Medicare | Therapy Services
Therapy services funding support available through Medicare includes:
Team Care Arrangements
TCA's can be set up by your GP. The GP's role is to determine the appropriate programme for your child based on your concerns, to refer to relevant service providers and to monitor/coordinate care. This is officially termed a Chronic Disease Management Plan (previously called Enhanced Primary Care or EPC). Children are referred to therapists at Skillbuilders by their GP for up to 5 therapy sessions per calendar year. This can be for 5 sessions of one therapy, eg OT, or any combination of speech, physio and/or OT sessions to a total of five.
MBS Item numbers for Allied Health assessment and treatment sessions are:
- 10958 Occupational Therapy
- 10960 Physiotherapy
- 10970 Speech Pathology
Current rebates are $58.00 per session. Please note: these services are not free. There is a gap between our fees and the Medicare rebate.
Helping Children with Autism programme
Under the HCWA programme a child can be referred by a paediatrician or psychiatrist for the following allied health services:
- up to 4 diagnostic/assessment services from psychologists, speech pathologists, and occupational therapists to assist the referring practitioner with diagnosis or to contribute to a child’s treatment and management plan (for a child under 13 years of age).
- up to 20 treatment services from psychologists, speech pathologists, occupational therapists, or physiotherapists (for a child under 15 years of age, providing a treatment and management plan is in place before their 13th birthday).
These are the total number of services available to each child through the Helping Children with Autism program – not an annual entitlement.
Assistance with diagnosis/contribution to a treatment plan - MBS items for allied health assessment of autism
- 82005 Speech pathologist
- 82010 Occupational therapist
- 82030 Physiotherapist
Treatment services - MBS items for allied health treatment of children with autism
- 82020 Speech pathologist
- 82025 Occupational therapist
- 82035 Physiotherapist
A course of treatment for the allied health treatment services consists of the number of allied health services stated on the child’s referral, up to a maximum of 10 services. This enables the referring practitioner to consider a report from the allied health provider(s) about the services provided to the child, and the need for further treatment.
Children require a separate referral for each allied health provider they are referred to and they will also need new referrals for each new course of treatment.
Current rebates are $81.90 per session. Please note: these services are not free. There is a gap between our fees and the Medicare rebate.