Can Medicare pay for paediatric occupational therapy?

Paediatric occupational therapy helps children develop skills for everyday activities like self-care, school participation, and play. In Australia, Medicare rebates are available through three main pathways:

**Chronic Disease Management (CDM) Plans** Your GP can create a CDM plan if your child has a chronic condition (such as cerebral palsy, autism, ADHD, or developmental delay) that requires ongoing allied health support. This allows up to 10 Medicare-rebated OT sessions per calendar year. The Medicare rebate is approximately $73.60 per session, though your actual cost depends on the therapist's fees. Many occupational therapists bulk-bill under this scheme, meaning you pay nothing out-of-pocket.

**Better Access Initiative** If your child has a diagnosed mental health condition, their psychiatrist, psychologist, or GP can refer them for OT under the Better Access scheme. This provides up to 10 sessions per year with similar rebate amounts.

**Historical Context: Helping Children with Autism** The Helping Children with Autism (HCWA) program closed on 30 June 2022. Families previously accessing this scheme were transitioned to the National Disability Insurance Scheme (NDIS) or other Medicare pathways. If your child is NDIS-eligible, occupational therapy is funded through individualised NDIS plans rather than Medicare.

**What to do next:** 1. Contact your child's GP to discuss whether a CDM plan is appropriate 2. Ask your GP for a referral to a registered occupational therapist (check AHPRA registration) 3. Confirm the therapist bulk-bills or clarify gap fees before your first appointment 4. If your child has autism or significant disability, explore NDIS eligibility at ndis.gov.au

**Important notes:** Rebate amounts are indexed annually (usually November). If your child doesn't have a chronic condition diagnosis but you're concerned about their development, ask your GP for a paediatrician referral first—they can assess whether OT is needed and what funding pathway suits your situation. State-based early intervention services may also offer free or subsidised OT for children under 6 in some circumstances.