Funding you can access for OT Services

Enhanced Primary Care Plan

This program can be accessed through your GP if you meet the criteria for having a “chronic” condition that is likely to impact you for over 6 months and there are 2 other health professionals involved in providing services. Your GP must co-ordinate the Care Plan and send out the appropriate referrals to the involved professionals. Most GPs prefer you to book a double session in order to do this. Under this program you can access up to 5 sessions for individual therapy per calendar year with health professionals that are registered providers with Medicare.  All OTs at Sprout are registered with Medicare under this scheme.

Better Access to Mental Health

This program can be accessed via a referral from a GP, Psychiatrist or Paediatrician. You must be diagnosed with a specific mental disorder (these include Anxiety, Depression, Conduct Disorders, Sleep problems, ADHD).  This program entitles you to  6 sessions initially to an Allied Health professional (e.g. Psychology, Approved Mental Health OT, Social Work) and then the health professional must write to the referrer following this, and then you may receive another 4.

These sessions are per calendar year. Some of our OTs are Approved Mental Health OTs under this scheme. Rates of rebate depend on length and type of session. Again, you cannot also claim private health insurance for sessions for which you claim a Medicare rebate.

Helping Children with Autism / Better Start

This package entitles children with a range of diagnoses to claim up to 4 sessions for assessment (until 13 years of age) and up to 20 sessions for treatment (up until 15 years of age). In order to be able to claim any of these, an initial consultation is required with a Paediatrician or Psychiatrist (NOT a GP) to register the diagnosis with Medicare to make the child eligible to receive these rebates. It is important to note these consultations can only be used ONCE within the lifetime of a child, and not every calendar year. The sessions can be spread across years and across a range of professionals.

Also, there is an additional package of funding for children 0-7 years to access Early Intervention services (up to $12000 but no more than $6000 within one financial year). These services are run by DSS and must be provided by approved providers. The Sprout Team is on this panel of providers.

For more information on conditions covered by Better Start look at

For more information on conditions covered by Helping Children with Autism look at

Private Health Insurance

Depending on your level and type of cover you may also be able to claim rebates through your Private Health Insurance for Occupational Therapy – check with your provider.