All information is current as at 1 November 2016.
||Early diagnosis and treatment of children with an Eligible Disability
Medicare Items are available for assessment diagnosis and the creation of a treatment and management plan for a child under 13 years.
Referrals to allied health providers (AHP) to assist with diagnosis or for the purpose of contributing to a treatment plan by a GP; Specialist or Consultant Physician MBS Item 3-51 or as
Assessment, diagnosis and the creation of a treatment and management plan by a
GP MBS Item 139; Specialist or consultant physician MBS Item 137
|Ensure patient / client eligibility
Early intervention services for children with the following conditions. Sight impairment <6/18 vision ; hearing impairment; Deaf;blindness; 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; Retts disorder.
|Role of referring Medical Practitioner
||To contribute to the assessment, diagnosis and the creation of a treatment and management plan. The consultant may refer to an eligible health provider to assist with the diagnosis of the child for the purpose of contributing to the treatment plan.
When a treatment plan is in place, the practitioner who develops the plan can refer a child for allied health treatment services (the child is < 15 years and had a plan prepared for them before their 13th birthday).
|Contribution of AHP
Assistance with Diagnosis and contribution to a treatment plan
Up to four diagnostic services for a child under 13 years of age
MBS item 82000 Psychologist; MBS item 82005 Speech pathologist; MBS Item 82010 Occupational Therapist; MBS Item 82030 Audiologist; Optometrist; Orthoptist; Physiotherapist
Treatment services once a plan is in place
Up to 20 treatment services between the age of 13 and 15 years
MBS item 82015 Psychologist; MBS item 82020 Speech pathologist; MBS Item 82025 Occupational Therapist; MBS Item 82035 Audiologist; Optometrist; Orthoptist; Physiotherapist
A course of treatment for AH services consists on the number of services stated on the referral, up to a maximum of 10, there is a requirement for a separate referral for each AHP and for feedback following initial course of treatment to determine the need for future treatment.
|Frequency of service completion
|Only one treatment and management plan can be prepared for a child in their lifetime.
If plan created under MBS items 135 or 289 it can be reviewed under attendance items for a Paediatrician or Psychiatrist
The AHP services available are the total number of services available not an annual entitlement, for example 4 assessment services and up to 20 treatment services provided a plan is in place before the child's 13th Birthday.
||MBS Online - Medicare Benefits Schedule
Australian Department of Health - Primary care (GP, nursing, allied health)
Australian Department of Human Services - Education services for health professionals