Medicare Benefit Schemes
What is a Chronic Disease Management Plan?
A Chronic Disease Management (CDM) plan (sometimes called an EPC plan) is arranged by your GP for people with a long-term medical condition (lasting 6 months or more). It helps coordinate care and gives access to Medicare-subsidised allied health services.
What services are included?
With a CDM plan, you can receive up to 5 subsidised allied health visits per calendar year, which may include:
- Physiotherapy
- Occupational therapy
- Speech therapy
- Psychology
- Dietetics
- Podiatry
(Your GP decides which services are appropriate.)
Who is eligible?
You or your child may be eligible if you have a chronic or complex condition, such as:
- Developmental delays or disabilities
- Autism
- Chronic physical or mental health conditions
How do families access it?
- Visit your GP
Book a longer appointment and ask about a CDM plan. - Assessment and plan creation
The GP will assess your needs and create a care plan. - Get referrals
The GP will refer you to specific allied health providers. - Book with providers
Contact the recommended therapists and let them know you have a CDM referral. - Claim Medicare rebate
After each session, you can claim a rebate through Medicare (there may be a gap fee depending on the provider).
Important things to know...
- Only 5 sessions per year are covered across all allied health services combined
- Not all costs may be covered (out-of-pocket fees can apply)
- Plans should be reviewed regularly with your GP.
What are the Medicare M10 Speech Pathology Sessions?
The M10 sessions refers to Medicare-supported speech pathology services provided under specific Medicare item numbers. These sessions are typically accessed through a GP or specialist referral and are designed to support young people with communication or swallowing difficulties.
What services are included?
M10 sessions allow access to speech pathology support for children (under the age of 25) with:
- Stuttering
- Specific Speech Sound disorders
- Cleft lip and palate
How do families access it?
- Visit your GP
Book a longer appointment and discuss your concerns. - Get a referral
The GP will determine eligibility and provide a referral for speech pathology services. Sometimes they may request supporting documentation from therapists. - Book with a speech pathologist
Contact your chosen provider and let them know you have a Medicare referral. - Attend sessions and claim rebates
After each appointment, you can claim a Medicare rebate (gap fees may apply).
How many sessions can you access?
Eligible children can claim:
- Up to 8 assessment sessions
- Up to 20 treatment sessions
This is the total number of services that can be claimed before the person turns 25.
