Occupational Therapy

Eligible Clients

Service Details and Referral Pathway

Rebate and Service Limits

Clients who have a chronic (or terminal) medical condition and complex care needs, requiring a multidisciplinary approach

MBS item 10958

The client must be referred by their GP using the ‘Referral Form for Chronic disease Allied health (individual) Services under Medicare’. This can be downloaded here.

Rebate: $52.95 per session

Up to five (5) individual services (in total) per calendar year.

Aboriginal and Torres Strait Islander people who have had a health check.

MBS item 81330

Occupational therapy health service provided to a person who is of Aboriginal or Torres Strait Islander descent by an eligible audiologist. A ‘Referral form for Follow-up Allied health Services under Medicare for Aboriginal or Torres Strait Islander Peoples’ must be completed by a GP who has conducted a health check consistent with the Aboriginal and Torres Strait Islander Medicare health checks. This can be downloaded here.

Rebate: $52.95

Up to five (5) individual services (in total) per calendar year (Note: these services are in addition to the five individual services for patients with a chronic medical condition and complex care needs)

Children with Autism, Pervasive Developmental Disorder or an eligible disability. Clients must be aged under 13 years for diagnosis services and aged under 15 years for treatment services

MBS items 82010 and 82025

Item 82010 is for an occupational health service provided by an eligible occupational therapist to a child under 13 years of age where the child has been referred to assist with diagnosis or to contribute to a Pervasive Developmental Disorder (PDD) or Disability Treatment Plan. Item 82025 is for an occupational health service provided by an eligible occupational therapist to a child under 15 years of age for the treatment of Pervasive Developmental Disorder (PDD) or an eligible disability. Both services require a referral from an eligible practitioner.

 

Rebate (82010): $74.80

Up to four (4) services for assessment (in total per child). 

Rebate (82025): $74.80

Up to twenty (20) early intervention treatment services (in total per child).

Patients with an assessed mental disorder.

MBS items 8012580126 and 80130

Item 80125 is a service delivered at consulting rooms by an eligible occupational therapist lasting more than 20 minutes but not more than 50 minutes. Item 80126 is the same service as 80125, however the attendance is by video conference. Item 80130 is the same service, but is provided at a place other than consulting rooms.

Patients must be:

  • referred by a GP who is managing the patient under a GP Mental Health Treatment Plan
  • referred by a medical practitioner who is managing the patient under a referred psychiatrist OR
  • referral by a psychiatrist or paediatrician from an eligible service

Rebate (80125): $52.95

Rebate (80126): $52.95

Rebate (80130): $74.55

Up to ten (10) individual services per calendar year and up to ten (10) group therapy services per calendar year.

Services provided under the Access to Allied Psychological Services (ATAPS) should not be used in addition to the 10.

Patients with an assessed mental disorder.

MBS items 80145

Group therapy of 6 to 10 patients lasting for at least 60 minutes duration. Patients must be:

  • referred by a GP who is managing the patient under a GP Mental Health Treatment Plan
  • referred by a medical practitioner who is managing the patient under a referred psychiatrist OR
  • referral by a psychiatrist or paediatrician from an eligible service.

Rebate: $19.00 per patient for each group session.

Up to ten (10) group therapy services per calendar year.

Children under the age of six with an eligible disability.

Better Start Iniative

Eligible disabilities are;

  • Cerebral palsy
  • Deafblindness
  • Down syndrome, including mosaic Down syndrome
  • Fragile X syndrome with full mutation
  • Hearing impairment
  • Sight impairment
  • Prader-Willi syndrome
  • Williams syndrome
  • Angelman syndrome
  • Kabuki syndrome
  • Smith-Magenis syndrome
  • CHARGE syndrome
  • Cornelia de Lange syndrome
  • Rett’s Disorder
  • Cri du Chat syndrome; or
  • Microcephaly

Children registered with Better Start can access up to $12,000 (maximum $6,000 per year) to pay for early intervention services. These services include:

  • audiology
  • occupational therapy
  • orthoptics
  • physiotherapy
  • psychology and
  • speech pathology.

Up to 35% of a child’s Early intervention Funding may be used to purchase resources, to a maximum of $2,100 per financial year, or $4,200 in total.

The $12,000 in funding under the early intervention component can be used until the child’s seventh birthday to a maximum of $6,000 per financial year.

Accreditation:

Contact Us:

PO Box 368, 66 Callide St
BILOELA QLD  4715

(07) 4992 1040

admin@cqrdgp.com.au

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