In Australia, Medicare provides funding for Occupational Therapy under several item numbers. These include the Chronic Disease Management Plan (M3), Better Access to Mental Health (M7), Complex Neurodevelopmental Disorders (M10), and Eating Disorders Plan (M16). With a GP referral and a completed care plan, eligible clients can receive rebates for OT sessions. Our team helps you navigate eligibility, referral pathways, and funding options, ensuring you access the support you need for your physical and mental wellbeing.

Understanding Out-of-Pocket Costs for OT

While Medicare and Private Health cover part of OT service fees, gap payments may still apply. Medicare rebates range from $58.30 to $82.80 per session depending on the plan. Standard session fees vary by provider and typically range from $120 to $220, meaning an average out-of-pocket cost between $60 and $140. Private Health Extras cover may also reimburse some costs depending on your provider and level of cover. We’re happy to guide you through expected costs before your first appointment.

Occupational Therapy Services in Australia: Access Through Medicare or Private Health

Introduction

We are proud to offer comprehensive Occupational Therapy (OT) services, supporting clients across Australia through a range of funding options, including Medicare and Private Health. Whether you are managing a chronic health condition, a mental health concern, a neurodevelopmental disorder, or recovering from an injury, we are here to help you thrive.
Occupational Therapy empowers you to engage in daily activities with greater independence, resilience, and purpose. Using a client-centred, evidence-based approach, we work closely with you to set meaningful goals and create real, lasting change.

What is Occupational Therapy?

Occupational Therapy helps people of all ages overcome physical, cognitive, sensory, and emotional barriers that prevent full participation in everyday life. Occupational Therapists support individuals to:

• Develop psychological strategies (for anxiety, depression, PTSD)

• Improve independence in self-care (e.g., dressing, hygiene)

• Build emotional regulation skills

• Enhance memory, attention, and executive function

• Manage pain, fatigue, or long-term conditions

• Engage in education, employment, and social life

• Navigate daily life with resilience and purpose

• Modify environments at home, school, or work for safety and success

We aim to help you live with more ease, safety, connection, and confidence.

How We Help: Mental Health Presentations We Support

We proudly assist clients experiencing a wide range of presentations. Here’s how Occupational Therapy can support you:

Anger Management
OTs help identify triggers, manage frustration, and develop healthier coping strategies.

Anxiety Disorders
Support includes practical strategies for worry reduction, daily planning, and social engagement. Subtypes supported:

• Generalised Anxiety Disorder

• Panic Disorder

• Social Anxiety Disorder

• Specific Phobias

Attention-Deficit/Hyperactivity Disorder (ADHD)
OT provides executive function coaching, emotional regulation training, and support in daily structure.

Auditory Processing Disorder (APD)
We assist with auditory training, communication strategies, and school/work adaptations.

Autism Spectrum Disorder (ASD)
We use sensory integration, support daily skills, and enhance emotional/social participation.

Chronic Pain and Somatic Disorders
Pain management strategies include energy conservation and adaptive equipment education.

Burnout and Chronic Stress
We focus on restoring energy balance, time management, and daily rhythm.

Dementia and Cognitive Decline
Support includes memory aids, routine enhancement, and environment modifications.

Depression (MDD, PDD)
OT encourages activity engagement, goal setting, and meaningful routine creation.

Dyslexia
Strategies target handwriting, learning support, and organisation.

Grief and Loss
We help re-establish routines and process loss through therapeutic activities.

Obsessive-Compulsive Disorder (OCD)
OT supports behaviour change using structured routines and exposure strategies.

Post-Traumatic Stress Disorder (PTSD)
We build trauma-informed routines and resilience through structured daily practices.

Sleep Disorders
Support includes sleep hygiene education, bedtime routines, and relaxation techniques.

Traumatic Brain Injury (TBI)
OT helps retrain cognitive and physical functions, supporting a return to daily activities.

Accessing Occupational Therapy Through Medicare

There are four main Medicare programs that provide subsidised access to Occupational Therapy:

1. M3 – Chronic Disease Management (CDM)
   With a GP Management Plan (GPMP) and Team Care Arrangement (TCA), you may access up to 5 subsidised allied health sessions per calendar year (shared). A Medicare rebate of approx. $58.30 applies.

2. M7 – Better Access to Mental Health (Focused Psychological Strategies)
   With a Mental Health Treatment Plan, clients with mental health diagnoses may access up to 10 subsidised sessions annually. Occupational Therapists must hold a Mental Health Endorsement.

3. M10 – Complex Neurodevelopmental Disorders
   Children with Autism or similar developmental conditions may access early intervention OT services. A referral from a paediatrician or psychiatrist is required.

4. M16 – Eating Disorders Treatment Plan
   With a diagnosis of Anorexia, Bulimia, or similar, eligible clients may receive up to 20 sessions per year. Services must be provided by a Mental Health Endorsed OT.

Important: You must have a valid referral from a GP or specialist, and the OT must be Medicare-registered to claim rebates. Our team can help you organise all documentation required.

What You Need to Know About Using Medicare

To claim your rebate under Medicare:

• Obtain a valid referral from your GP or specialist before your first session

• Pay the session fee upfront — the rebate is reimbursed into your account

• You can’t claim both Medicare and Private Health for the same session

• Session limits reset annually (for M3 and M7 plans)

• Medicare rebates vary by service type and therapist qualifications

Still unsure about eligibility?
Book a FREE 15-minute Discovery Call with our team — we’ll assess your needs, check rebate options, and guide you to the right funding pathway.

Expected Out-of-Pocket Costs for OT Under Medicare

Depending on the type of Medicare plan and your therapist’s fees, some gap payments may apply:

Private Health Insurance Options

Many Extras policies include coverage for Occupational Therapy. Major Australian providers offering OT rebates include:

• Bupa

• Medibank Private

• HCF

• nib

• Australian Unity

• Teachers Health

• Defence Health

• CBHS

• HBF

• GMHBA

• Health Partners

• Westfund

• Peoplecare

• Police Health

• TUH

• St.LukesHealth

• CUA Health

• Phoenix Health

Tip: OT may appear under “Allied Health” or “Other Medical” in your Extras cover. Check your policy or contact your insurer for rebate limits and annual caps.