|Accessing Medicare Funding
Over recent years there have been Medicare schemes established
that enable people to access funding for Occupational Therapy
services. Coastwide Therapy Services is registered with Medicare.
Helping Children with Autism
This package entitles children with an Autism Spectrum Disorder
to claim up to 4 sessions for assessment (until 13 years of age)
and up to 20 sessions for treatment (until 15 years of age). In
order to access this package an initial consultation is required
with a Paediatrician or Psychiatrist (NOT a GP) to register the
diagnosis with Medicare therefore making the child eligible for
these rebates. Please NOTE these consultations can only be used
ONCE within the lifetime of the child, and NOT every calendar
year. The sessions can be spread across years and used with a
range of health professionals. It covers diagnoses of Autism,
Pervasive Development Disorder, Rett's Disorder, Asperger's Syndrome
and childhood Disintegrative Disorder. The amount rebated for
Occupational Therapy is $70 per assessment and treatment session.
Coastwide Therapy Services is an eligible provider of early intervention
services under the FaHCSIA guidelines for children with Autism
Spectrum Disorder. To be eligible for the early intervention funding package a child
must have been seen by an Autism Advisor and deemed eligible to
access the program before their sixth birthday. The $12,000 in
funding under the early intervention component can be used until
the child's seventh birthday to a maximum of $6,000 per financial
year. The Autism Advisor for NSW is ASPECT and they
can be contacted on 1300 978 611
Better Start for children with disabilities
As of 1 July 2011, children who are aged under 6 years and have
been diagnosed with Down syndrome, cerebral palsy, Fragile X syndrome,
or a moderate or greater vision or hearing impairment, including
deafblindness, can be registered to access early intervention
funding. If a child is diagnosed with one of the listed disabilities
he/she can be registered to access early intervention funding
of up to $12,000 (up to a maximum of $6,000 per financial year).
The funding can be used to pay for early intervention services
provided by health professionals who are members of the Better
Start Early Intervention Service Provider Panel. The professionals
on the panel include speech pathologists, audiologists, occupational
therapists, physiotherapists, psychologists, orthoptists and others.
In order to access this package children are required to be seen
by a paediatrician, OR a relevant medical specialist, such as
a neurologist, ophthalmologist, otologist or ENT, OR your GP,
OR Australian Hearing.
Support for families with older children
A Medicare item for the development of a treatment and management
plan will be available for children up to the age of 13. Medicare
items will also be available for up to four allied health diagnostic
services and for a total of 20 relevant allied health services
per eligible child.
The new items will be available for children up to the age of
15 provided the treatment and management plan is in place before
13 years of age.
To register your child for the Better Start initiative, call the
Carers Australia RIS on 1800 242 636.
For further information about the Better Start initiative, please
visit the Department of Families, Housing, Community
Services and Indigenous Affairs (FaHCSIA) website at www.fahcsia.gov.au.
Enhanced Primary Care Program
This program can be accessed through your GP. The eligibility
criteria states that you must have a "chronic" condition
(your condition is likely to impact you for over 6 months) and
there needs to be 2 health professionals involved in providing
services. Your GP must co-ordinate the Care Plan and send out
the appropriate referrals to the involved health professionals.
Under this program you can access up to 5 sessions in total for
individual therapy rebated by Medicare for "Allied Health"
NOT 5 sessions for each professional, per calendar year. The Health
Professional providing the service must be registered with Medicare.
For Occupational Therapy the rebated amount is approximately $50
Better Access to Mental Health
This program can be accessed via your GP, Psychiatrist or Paediatrician.
You must be clinically diagnosed with a specific mental disorder
(these include Anxiety, Depression, Conduct Disorders, Sleep Problems,
ADHD etc). This program entitles you to up to 12 session rebates.
Initially referrals are for 6 sessions to an Allied Health professional,
after this time the health professional must write to the referrer,
and you may receive another 6 sessions if needed. Health professionals
must be registered as a Mental Health provider with Medicare.
12 sessions are calculated per calendar year. Rates of rebate
may vary, however typically 45 minute session conducted at the
clinic, the rebate is approximately $50 and approximately $70
for a session that is a minimum of 50 minutes long.