Medicare has changed what it covers for speech therapy, and there’s more than one pathway. This guide helps you find yours and tells you exactly what to ask for.
The big change: since 1 March 2026, stuttering and speech sound disorders are on Medicare’s Eligible Disabilities list. That includes articulation disorders, phonological disorders, childhood apraxia of speech and dysarthria. Cleft lip and palate are on the list too. Everything below is for video telehealth speech therapy.
Find your pathway
Area of Speech Therapy
Age
Pathway
Who refers
Rebate
Sessions
Area of Speech Therapy
Stuttering
Speech sound disorder
Cleft lip/palate
Age
Under 25
Pathway
M10 Eligible Disabilities
Who refers
GP
Rebate
$89.50
Sessions
Up to 4 assessment, then 2 blocks of up to 10 treatment
Area of Speech Therapy
Autism or
Other complex neurodevelopmental condition
Age
Under 25
Pathway
Complex neuro-developmental conditions
Who refers
Consultant paediatrician or psychiatrist
Rebate
$89.50
Sessions
Up to 4 assessment, then 2 blocks of up to 10 treatment
Area of Speech Therapy
Any speech or language condition lasting 6+ months
Age
Any age
Pathway
GP Chronic Condition Management Plan (GPCCMP)
Who refers
GP
Rebate
$63.40
Sessions
Up to 5 per calendar year
Area of Speech Therapy
Any speech or language condition lasting 6+ months
Plus ATSI
Age
Any age
Pathway
ATSI Health Plan
Who refers
GP
Rebate
$63.40
Sessions
Up to 10 per calendar year
A rebate is Medicare’s contribution towards the fee, so there may still be a gap. Your GP or specialist decides final eligibility.
Every referral needs the same basics
- The right wording on the letter. It must say “assessment” or “treatment” AND “Speech therapy” or “speech pathology”
- The correct item number (see the table below).
- Details of referrer and patient: the GP’s or specialist’s full name and practice address or provider number, the date, their signature (electronic is fine) and your child’s name.
- Email it to [email protected] before your first session.
Pathway
The letter also needs
Item
Pathway
M10 assessment
The letter also needs
“Assessment” and the suspected condition, e.g. “suspected speech sound disorder”
Item
93033
Pathway
M10 treatment
The letter also needs
“Treatment” and the confirmed diagnosis, e.g. “stuttering”. Block number (Block 1 or 2) is recommended
Item
93036
Pathway
Complex neurodevelopmental assessment
The letter also needs
“Assessment” and the suspected condition, e.g. “suspected autism spectrum disorder”
Item
93033
Pathway
Complex neurodevelopmental treatment
The letter also needs
“Treatment” and the confirmed disorder named
Item
93036
Pathway
GPCCMP
The letter also needs
A reference to the “GPCCMP”
Item
80010
Pathway
ATSI Health Plan
The letter also needs
A reference to the “Chronic Conditions Plan” and 10 speech pathology rebates
Item
93048
M10: stuttering, speech sound disorders and cleft lip/palate
You're eligible if you're:
Under 25 (checked at each session), have a valid Medicare card, have a suspected diagnosis of one of these conditions, and aren’t currently in hospital or admitted to a care facility.
Step 1: Assessment
Book a GP appointment and describe what you’re noticing: stuttering, unclear speech sounds or difficulty being understood.
What to say: “My child has difficulty with [stuttering / speech sounds / being understood]. I need a referral for a speech pathology assessment under the M10 Eligible Disabilities pathway, MBS item 93033 for video telehealth.”
A tip many GPs miss: your GP must bill a consultation item for their own appointment first, or Medicare can reject the claim. The referral is valid for 18 months from your first session.
Step 2: Treatment
After the assessment, your speech pathologist sends your GP a written report with the findings, diagnosis and recommendations. You’ll then need a new referral, because the assessment referral can’t be reused. Book a 45-minute GP appointment for a Treatment and Management Plan (item 139). Your GP must bill it as item 139 for the referral to be approved.
What to say: “Pop Speech Therapy has sent you my child’s assessment report. My child has been diagnosed with [speech sound disorder / stuttering / cleft lip/palate]. I’d like to start treatment sessions. I need you to complete a Treatment and Management Plan (Item 139) and write a treatment referral for speech pathology, MBS item 93036.”
Treatment comes in two blocks of up to 10 sessions. After Block 1, we send a written report, and if more treatment is recommended your GP repeats the 45-minute appointment and writes a new referral for Block 2. The 20 treatment sessions are a lifetime maximum across all allied health professions, so check how many have been used.
Autism and other complex neurodevelopmental conditions
You're eligible if you're:
The condition needs to show that support is needed and that there’s impairment across two or more neurodevelopmental domains.
A GP can’t make this referral. It must come from a consultant paediatrician or consultant psychiatrist.
Step 1: Assessment
What to say: “I’d like a referral to a Speech Pathologist to contribute to the assessment towards a neurodevelopmental diagnosis. I’d like this assessment to be completed under the M10 Complex Neurodevelopmental Conditions pathway, MBS item 93033 for video telehealth.”
Step 2: Treatment
What to say: “I’d like to access speech therapy for my child. Please complete a treatment referral under the M10 Complex Neurodevelopmental Conditions pathway, MBS item 93036 for video telehealth treatment.”
For treatment, your specialist must have diagnosed the condition, completed a treatment and management plan, and bill item 135 or 289 for the rebate to be active.
GPCCMP and the ATSI Health Plan
GPCCMP Eligibility:
GPCCMP is for a speech or language condition that has lasted, or is likely to last, 6 months or more, at any age.
There’s no fixed list of conditions, and your GP uses their clinical judgement. Mention you want to discuss a GPCCMP when you book, so you get the right appointment.
What to say: “My child has had [condition] for [duration]. I’d like to explore whether they are eligible for a GP Chronic Condition Management Plan and a referral to Pop Online Speech Therapy for video telehealth speech pathology, MBS item 80010.”
ATSI Health Plan Eligibility:
ATSI Health Plan: People who identify as Aboriginal or Torres Strait Islander can access 5 extra rebates on top of a GPCCMP, 10 in total each calendar year.
Ask your GP for a 715 Health Check (about 45 minutes) when you book, and ask for 10 rebated speech therapy sessions under the “Management of Chronic Conditions for Aboriginal and Torres Strait Islander Patients”.
What to say: “My child has had [condition] for [duration]. I’d like to explore whether they are eligible for a Management of Chronic Conditions Plan and a referral to Pop Online Speech Therapy for video telehealth speech pathology.”
If you’re wondering whether speech therapy could support you or someone you know, book a free 15-minute discovery call with an experienced speech therapist.
Get more back with the Medicare Safety Net
Once your family has paid a set amount after Medicare, you can get back up to 80% of what you pay yourselves, with no extra forms.
- Most families: $2,699.10
- Concession card or Family Tax Benefit A: $861.20
Sign up once as a family on myGov, the Express Plus Medicare app, or by calling Medicare on 132 011, and add your partner and all your kids. Medicare keeps count for you. Only sessions claimed through Medicare count, not sessions paid by NDIS or private health. The extra money lasts until 31 December, then the count starts again on 1 January.
Private health insurance
Your fund may rebate speech therapy under your “extras” cover, not hospital cover. Rebates vary between funds, so call yours first and ask specifically about telehealth speech pathology (item codes 320, 340 and 350). You pay in full at the session, then claim with your receipt. Pop can’t guarantee any private health rebate.
FAQs
Does my child need a diagnosis before an M10 assessment?
No. A suspected condition is enough for the assessment referral. A confirmed diagnosis is needed for treatment.
Can adults use these pathways?
M10 and the complex neurodevelopmental pathways are for people under 25. The GPCCMP and ATSI Health Plan are available at any age.
Can my GP refer for the autism pathway?
No. It must come from a consultant paediatrician or consultant psychiatrist.
Not sure which one applies? Talk to us.
Our 85+ speech pathologists provide speech therapy online, anywhere in Australia. Book a discovery call and we’ll point you in the right direction.
1300 26 11 60 | [email protected]
Information is accurate as at July 2026 (Safety Net amounts as at 7 October 2026), based on MBS Notes MN.10.1 and MN 3.1, and the MBS note for item 93048. It relates to the Medicare Benefits Schedule for video telehealth speech pathology services only. This is general information, not an official endorsement, diagnosis or recommendation. Your GP or specialist determines final eligibility. The Government sets these amounts and they can change. Please contact the relevant programs directly for the most up-to-date details.
