Clients may be able to be reimbursed for some of the costs of private speech therapy services under:
- Medicare,
- Their private health insurance fund,
- Or a range of other government or state initiatives.
Private Health Rebates
It is recommended that clients contact their private health insurance provider to find out if they are covered for speech pathology services.
The relevant items are as follows:
The relevant items are as follows:
- Initial consultation: Item 310 to 330 (depending on time of consultation)
- Subsequent consultation: Item 340 - 360 (depending on length of consultation)
- Group session: Item 370 to 390 (depending on length of consultation)
Chronic Condition Management Plan
Formerly referred to as Enhanced Primary Care Program. This is a letter from your GP addressed to Spark Speech Pathology requesting for a Chronic Management Plan to be used for our services.
Spark clients may be eligible for a CCM plan if:
Spark clients may be eligible for a CCM plan if:
- The client has social communication difficulties due to a developmental or language delay or disorder.
- The client: has not met their speech and/or language milestones due to a developmental delay or language delay or disorder.
- The client has speech, language and/or swallowing difficulties related to a physical and/or intellectual disability.
- The client is difficult to understand because of a speech delay or disorder.
- The client finds it difficult to understand people, has a reduced vocabulary, cannot put sentences together or take part in conversations due to a language delay or disorder.
- The client loses their voice, cannot talk loudly or has poor voice quality due to a voice problem.
- The client has dysfluent speech due to stuttering.
Complex Neurodevelopmental Disorder
Age limit eligibility : under 25 years old
Update: From 1 March 2026, the definition of "eligible disabilities" will be expanded to incorporate people who have, or are suspected of having, stuttering, speech sound disorders and cleft lip and/or palate to access allied health assessment, diagnosis and treatment services.
Paediatrician referral
A letter will need to be adressed to us from a paediatrician requesting we use this plan for our services.
The suspected diagnosis of a Complex NDD requires evidence of requiring support and showing impairment across two or more neurodevelopmental domains. Complexity is characterised by multi-domain cognitive and functional disabilities, delay or clinically significant impairment.
Neurodevelopmental domains include:
Treatment: total of 20 per life time per client. However, after 10 sessions a new letter referral is needed following review from the paediatrician.
Update: From 1 March 2026, the definition of "eligible disabilities" will be expanded to incorporate people who have, or are suspected of having, stuttering, speech sound disorders and cleft lip and/or palate to access allied health assessment, diagnosis and treatment services.
Paediatrician referral
A letter will need to be adressed to us from a paediatrician requesting we use this plan for our services.
The suspected diagnosis of a Complex NDD requires evidence of requiring support and showing impairment across two or more neurodevelopmental domains. Complexity is characterised by multi-domain cognitive and functional disabilities, delay or clinically significant impairment.
Neurodevelopmental domains include:
- Cognition
- Language
- Social-emotional development
- Motor skills
- Adaptive behaviour: conceptual skills, practical skills, social skills or social communication skills
Treatment: total of 20 per life time per client. However, after 10 sessions a new letter referral is needed following review from the paediatrician.
Government Programs
The Victorian Government provides some funding for Speech therapy for eligible children who attend private schools in Victoria that are registered with Independent Schools of Victoria. This funding is only available for children in Prep to Year 4. Please check with your child's school as well as with your Speech Pathologist for the eligibility criteria.
Spark Speech Pathology is registered under the ‘Early Intervention Service Provider Panel’ for Helping Children with Autism (HCWA) and Better Start packages administered by the Department of Social Services. Children who are diagnosed before age 6 years with either Autism, Fragile X Syndrome, Down Syndrome, Cerebral Palsy or Hearing Impairment including children with a cochlear implant, can register with FaHCSIA to access these packages (up to $12,000 per child over 2 years, eligibility criteria apply). In summary:
Helping Children with Autism
Under the early intervention component of the package, all eligible children up to the age of seven years will have access to funding of up to $12 000 ($6000 per financial year). Eligible children need to have been diagnosed and registered with an autism advisor before their sixth birthday to receive funding.
Clients over seven are not able to access early intervention funding through HCWA or Better Start programs, but are still eligible for Medicare items.
Medicare items can be claimed for children whether or not they have accessed early intervention funding, as long as they have an eligible disability.
The first step is to develop a treatment and management plan with your child’s health care professional. You can access up to four diagnostic/assessment services to assist the referring practitioner with diagnosis or to contribute to a child’s treatment and management plan. This plan needs to be in place before your child turns 13.
You can access up to twenty treatment sessions once you have a treatment and management plan in place. This may include sessions with psychologists, speech pathologists, occupational therapists, audiologists, optometrists, orthoptists or physiotherapists. These sessions can be used up until your child turns 15.
Better Start for Children with Disability program.
Eligible disabilities include: · Sight impairment · Hearing impairment · Cerebral palsy · Down syndrome · Fragile X syndrome · Deafblindness · Prader-Willi syndrome · Williams syndrome · Angelman syndrome · Kabuki syndrome · Smith-Magenis syndrome · CHARGE syndrome · Cornelia de Lange syndrome · Cri du Chat syndrome · Microcephaly · Rett’s Disorder.
Spark Speech Pathology is registered under the ‘Early Intervention Service Provider Panel’ for Helping Children with Autism (HCWA) and Better Start packages administered by the Department of Social Services. Children who are diagnosed before age 6 years with either Autism, Fragile X Syndrome, Down Syndrome, Cerebral Palsy or Hearing Impairment including children with a cochlear implant, can register with FaHCSIA to access these packages (up to $12,000 per child over 2 years, eligibility criteria apply). In summary:
Helping Children with Autism
- This program was created for the early diagnosis and treatment of children with autism and other pervasive developmental disorders. A child can be referred by a consultant paediatrician or psychiatrist for allied health services including speech pathology for: Up to four diagnostic / assessment services 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 for a child under 15 years of age, providing a treatment and management plan is in place before their 13th birthday.
Under the early intervention component of the package, all eligible children up to the age of seven years will have access to funding of up to $12 000 ($6000 per financial year). Eligible children need to have been diagnosed and registered with an autism advisor before their sixth birthday to receive funding.
Clients over seven are not able to access early intervention funding through HCWA or Better Start programs, but are still eligible for Medicare items.
Medicare items can be claimed for children whether or not they have accessed early intervention funding, as long as they have an eligible disability.
The first step is to develop a treatment and management plan with your child’s health care professional. You can access up to four diagnostic/assessment services to assist the referring practitioner with diagnosis or to contribute to a child’s treatment and management plan. This plan needs to be in place before your child turns 13.
You can access up to twenty treatment sessions once you have a treatment and management plan in place. This may include sessions with psychologists, speech pathologists, occupational therapists, audiologists, optometrists, orthoptists or physiotherapists. These sessions can be used up until your child turns 15.
Better Start for Children with Disability program.
Eligible disabilities include: · Sight impairment · Hearing impairment · Cerebral palsy · Down syndrome · Fragile X syndrome · Deafblindness · Prader-Willi syndrome · Williams syndrome · Angelman syndrome · Kabuki syndrome · Smith-Magenis syndrome · CHARGE syndrome · Cornelia de Lange syndrome · Cri du Chat syndrome · Microcephaly · Rett’s Disorder.
