About MBS Item 135/137
This is an early intervention service for children and young adults with suspected or diagnosed Complex Neurodevelopmental Disorders that require further assessment and/or treatment by the following eligible* allied health professionals:
- Speech Pathologists
- Occupational Therapists
- Psychologists
- Audiologists
- Optometrists
- Orthoptists
- Physiotherapists
Services
*Eligibility requirements for Speech Pathologists to provide services under Item 135 are that they are certified practicing members of Speech Pathology Australia. All of our speech pathologists at HDST meet these requirements in addition to being registered as medicare service providers.
Who is Eligible?
A paediatrician, psychiatrists, or clinical psychologist can develop a management plan for:
- Children and young adults aged up to 24 years and 11 months with a valid Medicare card
- Children with suspected/diagnosed Complex Neurodevelopmental Disorders, such as:
- Autism Spectrum Disorder
- At the discretion of treating specialists, eligible disabilities including: sight impairment, hearing impairment, deafblindness , Cerebral Palsy, Down Syndrome, Fragile X syndrome, Prader-Willi syndrome, Williams syndrome, Angelman syndrome, Kabuki syndrome, Smith-Magenis syndrome, CHARGE syndrome, Cri du Chat syndrome, Cornelia de Lange syndrome, Microcephaly, Rett’s disorder, Fetal Alcohol Spectrum Disorder (FASD), Lesch-Nyhan syndrome, and 22q deletion syndrome
What’s the Referral Process?
A referral under Item 135/137 is made by the referring professional (i.e. paediatrician or clinical psychologist) in the form of letter or note that is addressed to the allied health professional (e.g. the name of your client’s therapist), and is signed and dated. A psychiatrist can also make a referral under Item 289 – click here for more information. Only one Item 135 management plan can be made in the client’s lifetime and a separate referral is made for each allied health professional involved in the client’s management plan.
The Consultant Paediatrician is responsible for managing the plan and reviewing the child’s attendance and progress as they receive services. It is the responsibility of the child’s allied health professional/s to communicate with the consultant paediatrician during the duration of the plan. Under the MBS Item 135/137 referral, a client can access a medicare rebate for the following services in their lifetime:
- up to eight diagnostic / assessment services before the child turns 25. Information obtained from these services can assist the referring clinician in making a formal diagnosis and/or contribute to a child’s treatment and management plan. This is called the ‘Helping Children with Autism Increased Access to Diagnosis’.
- up to twenty treatment services with an allied health professional before the client turns 25 years of age. This is called the ‘Helping Children with Autism Treatment Plan.’
How much is the rebate?
You will need to contact Medicare directly to determine the rebate amount. We do not bulk bill (i.e. only charge the Medicare rebate) for services at Hills District Speech Therapy. Our therapy and assessment fees are more than the rebate amount and need to be paid in full prior to making a claim. You will be left with an out of pocket expense from each assessment/treatment session, however these expenses will count towards your Medicare safety net.
How can I make a claim?
Upon having provided your therapist with a copy of the referral and paying the full session fee, you will be emailed a receipt with important information required by Medicare to make a successful claim. You can then provide Medicare with this receipt using the app or visiting your closest Medicare branch. The rebate will be deposited into your nominated bank account. If you lose track of how many services you have claimed under the plan, please contact Medicare on 132 011.