Funding Information

National Disability Insurance Scheme (NDIS)

Autism FaHCSIA Funding

Medicare Rebates (EPC/FPS Plans)

 

National Disability Insurance Scheme (NDIS)

The National Disability Insurance Scheme (NDIS) provides support to people with disability, their families and carers. If you have a disability that is likely to be permanent and significant you can, subject to eligibility, receive funding from the NDIS.

You are eligible for the National Disability Insurance Scheme (NDIS) if you:

  • are under 65 years of age, and
  • are an Australian citizen or resident or permanent visa holder, and
  • meet the disability or early intervention requirements.

People with disability, or their family or advocate, can use the NDIS eligibility check list to see if they are eligible. If so, they can then apply to receive support through the NDIS.  NDIS funding is available for “reasonable and necessary supports” to help people with disability to reach their goals and aspirations, take part in activities to increase their social and economic participation and to live a life as “ordinary” as possible.

People who have been approved to be included in the National Disability Insurance Scheme are referred to as “Participants”. People or organisations who provide these Participants with products and/or services are referred to as “Providers”.

Participant allocated funding will be managed in accordance with an NDIS Plan. A Plan may be managed by the Participant (Self Managed), by the National Disability Insurance Agency (Agency Managed), by a 3rd Party Agency (3rd Party Managed) or by a combination of the above.

Therapies for Kids procedures for NDIS participants

The Directors of Therapies for Kids remain committed to providing the highest quality of services to our clients. In order to ensure this, we have certain procedures, which are designed to ensure easier access to NDIS services and easier & improved management of client plans. The following procedures are in line with NDIS recommendations.

Therapies for Kids (TFK) is a registered NDIS Provider. We are required to enter into a Service Agreement with every NDIS Participant who accesses our services. This agreement details the services to be delivered and provides a schedule of the future appointments. It is designed to assist you access our services in the most straightforward way and for us to be able to be paid for the services provided.

Getting started

For NDIS Participants who are managed by the NDIA or are managed by a registered third party Plan Management Agency, TFK requires a copy of the Participant’s NDIS Plan prior to the first appointment for which payment from the NDIA or the Plan Management Agency is expected.

TFK will prepare a Service Agreement prior to this appointment in order to create a Service Booking, (which specifies a $ allocation for the cost of confirmed future appointments), in the NDIS portal – this is essential to us claiming the appointment fee after each appointment.

For participants who are approved to manage their own plan, payment for services will be due and payable at the conclusion of their treatment session. Self Managed Clients are reminded that they may submit their payment for reimbursement from the NDIS directly.

Once a Service Agreement has been signed and a Service Booking made, if a Participant increases or decreases the number or duration of confirmed future appointments, the Service Booking $ allocation may be amended by the Participant, an NDIA staff member or, with consent, by Therapies for Kids.

Unavailability of funds

In order to ensure that we can continue to provide our services to all clients, Therapies for Kids will require payment from the participant at the conclusion of their treatment in the following circumstances:

  • If we have not received a copy of the Participants NDIS Plan or;
  • If another Provider has reserved the Participants NDIS funds so that there are insufficient funds available to meet the cost(s) of the scheduled appointment

If a Participant has insufficient funds available to be allocated to a TFK Service Booking after a plan has been activated, the Participant will be responsible for meeting the costs of any appointment(s) until funds become available. TFK will not extend credit to the Participant for services provided.

Therapies for Kids endeavours to maintain a current register of NDIS Participants, their plan management type and when their plan is due for expiry. Therapies for Kids will attempt to advise NDIS Participants when their plan is due to expire and / or if funds reserved in their Service Booking are low. However, participants are responsible for ensuring that their plan is current and that there are sufficient funds available pursuant to their NDIS plan to cover the costs of any treatment delivered.

Other costs

Patient Notes and communications required with other medical professionals will be completed during a participants treatment session. Where it is necessary to communicate with other medical professionals regarding your condition or treatment outside of your treatment session, the communication will be charged in 6 minute (or part thereof) increments @ $18.50 per increment. These costs are not covered by NDIS funding, so be aware that these charges will have to be met from your other resources.

From time to time the NDIS will require the participant to provide a report on the effectiveness of services provided in relation to the participant’s goals stated in their plan. The NDIS make provision to pay for this requirement and Therapies for Kids makes a provision for time in the Service Agreement and Service Booking for this item.

Out of Clinic appointments

Appointments out of rooms for NDIS clients are difficult to accommodate due to the NDIS policy restricting the ability to charge for the time taken to travel to and from an out of rooms appointment. However, this can be discussed with our Director.

Therapies for Kids looks forward to treating your child under the NDIS and appreciates your patience and cooperation in ensuring that accessing the NDIS is as easy as possible for all involved.

 

MEDICARE REBATES AT THERAPIES FOR KIDS

What rebates are available?

There are two Medicare plans accessible for patients receiving services at Therapies for Kids.

The Chronic Disease Management (CDM) Plan*:

  • Patients with a chronic medical condition (i.e. that has or is expected to last more than 6 months are eligible for this plan,
  • Up to five sessions are rebated by Medicare. These five visits can be used across a combination of services (i.e. 3 for physiotherapy and 2 for Occupational Therapy),
  • The plan can be used for a year after the Date of Referral.
  • This plan is available for use with Physiotherapy, Occupational Therapy and Speech Pathology Services at Therapies for Kids.

*Formerly the ‘Enhanced Primary Care’ Plan

The Focused Psychological Strategies or Better Access Plan:

  • Eligibility can be decided by a GP or a mental health care practitioner,
  • An initial provision of up to 6 rebated therapy sessions. Upon review, another 6 may be approved,
  • The plan can be used for a year after the Date of Referral.
  • This plan is available for use with Occupational Therapy services at Therapies for Kids 

Getting a referral

Your GP will be able to help organise a referral for either one, or both of these plans.

Under Medicare, CDM Plans require your doctor to prepare GP Management Plan or Team Care Arrangement, while FPS Plans require your doctor to prepare a GP Mental Health Treatment Plan at the time of referral. 

Accessing services with your plan

Once your GP has arranged a referral under a plan, bring your referral to Therapies for Kids in order to start accessing rebates. Currently you will have to pay and your receipt will allow you to claim at Medicare. 

How will Medicare know that I have a plan?

When your doctor creates your referral, it registers on the Medicare system, meaning that you can only access services from that day, and meaning that they know you have access to rebates.

Additionally, your receipt will include extra information indicating what rebate you are entitled to. Medicare uses this information to issue you a rebate. 

Some tips

  • Talk to your doctor about eligibility as certain thresholds do apply.
  • Call Medicare for the most up to date rebate amounts.
  • We encourage clients to keep track of how many sessions they have claimed using their plan.
  • All receipts must have extra details on them- talk to reception if you are concerned that your receipt is not correct. 

Further resources

The Department of Health and Ageing’s website www.health.gov.au

Medicare website http://www.humanservices.gov.au/

Click here to download the document

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