Medicare, the NDIS and private health for online speech therapy
Online Speech Therapy Online Speech Therapy 8 min read
Yes, Medicare rebates apply to online speech therapy. Telehealth sessions by video with a speech pathologist have their own Medicare items. They pay a rebate when your child has the right referral from a doctor. Self-managed and plan-managed NDIS funding can pay for online sessions here, and a private health fund may pay a benefit if your extras cover includes speech pathology by telehealth.
Every figure below is worked out for a $193 video session with Dr Lauren and read from MBS Online on 15 November 2026. Medicare re-indexes rebates each July, so the item pages listed under Sources show the current amounts.
Does Medicare cover online speech therapy?
Medicare pays for a speech pathology session held by video through its own telehealth items, listed in the table below. You do not need a referral to start with a speech pathologist; you need one only to claim. Two referral pathways lead to a video item.
The first is the GP chronic condition management plan. Until 1 July 2025 it was called a chronic disease management plan (a GP Management Plan with Team Care Arrangements), and many people still use that name for speech pathology. The second is the under-25 pathway, Group M10 in the Medicare schedule.
| Funding | Does it apply to a video session? | What you need |
|---|---|---|
| Medicare, chronic condition plan | Yes, item 93000 | A GP chronic condition management plan and a referral from your GP. Up to five allied health sessions a calendar year, shared across all allied health |
| Medicare, under-25 pathway (Group M10) | Yes, items 93033 (assessment) and 93036 (treatment) | A diagnosis or suspected diagnosis on the Medicare list and a referral from the right doctor. Up to 8 assessment and 20 treatment sessions in a lifetime, shared across all allied health under these items |
| NDIS | Yes, if the plan is self-managed or plan-managed | Funding for therapy in your child’s plan. NDIA-managed funding cannot be used here |
| Private health | Depends on your fund and policy | Extras cover that pays for speech pathology, including by telehealth |
How do I claim a Medicare rebate for online speech therapy?
To claim a Medicare rebate for an online speech therapy session, follow these steps:
- See your GP. Ask which pathway fits your child. The chronic condition plan is for a chronic (long-lasting) condition, and your GP decides whether your child qualifies. The under-25 pathway suits a child with stuttering, a speech sound disorder, cleft lip or palate, or another condition on the Medicare list. For autism, the referral comes from a paediatrician or psychiatrist rather than the GP.
- Get the referral. Under the under-25 pathway, each allied health practitioner needs a separate referral, so ask for one addressed to the speech pathologist you plan to see.
- Send a copy to the practice before the first session you want to claim.
- Have the session by video. The video items need a video call, not a phone call, and a minimum length: 20 minutes under a chronic condition plan, 30 minutes for under-25 treatment and 50 minutes for an under-25 assessment.
- Pay and claim. You pay the session fee and claim the rebate through your Medicare online account in myGov, unless the practice lodges the claim for you. The Express Plus Medicare app was retired on 1 November 2025.
- The report goes back to the doctor. The speech pathologist sends a written report to the referring doctor, which both pathways require.
How much is the Medicare rebate on a $193 online session?
The Medicare rebate on a $193 online speech therapy session is $63.40 under a chronic condition plan, leaving a gap of $129.60, or $89.50 under the under-25 pathway, leaving a gap of $103.50.
| Pathway | Video item | Medicare rebate | What you pay on a $193 session |
|---|---|---|---|
| Chronic condition plan | 93000 | $63.40 | $129.60 |
| Under-25 treatment (Group M10) | 93036 | $89.50 | $103.50 |
The rebate for a video session under a chronic condition plan is the same as for the in-person item (10970, also $63.40). Rebates are a set amount for each item, not a share of the fee, and they are indexed, usually each July; these figures were set on 1 July 2026. Families who pass the Extended Medicare Safety Net threshold in a calendar year may get more back.
What does a block of ten online sessions cost under each route?
Ten online sessions with Dr Lauren cost $1,930 before any funding ($193 each). The initial assessment is separate (Short $590, Mid-Length $890 or Long $1,290), and whether any of it can be claimed depends on the pathway.
| Route | Sessions with a rebate | Total rebate | What you pay for ten sessions |
|---|---|---|---|
| No funding | 0 | $0 | $1,930.00 |
| Chronic condition plan, all five sessions still unused this year | 5 | $317.00 | $1,613.00 |
| Under-25 treatment course | 10 | $895.00 | $1,035.00 |
| Private health extras | Set by your fund | Set by your fund | $1,930 less your fund’s benefit |
| NDIS, self-managed or plan-managed | Paid from the plan | Not a rebate | Paid from your child’s plan, within its therapy funding and, for plan-managed funding, NDIS price limits. Check with your plan manager |
The figures use the rebates above: 5 × $63.40 and 10 × $89.50. Full fee details are on the fees page, and what the first appointment involves is on the online speech assessment page.
Which children gained Medicare video sessions on 1 March 2026?
On 1 March 2026 three conditions were added to the Medicare list that opens the under-25 pathway, and with it the video items 93033 and 93036.
| Added on 1 March 2026 | What MBS Online includes under it |
|---|---|
| Stuttering | Stuttering |
| Speech sound disorder | Articulation disorder, phonological disorder, childhood apraxia of speech and dysarthria |
| Cleft lip or palate | Cleft lip or palate |
For a child under 25 with one of these, the GP can now refer to the under-25 pathway. In practice that means a course of up to 10 rebated video treatment sessions at a time, with a fresh referral for each course, up to 20 treatment and 8 assessment sessions in a lifetime, in place of the five a year a chronic condition plan allows. Video and in-person sessions draw on the same limits.
Two of the reasons families come to Dr Lauren are not on the list: a language disorder, and trouble with reading and spelling. For those children a chronic condition plan is usually the Medicare route, if the GP judges that the plan applies.
Can I use NDIS funding for online speech therapy?
You can use NDIS funding for online speech therapy with Online Speech Therapy if your child’s plan is self-managed or plan-managed. Online Speech Therapy is not NDIS registered. NDIA-managed funding can only be used with registered providers, so it cannot be used here.
The NDIS and Medicare cannot both be claimed for the same session. Online speech therapy for autistic children explains how sessions work for families whose child has an NDIS plan.
Does private health insurance cover online speech therapy?
Private health insurance may cover online speech therapy if your extras policy includes speech pathology. Each fund decides whether it pays for a session by video, how much it pays for each session and how much in a year. You cannot claim Medicare and a private health fund for the same session; you choose one.
Ask your fund about video sessions specifically:
- Does my extras cover pay a benefit on a speech pathology session held by video, or only in person?
- Is the benefit for a video session the same as for a clinic visit, and does it come out of the same yearly limit?
- What must the invoice show for a video session to be paid?
Ask the practice how health fund claims are handled.
Where does private online therapy fit among the routes to speech pathology?
Private online therapy is one of four routes to a speech pathologist for a child in Australia. Each suits a different family.
Public and community health services. Government-run services, through community health centres and hospitals, are usually free or charge a small fee. Places and eligibility rules vary, so ask your GP or child health nurse what is offered where you live.
School and early childhood services. Some schools and early childhood services have speech pathologists or can arrange support. Ask your child’s teacher or the school what is available.
The NDIS and Thriving Kids. The NDIS funds therapy for children with a permanent and significant disability. Thriving Kids, rolling out since October 2026, is a separate national program for children aged 8 and under with developmental delay or autism and low to moderate support needs, and no diagnosis is needed. Online Speech Therapy is not a Thriving Kids provider.
Medicare and private. A Medicare plan reduces the cost of a private speech pathologist, online or in person, as set out above. Private online therapy means choosing your clinician, seeing the same person each time and paying a published fee. The guide to choosing an online speech pathologist sets out what to check.
Families who would like to work with Dr Lauren Crumlish can apply. Our team will review your application.
Sources
- MBS Online, items 93000, 10970, 93033 and 93036, and notes MN.10.2 and MN.10.3, read 15 November 2026.
- MBS Online, March 2026 news, read 15 November 2026.
- Services Australia, Express Plus Medicare mobile app, read 15 November 2026.
- PrivateHealth.gov.au, What is covered by private health insurance and Medicare, read 15 November 2026.
- Healthdirect, Speech pathology, read 15 November 2026.
- Department of Health, Disability and Ageing, About Thriving Kids, read 15 November 2026.
- NDIS, NDIA-managed funding.
Topics
- Medicare
- NDIS
- Private health
- Fees
