Do I need a GP referral for paediatric OT?

Understanding when you need a GP referral depends on how you're paying for occupational therapy (OT) services.

**Medicare CDM rebates** If you want to claim Medicare rebates, your child's GP must first complete a Chronic Disease Management plan. This requires the GP to identify a chronic condition (such as autism, cerebral palsy, or developmental delay) and refer your child to an OT. Once the plan is in place, Medicare typically covers 10 sessions per year at around $50–$80 per session (with the remainder paid by you). This pathway requires a GP referral.

**Private pay (no Medicare rebate)** You do not need a GP referral to see a private OT. You can contact clinics directly and book an appointment. Sessions typically cost $120–$200+ depending on location and experience. No referral is required, though some clinics may ask for a brief GP letter to understand your child's medical history.

**NDIS pathway** If your child is NDIS-eligible, you do not need a GP referral to access OT through an NDIS plan. You can self-refer or ask your local area coordinator to help arrange services. The NDIS funds OT at set rates (typically $60–$90 per hour depending on your state and the therapist's qualifications, as per 2025–26 NDIS Pricing Arrangements). A GP letter may still be helpful for your NDIS planning meeting to explain your child's needs.

**What many clinics ask for** Even when a referral isn't legally required, many OT clinics request a letter from your GP or paediatrician. This helps the therapist understand your child's medical background, current diagnoses, and any relevant medications. It's not a barrier—it's administrative context.

**Next steps** 1. Decide how you'll pay (Medicare CDM, private, or NDIS). 2. If using Medicare CDM, book a GP appointment to discuss a referral. 3. If paying privately or via NDIS, contact OT clinics directly; ask whether they need a GP letter. 4. Have your child's diagnosis or developmental concerns documented by your GP or paediatrician before your first OT appointment.

If you're unsure whether your child qualifies for NDIS, contact your state's NDIS Local Area Coordinator or visit ndis.gov.au.