📅 Updated: 19 March 2026
⚠️ This is a general guide only. Clients should seek independent advice where needed.
⚠️ This is a general guide only. Clients should seek independent advice where needed.
Private Health Insurance
✅ Eligibility
- Depends on your insurer and level of cover
- Clients must check directly with their provider
- No private health details needed
- Invoices automatically include correct HICAPS codes but we cannot process rebate
- Varies depending on your insurance plan
- Pay invoice in full
- Receive receipt from Spark
- Submit claim to your insurer to receive a rebate
- Initial consultation: 310–330 (depending on duration of session)
- Subsequent consultation: 340–360 (depending on duration of session)
- Group session: 370–390 (depending on duration of session)
- Assessments
- Individual therapy
- Group sessions
- Parent/teacher/allied health meetings (without client present)
- Report writing
- Services not delivered directly to the client
- Initial sessions usually have higher rebates
- One initial consultation per therapist per calendar year
Chronic Condition Management Plan
Formerly referred to as Enhanced Primary Care Program.
✅ Eligibility
✅ Eligibility
- Under 25 years old
- Must have a condition lasting (or likely to last) 6+ months
- Requires GP assessment and referral
- Signed + dated GP referral letter. Please note that you may need a longer appointment with the referring practitioner for them to assess your eligibility criteria for this referral.
- $61.80 per session
- Higher if Medicare Safety Net reached
- 5 sessions total per calendar year (across all services)
- Referral valid for 18 months
- Still limited to 5 sessions per calendar year
- Pay invoice in full
- Receive receipt
- Claim via myGov app. For further information click here.
- Assessments
- Individual therapy (in-person or telehealth)
- Parent/teacher/other meetings
- Group sessions (incl. holiday programs)
- Report writing
- Services not delivered directly to the client
- Indigenous Australians may access additional sessions
Complex Neurodevelopmental Disorder and Disability Services Plan
May also be referred to as “M10”.
✅ Eligibility
📋 What Spark Requires
✅ Eligibility
- Under 25 years old
- Diagnosed or suspected neurodevelopmental disorder such as ASD or eligible disabilities
- Stuttering
- Speech sound disorders including articulation and phonological disorders, childhood apraxia of speech (also known as dyspraxia, developmental verbal dyspraxia, or speech apraxia), and dysarthria)
- Cleft lip/palate
- Sensory problems such as hearing and vision impairment
- Chromosomal disorders such as Fragile X syndrome
- conditions with multiple causes such as cerebral palsy
- Down syndrome
📋 What Spark Requires
- Referral from GP, paediatrician, or eligible specialist. Please note that you may need a longer appointment with the referring practitioner for them to assess your eligibility criteria for this referral. A GP will need to claim item 139 and create a treatment plan in order for you to claim a rebate with Medicare under this plan.
- Additional referral needed after a course of treatment. A course of treatment is:
- 4 assessment sessions OR
- 10 treatment sessions
- $87.25 per session
- Higher if Medicare Safety Net reached
- 8 assessment sessions (lifetime)
- 20 treatment sessions (lifetime)
- Based on expiry date within the referral OR
- Default: 18 months from first session
- Pay invoice in full
- Receive receipt
- Claim via myGov app. For further information click here.
- Assessments
- Individual therapy
- Meetings. However, conferences where the referring doctor is present, may be eligible for a rebate
- Group sessions
- Report writing
- Services not delivered directly to the client
- You may be able to use BOTH CCM + CND plans, but it is up to referring doctor whether they can refer you for both.
