Fees and rebates

DSS

There are two types of funding streams under the Department of Social Services (DSS), previously known as FaHCSIA funding. These funding packages only apply to children diagnosed prior to their 6th birthday and can only be accessed until their 7th birthday. Both streams will come to a holt before the end of 2018.

Families will need to present a Letter of Introduction and sign convent forms prior to claiming services through WCSOT.

HCWA – Helping Children with Autism Package

BETTER START – The Better Start for Children with Disability initiative

  • $12,000 available funding for early intervention services and treatments
  • Up to a maximum of $6,000 in any one financial year
  • $2,100 can be used for resources per financial year

Families are required to present their Letter of Introduction from Amaze prior to claiming services through Splash Therapy.

After each session, families will be required to sign a Service Delivery form indicating that the session has been completed. Families will receive a quarterly statement from DSS regarding their funding balances.

NDIS

Children’s Speech and OT is a registered National Disability Insurance Scheme (NDIS) provider.

In order to provide your child with support, we require a copy of your NDIS plan in order to register you as a client.

NDIS sets fees each year for providers. These will vary depending on whether your child is accessing individual or group therapy.

MEDICARE (there’s another option for this below)

Your child may be eligible for a Medicare rebate if they are accessing Occupational Therapy or Speech Pathology services. You need to get a Medicare Plan from your GP or Paediatrician prior to your first session in order to claim the rebate. Please note that we charge a gap fee, so you will have some out of pocket expenses.

Due to a recent review of Medicare’s eligibility and processes specifically related to the Better access to mental health care, helping children with autism and the chronic disease plan (formally known as the enhanced primary care plan) it is important to note that allocation of Medicare plans and criteria for eligibility for plans is the responsibility of your GP or Paediatrician.

The following is an outline of the Medicare rebates available when receiving either Speech Therapy or Occupational Therapy services:

Speech Pathology

ASD – Autism Spectrum Disorder Plans

  • There are two seperate codes for Speech Pathology services under this code:
  • Diagnosis assessment appointments – up to 4 assessment appointment eligible for rebates across allied health professional involved in diagnosis, psychologist, speech pathologist and OT: $112/hour rebate (max 3 hours)
  • 20 sessions (one time use) until 15 years of age: $74.95 rebate,

CDMP – Chronic Disease Management Plan

  • 5 sessions per calendar year
  • $52.95 rebate

Medicare rebates can be processed by our reception staff at the time of payment, or can be claimed through your Medicare claims app on your smart phone.

Rules
You cannot pay the gap with your private health insurance.
ASD and CDMP plans needs to be shared across allied health providers. i.e. 5 sessions equals 5 in total across OT and Speech Therapy if your child is accessing more than one service at a time.

Medicare Safety Net
Please contact Medicare to discuss the Medicare family Safety Net eligibility and registration. Once families meet the threshold each calendar year the rebates they are eligible for increase to 80% of the fee charged.

Occupational Therapy

CDMP – Chronic Disease Management Plan

  • 5 sessions per calendar year
  • $52.95 rebate

ASD – Autism Spectrum Disorder Plans

  • 20 sessions (one time use) until 15 years of age
  • $74.95 rebate

MHCP – Mental Health Care Plans

  • 10 individual, 10 group sessions per year
  • Individual clinic: $74.80 rebate
  • Individual offsite: $96.35 rebate
  • Group sessions: $19/session rebate

Private Health

Children’s Speech and OT allows you to claim through your private health extras.

Depending on your private health fund, you may be eligible for a private health rebate from your OT or Speech Pathology sessions. In order to claim a rebate, this can be completed at our clinic at the time of payment, using our HICAPS machine. Alternatively, you can present your receipt to your private health fund and they will organise the rebate to your nominated account.

Your eligibility for a rebate and amount will depend on your specific health coverage. Private health rebates do alter and coverage may be different depending on when you purchased your private health insurance. Coverage also has annual limits that you will need to check with your private health fund.