Medicare Funding for Speech Pathology

Medicare: Chronic Disease Management Plan (CDM)

If you or your child has a ‘chronic’ condition (a condition that is present for a minimum of six months) requiring speech pathology, you may be eligible for a Chronic Disease Management Plan (CDM). This is a GP managed plan that provides a Medicare rebate for allied health services.

The CDM plan provides a maximum of 5 total rebates per calendar year for all allied health services. If you are accessing more than one type of allied health service, you are entitled to 5 rebates across all of the services combined, not 5 rebates per clinical service.

How do I access a CDM plan?

You need to visit your GP to have this discussion. At Talkshop, we can give you a CDM referral form for your GP to complete. Your GP will decide if you are eligible for these services and will refer you where appropriate. GPs will have a CDM checklist. For further information, please contact your GP.

Can I get a CDM for speech pathology?

Yes, speech pathology is an allied health service. If you need to access us along with one other service, you may be eligible.

Our most common co-providers are audiology, ear nose & throat (ENT) and occupational therapy (OT). If you are already seeing one of these health professionals, you are likely to be eligible for a GP CDM plan.

All Talkshop speech pathologists are registered as certified practising speech pathologists with Speech Pathology Australia, which means if you have a CDM plan you can claim with any of our clinicians

When can I use a CDM?

You can use a CDM at any time. Some of our clients use it at the end of the year to get 5 sessions with a rebate. They can re-apply in January for a new plan as they are only issued once per calendar year. This allows another 5 sessions with Medicare rebate. This effectively creates a 10-week block of therapy with Medicare rebate.

Is my child eligible if they have delayed speech or language?

A GP must make up their mind as to whether they consider a condition to be chronic (lasting more than 6 months), requiring at least two allied health professionals. In some cases, it is obvious that a CDM is needed. For example, a child with a diagnosed hearing impairment due to glue-ear or repeated ear infections impacting speech and language development will need to see both Audiology and ENT alongside Speech Pathology for ongoing management.

Some GPs will want an initial assessment report first before a CDM especially if they are unsure how significant the speech or language concern may be. This means that you will not be able to use a CDM to claim for the initial assessment but will be able to use it to claim against the therapy sessions.

I have been referred to you on a CDM plan, how does it work?

You will need to provide us with your referral form. We will write back to your GP along with our assessment results and plan of intervention. You will be eligible to claim up to a maximum of five rebated sessions per calendar-year, provided that your GP has registered your plan through Medicare. We will notify your GP once you have used the five Medicare rebated sessions.

Therapy provided by Talkshop Speech Pathology will need to be paid in full. You can immediately load your receipt to the Express Plus Medicare app on your mobile device which you can download from the App Store for apple users and Google Play for android users. Please update your bank account details with Medicare before submitting a claim.

Alternatively, you can claim your rebate online or in person.

The Medicare rebate is $58.00 per service as of 30/08/2023.

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