How Can Families Pay for Therapy? A Simple Guide to Medicare, NDIS & Private Health Insurance (Blackburn & Surrounding Suburbs)
Navigating therapy funding can feel overwhelming — especially when you’re trying to support your child’s development at the same time. At our Blackburn clinic, we want to make this part easy.
Whether you live in Blackburn, Box Hill, Doncaster, Burwood or Nunawading, here’s a parent-friendly breakdown of all the ways you can access therapy: Medicare, NDIS, private health insurance, or private pay.
Let’s walk through each option clearly and simply.
1. Can I use Medicare to help pay for my child’s therapy?
Yes — absolutely.
Our Blackburn clinic accepts Medicare Chronic Disease Management (CDM) Plans for:
- Speech Pathology
- Occupational Therapy
A CDM Plan gives your child up to 5 Medicare-subsidised sessions per calendar year.
How to get a CDM Plan
Just speak to your GP. Your child may be eligible if they:
- Have a condition expected to last 6 months or longer, and
- Need support from multiple health professionals.
If the GP approves the CDM referral, Medicare will rebate part of each session. You simply pay the remainder (the “gap”).
Why families love this option
It’s an affordable way to start therapy early — especially if you’re unsure whether your child needs long-term support.
2. Can I use Medicare for psychology or play therapy?
Psychology – YES
If your child sees a psychologist, your GP may provide a Mental Health Care Plan (MHCP).
This gives access to Medicare rebates for a number of psychology sessions each year.
Play Therapy – Not currently covered
Medicare does not provide rebates for play therapy.
Families usually pay privately or use NDIS funding if their child is eligible.
3. Can we use NDIS funding at your clinic?
Yes — we support many NDIS families across Blackburn and Box Hill.
You can use NDIS funding at our clinic if your plan is:
- Self-managed, or
- Plan-managed
How it works
Self-managed:
You pay the invoice → claim it back through the NDIS portal.
Plan-managed:
We send the invoice directly to your plan manager → no upfront cost for you.
What if my plan is NDIA-managed (agency-managed)?
NDIA-managed plans can only use registered NDIS providers for therapy.
Since we’re not registered yet, you would need to:
- Pay privately or
- Switch to self-managed/plan-managed funding (many families do this for choice and flexibility)
If you’re unsure what to do, our admin team can guide you through your options.
No referral needed
You don’t need a doctor’s referral to use NDIS at our clinic — just let us know when you book.
4. Will private health insurance cover therapy sessions?
Often, yes — if you have an extras policy.
Many families can claim rebates for:
- Speech therapy
- Occupational therapy
- Psychology
How it works
- You pay the session fee.
- We give you an invoice.
- You claim a portion back from your insurer.
Coverage varies, so check with your fund to confirm:
- How much they will rebate per session
- Annual limits
- Whether psychology is included
Important: You cannot claim both Medicare and private health insurance for the same session. You choose one or the other.
5. Do I need a referral to start therapy?
No referral is needed for:
- Speech pathology
- Occupational therapy
- Play therapy
- Psychology (unless using MHCP)
- NDIS therapy
- Private health insurance
- Private pay
The only time you need a GP referral is when using Medicare (CDM Plan or Mental Health Care Plan).
Otherwise, you can simply contact us directly and book.
6. What if we don’t have funding — can we pay privately?
Absolutely. Many families choose private pay, especially:
- While waiting for NDIS approval
- If they don’t qualify for NDIS
- After using up Medicare sessions
- If they want consistent weekly therapy
Private pay is simple:
You cover the session fee, and we book your preferred time. No referral needed.
We always discuss fees upfront so there are no surprises.
The Bottom Line: Support Should Be Accessible
We believe every child — whether in Blackburn, Box Hill, Doncaster or surrounding suburbs — deserves quality, bilingual and family-centred care.
Whether you’re using Medicare, NDIS, private health insurance, or paying privately, we’ll help you understand the steps and support you at every stage.
If you’re unsure where to start, just get in touch.
Our friendly team is here to guide you and make the process smooth and stress-free.