Medicare
You access medicare funded allied health services if you hold a medicare card.
To use Medicare for services like mental health care plans, chronic disease management plans, or complex neurodevelopmental disorder plans, you’ll need a valid referral from your GP before your first appointment. This allows you to claim partial rebates for your therapy sessions once you have made full payment. Rebates are generally issued to your nominated bank account within 48 hours.
Unfortunately, you can not claim though a Medicare program as well as private health insurance for the same session. However, once you have used all of your medicare rebates, you can continue services with private health.
Chronic Disease Health Care Plans
up to 5 sessions per calendar year
referrals are valid for 2 years
previously called “enhanced primary care plans“
The medicare rebate for a standard consult with an occupational therapist under this program is $60.35 (current March 2025)
for more information, visit Services Australia.
Mental Health Treatment Plans
Initial referral for 6 sessions (focused psychological strategies health service)
If required, your GP can complete an additional referral for 4 more sessions
Sometimes, this program is called “the better access initiative”
The medicare rebate for a standard consult with an occupational therapist under this program is $85.20 (current March 2025)
Complex Neurodevelopmental Disorders & Eligible Disabilities
this program provides an early intervention pathway for assessment and treatment of complex neurodevelopmental disorders such as Autism
your doctor may include up to 4 allied health assessment services in your initial plan (if clinically required, you may be eligible for an additional 4 sessions for assessment)
an initial referral enables up to 10 treatment sessions (you may be eligible for an additional 10 sessions in your lifetime)
The medicare rebate for a standard consult with an occupational therapist under this program is $85.20 (current March 2025)
to be eligible for this program you must be under the age of 25
See Services Australia’s Flow Chart of Services to learn more about how this initiative works.
Medicare Safety Net
The Medicare Safety Net helps reduce your out-of-pocket costs once you’ve spent a certain amount on out-of-hospital services (like GP visits, specialist appointments, or allied health) in a calendar year. After you reach the threshold, Medicare will pay a higher rebate—so you get more back. This can be especially helpful if you or your family need frequent medical or therapy appointments. You can register as a family to combine your medical expenses and reach the threshold sooner. For more information, visit Department of Health & Aged Care.
