and treatments for eligible children
• Additional assistance for eligible children who live in outer-regional, rural or remote locations to help with the costs of accessing services

Who is eligible to receive support under Better Start?

Eligible children who are aged under six years and have been diagnosed with:

• Down syndrome
• Cerebral palsy
• Fragile X syndrome
• A moderate or greater vision or hearing impairment, including deafblindness
• Prader Willi syndrome
• Williams syndrome
• Angelman syndrome
• Kabuki syndrome
• Smith-Magenis syndrome
• CHARGE syndrome
• Cornelia de Lange syndrome
• ‘Cri du Chat syndrome
• Microcephaly

Private Insurance

Consultation with a speech pathologist is covered under many private health insurance policies. Please speak directly to your private insurance company to see if you are eligible for speech therapy rebates.

Veterans Affairs and DVA Gold Card Holders

We are registered for services through Veterans Affairs for DVA gold card holders.

Workers Compensation

We also provide services to Workers Compensation clients.

Contact Us

If you have any queries about speech pathology funding or the cost of speech therapy sessions please contact us on 1300 123 368 Sydney.

For more information about funding for speech pathology

For FaHCSIA funding: fahcsia.gov.au

For better start funding: better start funding