Medicare Benefit Scheme

Chronic Disease Management Plan (Item No: 2710) (Formerly known as the Enhanced Primary Care Plan)

Sally-Ann is happy to work with your General Practitioner (GP) to provide therapy under the Chronic Disease Management Plan. This is initiated by your General Practitioner and is available to children and adults with Chronic Care needs. People with Autism are automatically eligible for the CDMP  because an Autism Spectrum Disorder is a chronic condition.

The Medicare rebate is available for 5 sessions of Allied Health therapy, including Speech Pathology per calendar year. It only provides a partial rebate of the fee and is approximately $52.00.

The procedure to access this funding is as follows:

• Child’s GP assesses the patient’s eligibility for Chronic Disease Management (CDM) and makes a referral to a speech pathologist.
• The GP will recommend a speech pathologist or the patient can requests a referral to a known speech pathologist. At this point you can ask the GP to refer to Sally-Ann
• Sally-Ann is eligible to give this service as she is registered with Medicare Australia and has a provider number (2976721K)
• Up to a maximum of five services can be claimed per calendar year.
• The five services may be with one allied health professional or a number of allied health professionals.
• The patient claims the rebate using a receipt provided by the speech pathologist.
• The speech pathologist reports to GP at the end of the first and last service.

Helping Children With Autism Medicare Rebates

In July 2008 the Federal Government introduced the Helping Children With Autism initiative. It is now possible for families to claim rebates from Medicare for Assessment and Treatment for Children with Autism Spectrum Disorders, providing a referral has been made by a Paediatrician.

The Paediatrician can allocate up to 4 sessions for assessment for which rebates are available up until the child turns 13 years of age.

For children with a diagnosis of Autism Spectrum Disorder, a total of 20 therapy sessions can be allocated, including Speech Pathology, until the child turns 15 years of age.

For further information on these schemes, links to the following website Information Sheets will be helpful: www.speechpathologyaustralia.org  and www.raisingchildren.net.au

Assistance for Parents who are suffering from Anxiety or Depression related to their child’s diagnosis.

The Chronic Disease Management Plan (Item No: 2710) can be drawn up by the parents’ general practitioner to assist those who are experiencing Anxiety or Depression in relation to their child’s Autism or Behaviour problems.