What is the Medicare rebate for children’s OT?

To access Medicare-rebated OT for your child, you'll need a referral from your GP or paediatrician. For CDM plans (item 81325), your child must have a chronic condition such as autism spectrum disorder, cerebral palsy, or developmental delay. Your GP creates a plan and refers your child to an accredited OT; Medicare then rebates up to 10 sessions per calendar year. The rebate amount is $52.95 per session, but most private OTs charge $80–$150+ per session, so you'll pay the difference out of pocket.

Better Access mental health plans are available if your child has a diagnosed mental health condition (such as anxiety or depression) and a referral from a GP or psychiatrist/psychologist. These plans typically allow 10 sessions per year with a mental health allied health professional, including OTs trained in mental health. Rebates range from $76.35 to $121.80 per session depending on the OT's qualifications.

If your child is eligible for the National Disability Insurance Scheme (NDIS), you may receive funding for OT through your NDIS plan instead of, or alongside, Medicare. NDIS funding rates for OT vary by state and therapist qualifications; as of 2025–26, typical rates range from $90–$180+ per hour depending on the OT's experience level.

Gap fees are standard because Medicare rebates don't cover the full cost of therapy. Always confirm the gap fee with your OT provider before your first appointment. If cost is a barrier, ask your GP about bulk-billing OTs in your area, though these are less common. Your child's paediatrician or GP can advise whether CDM, Better Access, or NDIS funding is most appropriate for your situation.