Medicare Care Plans for Children – What Families Need to Know
At Kids + Co.Lab, we know that accessing therapy can be a big commitment for families. To help with costs, there are Medicare-funded care plans that may provide rebates for occupational therapy sessions. Below, we’ve outlined the main options for children, how they work, and what steps you need to take.
Our Rates:
· Our standard OT rate is $200 per hour, which applies to both face-to-face and non-face-to-face services for Medicare or private clients.
GP Chronic Condition Management Plan (GPCCMP)
A GP Chronic Condition Management Plan is organised by your GP for children who need ongoing care from multiple health professionals. These conditions are present, or are likely to be present, for 6 months or longer.
What’s included:
Up to 5 Medicare-rebated sessions per calendar year (January–December).
These sessions are shared across all allied health providers (e.g., OT, speech, physio).
Rebate: $60.35 per session.
👉 Important: Parent-only sessions are not claimable under this plan. Your child must attend the session.
👉 No formal diagnosis is required, just that your GP identifies your child as needing ongoing care.
Complex Neurodevelopmental Disorder (such as Autism Spectrum Disorder) and Eligible Disability Services
Children with Autism Spectrum Disorder (ASD) or another eligible complex neurodevelopmental disorder or disability may be able to access Complex Neurodevelopmental Disorder (such as Autism Spectrum Disorder) and Eligible Disability Services care plans.
This plan can be organised by a paediatrician or psychiatrist when a child has a confirmed diagnosis of Autism Spectrum Disorder, or by their GP for children with an eligible disability.
Eligible conditions include: ASD, cerebral palsy, Down syndrome, Fragile X, Rett’s disorder, fetal alcohol spectrum disorder, and several other rare syndromes.
What’s included:
Up to 8 rebated sessions for assessment and diagnosis.
Up to 20 rebated sessions of therapy in total (lifetime, not annual), to be shared across allied health professionals.
Rebate: $85.20 per session.
Can Medicare and NDIS Be Used Together?
If your child is already receiving NDIS funding, they generally cannot also use Medicare care plans for the same services. However, Medicare rebates may be available while waiting for NDIS access, or if your child is undergoing assessment and not yet on the NDIS.
How Do Families Access a Care Plan?
Book an appointment with your GP or paediatrician.
For a GP Chronic Condition Management Plan (GPCCMP), start with your GP.
For the Autism/Complex Neurodevelopmental Disorder plan, you’ll need a paediatrician or psychiatrist referral.
Discuss your child’s needs. Your doctor will determine if your child is eligible and prepare the referral.
Bring your referral to us. We’ll keep it on file and discuss with you how many sessions you can claim.
Pay for your OT session as usual.
Claim your rebate through Medicare. Families need to lodge their own claims (either via the Medicare app, online, or at a Medicare service centre).
Final Thoughts
Medicare rebates can make a big difference in supporting your child’s therapy journey. While they don’t cover all the costs of ongoing support, they are a great way to access some initial sessions, particularly while waiting for NDIS funding or exploring your child’s needs.
If you’d like more information, or if you’re not sure which option might apply to your child, our team is happy to guide you in the right direction.
Please note, fees and rebates in this blog were correct at time of publishing but subject to change without notice.
