Medicare
Speech Pathologists are recognised by Medicare as health care providers that can form part of a larger multidisciplinary team that manages clients with chronic and complex health needs.
All our Speech Pathologists are registered Medicare Providers that are eligible to provide Speech Pathologist Services with the EPC/CDM or Item 135 Rebates.
You will need to claim your Medicare Rebate directly through Medicare, either using the Express Plus Medicare mobile application or attending a Medicare office. We do not have HICAPS available in our clinic
Enhanced Primary Care (EPC) Plan / Chronic Disease Management Plan
Your GPO will prepare a GP Management Plan and Team Care Arrangements and make a referral to the Speech Pathologist using a CDM/EPC referral form. You must provide your therapist with a copy of the Referral Form prior to commencing your next session. This can also be handed to our administration staff or emailed to blacktownspeech@bigpond.com.
Your GP then nominates the number of sessions up to a maximum of 5 per calendar year (if all sessions are not used during the calendar year in which you were referred, the unused sessions can be used in the next calendar year. However, those sessions will be counted as part of the 5 sessions which allied health professionals available to you during that calendar year). The five sessions are per client, not five sessions per allied health professional, and may be used across a number of allied health professionals (e.g. three with a Speech Pathologist and two with an Occupational Therapist).
Early Intervention Services for Children with ASD/PDD – MBS Item 135
A referral under Item 135 is made by the child’s Consultant Paediatrician in the form on a letter or note that is address to the Allied Health Professional (e.g. the name of your Speech Pathologist), and is signed and dated. Only one Item 135 management plan can be made in a child’s lifetime and a separate referral is made for each allied health professional involved in a child’s management plan.
The Consultant Paediatrician is responsible for managing the plan and reviewing the child’s attendance and progress as they receive services. It is the responsibility of the child’s Allied Health Professional/s to communicate with the Consultant Paediatrician during the duration of the plan. Under the MBS Item 135 referral, a child can access a Medicare rebate for the following services in their lifetime:
- Up to four diagnostic/assessment services before a child turns 13. Information obtained from these services can assist the paediatrician in making a formal diagnosis and/or contribute to a child’s treatment and management plan.
- Up to twenty treatment services before the child turns 15 (given the management plan was put in place before the child turns 13).
You will need to contact Medicare directly to determine the rebate amount. We do not bulk bill. You will need to pay for your assessment/therapy session in full and claim for your rebate directly from Medicare.
We look forward to speaking with you!
