funding

Funding Options for Occupational
Therapy Services

ndis

National Disability Insurance Scheme

We are approved to provide Occupational Therapy Services under the NDIS for children, adolescents and adults. Our team of OT’s are able to provide Assessment, Individual Therapy, Group Therapy and Training tailored to you or your child’s needs.

medicare

Medicare Rebates

There are a number of Medicare schemes that allow children and adults to access funding support for Occupational Therapy services. Ability Focus Occupational Therapy are registered to provide the following Medicare Schemes:

Chronic Disease Allied Health Service:

This Medicare Scheme can provide 5 rebated allied health sessions per calendar year. Eligibility criteria states that you must have a “chronic” condition (having been present for over 6 months) and there needs to be 2 health professionals involved in the clients care. The 5 sessions are for all Allied Health Professionals and not 5 per Allied Health Professional.

Your GP must coordinate the GP Management Plan or Team Care Plan with you.

For more information:

http://www.health.gov.au/internet/main/publishing.nsf/Content/mbsprimarycare-chronicdisease-pdf-infosheet

Rebate is: $52.95 per session

Better Access to Mental Health:

This Medicare Scheme can provide up to 10 rebated mental health sessions per calendar year for clients with an assessed mental disorder such as anxiety, depression, conduct disorders, emotional disorders, etc. Initially referrals are for 6 sessions to a suitably qualified therapist (e.g. Clinical Psychologist, Occupational Therapist, Social Worker, etc) and after the 6 sessions a review can be conducted where you may receive another 4 rebated sessions in that same calendar year.

Referrals can be made by your GP, Psychiatrist or Paediatrician.

For more information:

http://www.health.gov.au/internet/main/publishing.nsf/Content/mbsprimarycare-chronicdisease-pdf-infosheet

Rebates vary depending on length of session and/or location. Rebates is between $52.95 and $74.55

Helping Children with Autism:

This Medicare Scheme provides early intervention services for children undergoing diagnosis/assessment or treatment for autism or any other PDD. Eligible children are entitled to receive up to 4 assessment sessions (for children under 13 years of age) and up to 20 intervention sessions (for children under 15 years of age). These sessions can be spread across the years (up to cut-off ages) and are NOT renewable each calendar year.

Referrals can be made through your Paediatrician or Psychiatrist only.

For more information:

http://health.gov.au/internet/main/publishing.nsf/Content/025DB7067A4FAA8BCA257BF0001F50AB/$File/Autism_Fact%20Sheet_20-02-14.pdf

Rebate is: $74.80 for assessment and treatment sessions.

Better Start for children with disabilities:

This Medicare Scheme provides early intervention services for children undergoing diagnosis/assessment or treatment of children who are eligible for this services (i.e. vision impairment, hearing impairment, Cerebral Palsy, Fragile X Syndrome, Down Syndrome, Prader-Willi Syndrome, Williams Syndrome, Angelman Syndrome, Kabuki Syndrome, Smith-Magnesis Syndrome, CHARGE Syndrome, Cri du Chat Syndrome, Cornelia de Lange Syndrome, microcephaly).

Children with an eligible disability can be referred by a GP, specialist or consultant physician for the following OT services:

  • up to four diagnostic/assessment services from psychologists, speech pathologists, occupational therapists, audiologists, optometrists, orthoptists or physiotherapists to assist the referring practitioner with diagnosis or to contribute to a child’s treatment and management plan (for a child under 13 years of age).
  • up to twenty treatment services from psychologists, speech pathologists, occupational therapists, audiologists, optometrists, orthoptists or physiotherapists (for a child under 15 years of age, providing a treatment and management plan is in place before their 13th birthday).

These are the total number of services available to each child through the Better Start program – not an annual entitlement.

For more information: http://www.health.gov.au/children-disability

Rebate is: $74.80 for assessment and treatment sessions.

Australian Government

FaHCSIA Funding

Children with Autism:

Helping Children with Autism (HCWA) and Better Start for Children with Disability (Better Start):

Ability Focus Occupational Therapy provides services under these funding schemes. These packages are being phased out and replaced with NDIS plans for eligible individuals.

Please refer to the contact details below to discuss these schemes further with the Australian Department of Social Services.

Tel: 1800 778 581

Email: early.intervention@dss.gov.au

Private Insurance

Ability Focus Occupational Therapy is an approved provider for private health fund rebates. Contact your insurance company to find out what cover you have for our services.

Call or email to discuss fee schedule.

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