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Using Medicare at CliniKids

CliniKids can accept referrals under a number of Medicare programs across our speech pathology, occupational therapy and psychology services for children.

Different Medicare programs provide access to different services and rebates. The information below outlines the Medicare pathways accepted at CliniKids, including the referral requirements and eligibility criteria for each program.  

Medicare Pathways 
We currently accept referrals under the following Medicare pathways:

  • GP Chronic Condition Management Plan (GPCCMP)
  • Mental Health Care Plan (MHCP)
  • M10 Complex Neurodevelopmental Disorder and Disability Services

GP Chronic Condition Management Plan (GPCCMP)

A GP Chronic Condition Management Plan (GPCCMP), previously known as a Chronic Disease Management Plan (CDMP), may provide access to Medicare rebates for eligible allied health services. 

Services available under this plan at CliniKids 

  • Speech Pathology
  • Occupational Therapy
  • Psychology

How do I obtain a referral for my child? 
Your GP will prepare a GP Chronic Condition Management Plan (GPCCMP) together with the relevant referral documentation. 

Please note: Where a GP Chronic Condition Management Plan is prepared by a GP, Medicare requires it to be completed by the person's usual GP or through their MyMedicare-registered practice. A new GPCCMP can generally only be prepared once every 12 months. 


Who may be eligible? 
People who have a diagnosed chronic health condition that has been, or is expected to be, present for six months or longer 
Services & Session Limits

  • Up to 5 allied health services each calendar year
  • Up to 10 allied health services each calendar year for eligible Aboriginal and Torres Strait Islander clients
  • Services may be accessed across one or more eligible disciplines, including speech pathology, occupational therapy and psychology 

Please note: Sessions may be accessed across speech pathology, occupational therapy and psychology services. The total number of services available is shared across disciplines.  

Mental Health Care Plan (MHCP)

A Mental Health Care Plan (MHCP) may provide access to Medicare rebates for eligible services with a Clinical Psychologist or Registered Psychologist. 


Services available under this plan at CliniKids

  • Psychology 

How do I obtain a referral? 
A Mental Health Care Plan (MHCP) and referral may be prepared by your:

  • GP
  • Paediatrician
  • Psychiatrist

Please note: Where a Mental Health Care Plan is prepared by a GP, Medicare requires it to be completed by the person's usual GP or through their MyMedicare-registered practice. 


Services & Session Limits 
A Mental Health Care Plan may provide access to:

  • Up to 10 individual psychology sessions each calendar year
  • Up to 10 group psychology sessions each calendar year

Please note: A review with the referring practitioner is required after the first 6 psychology sessions before the additional 4 sessions available under a Mental Health Care Plan can be accessed. 

Mental Health Care Plans do not expire; however, we do require the referral to have been completed within the last 6 months. 

M10 Complex Neurodevelopmental Disorder and Disability Services

The M10 program may provide access to Medicare rebates for eligible assessment and treatment services for children with a complex neurodevelopmental disorder or eligible disability.

 
Services available under this plan at CliniKids

  • Speech Pathology
  • Occupational Therapy
  • Psychology

How do I obtain a referral? 
An M10 referral may be provided by a:

  • GP
  • Paediatrician
  • Psychiatrist

Who may be eligible? 
People who:

  • Are under 25 years of age
  • Have, or are undergoing assessment for, a complex neurodevelopmental disorder or eligible disability

Services & Session Limits

  • Up to 8 assessment services across a lifetime
  • Up to 20 treatment services across a lifetime
  • Services may be shared across eligible disciplines and providers

Please note: The M10 program includes a lifetime allocation of up to 8 assessment services and 20 treatment services. These services are shared across eligible providers and disciplines and are not allocated separately to each discipline. Assessment and treatment services require separate referrals.

Do you offer bulk-billed appointments?

CliniKids does not bulk bill Medicare-funded services. Eligible Medicare rebates can be claimed following your appointment; however, a gap fee will apply. 

Do I need a referral to access Medicare rebates?

Yes. A valid referral is required before Medicare rebates can be claimed for an appointment. 

How do I organise a Medicare referral?

The referral process will depend on the Medicare pathway being accessed. Your GP, paediatrician or psychiatrist can advise whether a referral may be appropriate and provide the required documentation. 

Can Medicare and NDIS funding both be used for services?

Depending on the purpose of the service, Medicare and NDIS funding may both be relevant. If you're unsure, our team can help explain the available options. 

Do you offer Telehealth appointments and can we use a Medicare referral for these?

Yes. In addition to our clinics in Subiaco and Joondalup, Perth, Telehealth appointment options are available for speech pathology, occupational therapy and psychology services for children at CliniKids, where suitable. Medicare rebates may be available for eligible telehealth appointments, depending on the pathway being accessed. 

My child has already accessed some Medicare services with another provider. Can we still use the remaining sessions at CliniKids?

In many cases, yes. If a valid referral is in place and there are sessions available, these may still be used at CliniKids.  

What if some of my child's M10 services have already been used?

Any M10 assessment or treatment services previously accessed will count towards the available Medicare allocation across the lifetime.  

Can Medicare services be used across different disciplines?

Some Medicare pathways, such as the GPCCMP, allow services for your child to be accessed across more than one discipline.  

What happens when all available Medicare services have been used?

Once Medicare-funded services have been exhausted, appointments may continue using another funding option, including NDIS funding or private-paying fees. 

What other funding options does CliniKids accept?

CliniKids is a registered NDIS provider. In addition to Medicare, we accept NDIS and private funding. Families can also utilise their private health insurance at their discretion. You can find more information about NDIS funding for Psychology, Occupational Therapy, Speech Pathology and other CliniKids services here. 

More about CliniKids

CliniKids is The Kids Research Institute Australia’s first clinical service, providing therapies and supports for young children, including those with autism and developmental delay. The Kids Research Institute Australia is one of Australia’s largest paediatric medical research institutes. At CliniKids, our team of world-class researchers and experienced clinicians work in collaboration to bring research into practice, providing children with the very best evidence-based therapies and programs.   

Our clinical team provides paediatric speech pathology, occupational therapy and psychology services for children in Perth. We have two locations offering psychology, occupational therapy and speech pathology in Perth, located at Subiaco and Joondalup.