Medicare Benefit Schemes

1. The Chronic Disease Management (CDM) Plan

The Chronic Disease Management (CDM) Plan previously known as the Enhanced Primary Care (EPC) Plan provides Medicare rebates for up to 5 Allied Health services (i.e. Speech Pathology and Occupational Therapy) per patient per calendar year.  

Who can access this funding?

A CDM plan is available to people who have a chronic medical condition and complex care needs that are being managed by their GP. A chronic medical condition is one that has been or will be present for six months or more.

How do I access this funding?

Your GP will determine whether your child is eligible for a CDM plan.

Where can I find out more information?

For further information, please contact your GP.

Alternatively, you can visit the Department of Health and Aging, MBS Primary Care Items

Please note that the CDM Plan can ONLY be used for individual therapy sessions. The CDM Plan cannot be used for group therapy sessions.

2. Helping Children with Autism Initiative

The Helping Children with Autism initiative is a funding scheme that enables children with autism or other pervasive developmental disorders to access early intervention services. Eligible children are entitled to a maximum of 4 rebated sessions for Allied Health assessments (i.e. Speech Pathology or Occupational Therapy) and a further 20 rebated sessions for Allied Health intervention.

These rebated sessions are available once a lifetime, and once used, cannot be claimed again.

Who can access this funding?

Children under the age of 13yrs may be eligible for assessment and treatment funding. Children under the age of 15yrs who have a previous diagnosis of ASD or PDD may be eligible for treatment funding only.

How do I access this funding?

If you suspect your child has ASD or PDD, consult your GP who can provide you with a referral to see a Paediatrician or Psychiatrist if appropriate. If further investigation is required, the Paediatrician or Psychiatrist may refer your child to an Allied Health professional for further assessment and treatment.

If your child already has a formal diagnosis of ASD or PDD, your existing Paediatrician or Psychiatrist will be able to provide you with a referral to an Allied Health professional.

Where can I find out more information?

For further information, please contact your child’s GP, Peadiatrician or Psychiatrist.

Further information is also available on the Department of Health and Aging, Helping Children with Autism website

Please note that the HCA Plan can ONLY be used for individual therapy sessions. The HCA plan can NOT be used for group therapy sessions.