HICAPS facilities are available at our clinic which allow you to claim from your health fund at the time of payment.
Do I need a referral from a doctor?
You do not need a referral from a doctor to see a speech pathologist, however some private health funds may require a referral letter from a doctor before paying benefits for speech pathology. We recommend that you contact your private health fund to discuss.
Eligibility for Funding
Medicare does not cover speech pathology services unless the client has a current Chronic Disease Management Plan (Previously known as the Enhanced Primary Care Plan). This referral is made by the client’s GP and covers five allied health services per year. Your GP will nominate the number of sessions that your child will receive. The five sessions may cover one type of service (e.g. speech pathology) or a combination of different types of services including: speech pathology, audiology, physiotherapy, occupational therapy etc. You will receive a rebate of $52.95 per session (as at Dec’ 2014). The five sessions cannot be simultaneously covered by the private health fund.
Talk to your GP as they will refer you to an eligible speech pathologist.
Private Health Insurance
Speech Pathology services can be rebated under certain ancillary tables of private health funds. Our speech pathologists are recognised by Private Health Funds as providers, so a portion of our fees are claimable. Consult your health fund to obtain details on the rebate amount or speech pathology consultations and the maximum amount you can claim per person or family in a calendar year.
Helping Children with Autism (HCWA)
HCWA is a funding scheme that has been allocated by the federal government, for early intervention services for children with Autism Spectrum Disorder (ASD), or Pervasive Developmental Disorder (PDD). Provided your child is aged 0-7 years and has not started full time compulsory schooling, you are eligible to access the funding. Families who are eligible can spend up to $6000 per financial year (up to a total of $12000) on early intervention for the child.
Further information on the Helping Children With Autism Package can be found on:
Better Start for Children with Disability Initiative
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 deaf blindness
– Prader Willi syndrome
– Williams syndrome
– Angelman syndrome
– Kabuki syndrome
– Smith-Magenis syndrome
– CHARGE syndrome
– Cornelia de Lange syndrome
– ‘Cri du Chat syndrome
– Microcephaly or
– Rett’s Disorder*
Parents or carers of eligible children will need to register their child for the Better Start early intervention funding before the child turns six years of age. Registration of eligible children is managed by the dedicated Registration and Information Service (RIS), which is operated by Carers Australia. To register a child for the Better Start early intervention funding parents and carers must call the RIS on 1800 242 636.