Helping Children with Autism or Better Start or Children with Disability

Referral under Helping Children with Autism or Better Start for Children with Disability– Allied Health Therapists

Referral and Sessions:

• A referral must be provided by an eligible consultant psychiatrist or paediatrician, with a management plan put in place before the child’s 13th birthday.
• For children with a disability other than autism, a referral may also be provided by a specialist or GP.
• The referral must state the referrers name, date of referral, referral provider number, name of practitioner being referred to and the required purpose of the referral. It must also include the number of sessions the child is being referred for and whether the services are for assessment or treatment.
• A child may receive up to four Medicare eligible services from an allied health professional on the same day.
• The allied health professional must personally attend the child, meaning that parent only sessions are not eligible for a rebate under this plan.
• Treatment must be consistent with the treatment plan prepared by the medical practitioner and in keeping with commonly established interventions for the child’s needs and disability and as practised by their profession.
• The allied mental health professional must be in receipt of the referral at the first allied mental health consultation. It is required that the allied health professional retain the referral for 24 months from the date the service was rendered (for the Department of Human Services auditing purposes).

Payment

• Sessions held with an allied health therapist under this referral are charged at the full professional rate according to the PosAbility schedule of fees (even for academic consultation services).
• Payment is required at the time of the appointment in alignment with the PosAbility Payment Procedures.
• Clients must pay in full at the time of the appointment. Medicare claims may be processed at the time of payment through the Hicaps machine with correct referral details and the client’s Medicare card. Alternatively, a receipt may be provided for the client to claim the rebate.
• Patients need to decide if they will use Medicare or their private health insurance ancillary cover to pay for these services. Patients cannot use their private health insurance ancillary cover to ‘top up’ the Medicare rebate paid for the services.