Medicare expansion for speech pathology starts 1 March 2026 – here’s what you need to know

Speech Pathology Australia is delighted that a major advocacy win for members and children and young people with communication and swallowing needs is now taking effect.  

From 1 March 2026, Medicare’s MBS M10 item group allied health services (for complex neurodevelopmental conditions and eligible disabilities) will expand to include stuttering, speech sound disorders, and cleft lip and/or palate, for children and young people aged under 25. 

This expanded eligibility recognises the importance of speech pathology access for people with these conditions, improving equitable access to rebated Medicare speech pathology services. 

This significant achievement follows a decade of SPA advocacy and close collaboration with the Department of Health, Disability and Ageing.

What’s changing?

  • Children and young people under 25 years old with stuttering, speech sound disorders (SSDs)*, or cleft lip and/or palate will be eligible for Medicare-rebated assessments and treatment services provided by speech pathologists, with a valid referral.
  • Referrals must be from a GP, consultant physician or specialist.   

What this means for members and families 

  • For clinicians, this change embeds recognition of these speech pathology needs into Medicare pathways and supports delivery of care within primary health funding.
  • For families, it means greater access to speech pathology support with a Medicare subsidy, reducing some of the financial burden of assessment and therapy. 

Find out more about eligibility and referral requirements.  

* SSDs including: articulation disorder; phonological disorder; childhood apraxia of speech (also known as dyspraxia, developmental verbal dyspraxia or speech apraxia); and dysarthria. 

More information 

Information for service users: 

FAQs  

What has changed? 

From 1 March 2026, the following conditions will be added to the eligible disabilities list for the Medicare M10 group: 

  • Stuttering
  • Speech sound disorders, including:
    • an articulation disorder; 
    • a phonological disorder;
    • childhood apraxia of speech (also known as dyspraxia, developmental verbal dyspraxia, or speech apraxia); and
    • dysarthria.
  • Cleft lip and/or palate.

Service users who are suspected of having, or are diagnosed with, these conditions will be able to access to MBS items under the M10 item group, including allied health assessment, diagnosis and treatment services. 

Is this a new MBS item group?  

No. This is not a new MBS item or program.  

The existing M10 item group remains unchanged — the reform simply expands the list of eligible conditions to include stuttering, speech sound disorders and cleft lip and/or palate.  

Who is eligible?  

Service users must:  

  • Be under 25 years of age
  • Have a referral from a GP, consultant physician or specialist
  • Be suspected of, or diagnosed with, an eligible condition under the M10 list.  

How many people does this affect?  

For the first time, around 385,000 children and young people will have better access to the speech pathology support they need — backed by Medicare.  

How many sessions can service users access?  

Eligible service users can claim: 

  • Up to 8 assessment sessions 
  • Up to 20 treatment sessions 

This is the total number of services that can be claimed before the person turns 25. 

These are delivered under existing M10 MBS items and follow the standard referral, assessment and treatment planning process.  

How much could this save families?  

With Medicare rebates available under M10, families can receive money back for each session. Over a full course of assessment and treatment - especially when multiple sessions are needed - this can add up to hundreds of dollars in savings. 

The rebate amount varies depending on individual circumstances. Health professionals set their own fees, so there may still be some out-of-pocket costs. 

You should discuss your fees with service users. Refer to SPA’s Determining a Schedule of Fees FAQ for more information.  

What MBS items do speech pathologists use for M10?  

Speech pathologists will continue to use existing M10 assessment and treatment items, including:  

How is M10 different from the Chronic Condition Management Plan (CCMP)? 

Although both M10 and CCMP allow service users to access Medicare rebates for allied health services, they are different pathways: 

M10 

  • Has specific eligibility criteria.
  • Requires a referral from a GP, consultant physician or specialist.
  • Does not require a Chronic Condition Management plan.
  • Provides access to eligible allied health services under the M10 referral pathway.
  • Has a lifetime cap of 8 assessments and 20 treatment sessions up to age 25. 

Chronic Condition Management Plan (CCMP) 

  • Requires a GP to prepare a Chronic Condition Management Plan (CCMP).
  • Allows access to up to 5 of Medicare-rebated allied health services per calendar year. There are no specific age restrictions.
  • The speech pathology item codes are
  • The current standard Medicare rebate for these items is $61.80 per session (as at 16 February 2026). 

Can people access both M10 and CCMP items? 

Yes, but not for the same session on the same day.  

If a person meets the eligibility criteria for both M10 and CCMP, they can use either pathway to access speech pathology services. Item codes and rebates differ between the two pathways. 

An eligible child or young person is referred under the M10 can use these sessions at any time up until they turn 25. These M10 sessions are separate from, and in addition to, any services accessed under a CCMP. 

If the person also has a CCMP, they may access up to five rebated allied health sessions per calendar year under that plan (subject to the rules and service limits of each item). 

Is Developmental Language Disorder (DLD) included in this change?  

No. Developmental Language Disorder (DLD) is not included in the M10 expansion commencing on 1 March 2026.  

While this reform expands eligibility to include stuttering, speech sound disorders and cleft lip and/or palate, DLD has not been added to the M10 eligibility list at this time.  

While SPA advocated for the inclusion of DLD, it has not been included as part of this measure.  We will continue to advocate for funding systems that increase the opportunities for people with communication and swallowing needs to access care.  

Is this part of the Thriving Kids reforms?  

No. The M10 expansion is a change to the Medicare Benefits Schedule, it is not part of the Thriving Kids program.   

However, some children that are eligible for services under the MBS M10 group may also be eligible to access Thriving Kids in future.   

Thriving Kids is a separate program currently in development. It is intended to support children aged 8 and under, who:  

  • are Autistic, and/or
  • have a developmental delay, and 
  • have low to moderate support needs. 

Learn more about Thriving Kids: Fact sheet; FAQs .  

Where can I find more information?  

Members can direct non-speech pathologists or members of the public to this general information on SPA’s website .  

Information for referrers, including specialists, consultant physicians and GPs is available on the MBS website: assessment referrals ; treatment referrals .  

The following member resources provide more information on Medicare billing, provider numbers, and other Medicare Groups, including Chronic Condition Management Plans: