Medicare Rebates for Speech Pathology

Families often ask whether Medicare can help with the cost of speech pathology. 

In some situations, Medicare rebates may be available.  These depend on your child’s individual circumstances, and require a GP to determine whether a child is eligible.

This page explains when Medicare may apply, how the system works, and what families might consider when planning therapy.

Medicare rebates for speech pathology are available under a Chronic Condition Management Plan, arranged by a GP. 

A GP may determine that a child is eligible if they have a condition that:

• Has been present, or is expected to be present, for six months or longer
• Requires ongoing management by a medical practitioner

Eligibility is based on the presence of a chronic condition and the GP’s clinical judgement.

Speech pathology is recognised as an eligible allied health service under Medicare, but rebates are only available when a valid plan and GP referral are in place.

Note: Children must also be eligible to receive Medicare Benefits in Australia to be considered for this plan.

Under Medicare, rebates are available for up to five allied health sessions per calendar year in total. These five sessions are not just for speech pathology.

This means the five sessions are shared across all allied health services, such as:

• Speech Pathology
• Occupational Therapy
• Physiotherapy
• Psychology, or
• Other eligible allied health supports

Your GP decides how many sessions are allocated to each service, based on your child’s needs.

For example:

If a child has a Chronic Condition Management Plan and is referred to:

• Speech Pathology
• Occupational Therapy

The GP might allocate:

• 3 sessions to speech pathology
• 2 sessions to occupational therapy

Once those five sessions are used, no further Medicare rebates are available for allied health for that calendar year, even if they were all used for one type of allied health service.

Medicare rebates cover part of the cost of a speech pathology session. They do not usually cover the full fee. Families pay the remaining amount, often called the gap.

Rebate amounts are set by the Australian Government and may change (see here for current details: Item 10970 | Medicare Benefits Schedule). 

Your clinic can explain current rebate amounts and how claiming works at your location.

1. Speak with your GP about your concerns with your child's speech and language development.  Your GP will determine whether or not a Chronic Condition Management Plan (CCMP) is appropriate.
2. If your child is eligible for a CCMP, ask how the five allied health sessions can be allocated in your individual situation.
3. Talk with your Speech Pathologist about fees, rebates, and other funding options.

If you're interested in learning more about our speech therapy services or would like to schedule an appointment, please contact us. Our friendly staff are available to answer any questions you may have and help you get started with therapy. 

If you would like to find a speech pathologist closer to home please see here to Find a Speech Pathologist   

Note: This is a list of Certified Practising Speech Pathologists who have agreed to have their contact details made available to the general public. It is not a full list of all speech pathology services throughout Australia - there may be services such as hospitals, community health centres etc that may not be listed here. Please speak with your GP, local council, Primary Health Network etc about services in your area.