COVID-19: Funded programs

Updated 16 June 2022

On this page Speech Pathology Australia has provided information on the response to COVID-19 as it relates to the following:

Medicare

Telehealth sessions introduced on a temporary basis in response to the COVID-19 pandemic are now permanent. Refer to the Australian Government Department of Health Ongoing MBS telehealth services. This includes sessions delivered under the Chronic disease management program and the follow up items for people of Aboriginal and Torres Strait Islander descent.

  • Service may only be provided by telehealth where it is safe and clinically appropriate.
  • Videoconference services are the preferred approach for substituting a face-to-face consultation, however audio only services can be provided via telephone if video is not available.
  • Practitioners must ensure that their chosen telecommunications solution meets their clinical requirements and satisfies privacy laws.
  • Providers do not need to be in their regular practice to provide telehealth services.
  • Providers should use their provider number for their primary location.
  • The MBS telehealth items have the same clinical requirements as the corresponding face-to face consultation items.

For more information, including details about telehealth item numbers, see SPA’s Information sheet on the Chronic Disease Management program on the the Association's website.

Department of Veterans' Affairs

As of 1 January 2022, DVA introduced permanent telehealth arrangements for general practitioner, medical specialist and allied health services (except dental, optical and neuropsychology), for eligible DVA clients. These arrangements reflect the whole-of-government approach to permanent telehealth services provided under the Medical Benefits Schedule (MBS). View the Department of Veterans' Affairs website.

Telehealth and aged care

There are no current restrictions on the use of telehealth (e.g. Home Care Packages) by the funding body, so speech pathologists need to consider the clinical efficacy in each client’s individual situation and discuss with your client and HCP provider to confirm arrangements.

Private Health Funds (PHFs)

As a result of the advocacy work, the Association is aware that most Private Health Funds (PHFs) have announced that customers who have extras cover for speech pathology will be able to make a claim for speech pathology services delivered via telehealth. Some PHFs have announced permanent telehealth items.

Below is a list of providers and details and links to relevant information on their websites. If you or your clients are unsure if telehealth rebates are possible, please contract the PHF directly for confirmation.

Telehealth codes typically used by PHFS are

  • 501 – Individual Initial /Referred assessment by teleconsultation
  • 502 – Individual subsequent treatment by teleconsultation.

The Association recommends that members providing services that attract a PHF rebate are familiar with individual PHF provider rules around billing as there are variations amongst PHFs as well as different item codes and varying dates around when rebates will be provided for telehealth services.

ahm

Funding for the provision of telehealth services for Speech Pathology will continue on an ongoing basis.

AIA Health Insurance

Australian Unity

Telehealth services will be covered indefinitely.

Bupa

Bupa has announced that they have made a long term commitment to providing rebates for speech pathology services delivered via telehealth.

They have introduced telehealth guidelines for members.

CBHS

Telehealth benefits for speech pathology consultations are available. View the CBHS website.

Defence Health

Telehealth benefits for speech pathology consultations are now a standard inclusion on eligible covers.

GMHBA

GMHBA members with extras cover can access benefits for telehealth consultations. View the GMHBA website.

GU health

Access to selected services, including speech pathology, via telehealth will be available permanently in line with level of Extras cover.

HBF 

HBF have permanently extended telehealth benefits for speech pathology services up to available limits provided that the service being claimed is delivered in line with HBF’s telehealth criteria; normal Waiting Periods apply.

In addition to account requirements outlined in the HBF Approved Provider Terms and Conditions, the account must clearly indicate:

  • Required Delivery Method – i.e. phone call or video conference
  • Treatment start and end times (e.g. 1pm to 1.30pm)
  • Duration (e.g. 30 minutes).

Use the following item numbers and descriptions.

HCF

The Association is seeking clarification from HCF about rebates for speech pathology services delivered via telehealth.

Queries: 1300 799 275 or email HCF.

Health Partners

Telehealth services for speech pathology services extended until further notice.

HIF

HIF is now providing telehealth benefits for speech pathology services.

Latrobe

Latrobe Health Services will pay benefits for extras services delivered via telehealth on a permanent basis.

Medibank

Funding for the provision of telehealth services for speech pathology will continue on an ongoing basis .Provider queries relating to Medibank can be directed to the Medibank provider help desk.

Note:

  • The clinician should use their clinical reasoning to determine if the patient is clinically appropriate to receive the service via telehealth and must work within their scope of practice.
  • The service is undertaken in accordance with each profession’s telehealth policy and guidelines.
  • The suitability of the telehealth modality is decided upon by the clinician in consultation with their client (including client’s access to technology and comfort levels with telehealth as a substitution for face to face services).
  • The clinician and the client are both located in Australia at the time of the service provision.

Mildura Health Fund

nib

Rebates for telehealth services have been extended on an ongoing basis for speech pathology services.

Phoenix Health

Telehealth services have been extended for speech pathology services.

Police Health and Emergency Services Health

RT Health

St Lukes

Rebates for telehealth services have been extended on an ongoing basis for speech pathology services.

Teachers Health

Telehealth items have been extended until 30th June 2021.

TUH

Funding individual or group sessions.

Westfund