Information for Families (Children and Young People Under 25)
If your child or young person has a stutter or a severe speech sound disorder, Medicare may help cover part of the cost of speech pathology services.
These services are funded through Medicare’s Eligible Disabilities program (MBS Group M10), which provides rebates for assessment and treatment with a speech pathologist.
Who Is Eligible?
Your child or young person may be eligible if they:
Are under 25 years of age
Hold a Medicare card
Are not admitted to hospital
Have been diagnosed with either:
Stuttering, or
A severe speech sound disorder (such as Childhood Apraxia of Speech)
A General Practitioner (GP) must confirm the diagnosis and prepare a Treatment and Management Plan before Medicare rebates for therapy can begin.
What Medicare Covers
Medicare provides rebates for speech pathology services, including:
Up to 8 assessment sessions with a speech pathologist (lifetime limit)
Up to 20 treatment sessions with a speech pathologist (lifetime limit)
These are lifetime caps, not annual limits.
How the Process Works
Step 1 – Visit Your GP
The process begins with an appointment with your GP.
Your GP will:
Assess your child
Determine whether a speech pathology assessment is required
Provide a referral to a speech pathologist
The GP appointment is billed under standard consultation items.
Step 2 – Speech Pathology Assessment
Your child can access up to 8 assessment sessions with a speech pathologist to help confirm the diagnosis and determine appropriate treatment.
Following the assessment, the speech pathologist will provide a report to your GP.
Step 3 – GP Treatment and Management Plan
Once the diagnosis is confirmed, your GP prepares a Treatment and Management Plan.
This plan allows Medicare rebates to be used for therapy sessions.
Step 4 – Speech Pathology Treatment
After the Treatment and Management Plan is in place, your child can begin therapy.
Medicare allows:
Up to 20 treatment sessions in total
Up to 10 sessions per referral
A second referral is required to access the remaining sessions
Important Things to Know
These rebates are different from Chronic Disease Management plans, which only allow 5 allied health sessions per year.
The Eligible Disabilities (M10) program allows up to 20 lifetime therapy sessions, offering significantly more support.
A GP must document the diagnosis and functional impact.
Rebates for therapy can only begin after the GP completes the Treatment and Management Plan.
Need More Information?
You can speak with your GP or contact Prosper about whether your child may be eligible.
Further details are also available through:
Services Australia
MBS Online