Kid-Eze Therapy Services

Medicare Items for Autism

From 1 July 2008, as part of the Australian Government’s $190 million Helping children with autism package, new Medicare items will be available for eligible allied health professionals (general psychologists, speech pathologists and occupational therapists) to provide assessment and treatment services to children with autism or any other pervasive developmental disorder (PDD).

The new items are in addition to existing Medicare items. Eligible children are able to access the new Autism Medicare items in addition to the Enhanced Primary Care and Better Access to Mental Health items.

Assessment items

Medicare items are available for eligible occupational therapists to collaborate with referring consultant psychiatrists and consultant paediatricians in the diagnosis of, and/or the preparation of an ASD treatment and management plan for children aged under 13 years. Eligible children will be able to receive up to four (4) of these services, in total, with the referring practitioner having responsibility for how these services are allocated to allied health professionals.

Treatment items

Medicare items are available for eligible occupational therapists to provide ASD treatment services to children aged under 15 years (where the child has received an ASD treatment and management plan from a consultant psychiatrist or consultant paediatrician prior to their thirteenth birthday).

Eligible children will be able to receive up to twenty (20) of these services, in total, with the referring practitioner again having responsibility for how these services are allocated to participating allied health professionals.

Reporting Requirements

On completion of a course of treatment (up to 10 treatment services) a written report must be provided to the referring consultant psychiatrist or paediatrician by the occupational therapist.

The report does not need to be detailed, but should include information on:

  • The treatment provided
  • Recommendations on future management of the child’s disorder
  • Any advice provided to third parties (e.g., parents, schools).

A written report must also be provided to the referring psychiatrist or paediatrician at the completion of any subsequent course(s) of treatment to the child.

Medicare Safety Net

Families will be able to put their out of pocket costs for these items, the amount between the Medicare rebate and the amount charged by the occupational therapist, towards the Medicare Safety net. More information on the Medicare Safety Net is available on the Medicare Australia website - http://www.medicareaustralia.gov.au/public/services/msn/index.jsp

Further information

Further information on these new Medicare items can be found on the Department of Health and Ageing website at ─ http://www.health.gov.au/autism
Alternatively phone Medicare Australia on 132 150 OR phone the “Helping Children with Autism” Helpline – 1800 289 177.