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Fact Sheet for Health Professionals - Better Start for Children with Disability Initiative

The Australian Government has committed $122 million over four years for the Better Start for Children with Disability initiative, which commenced on 1 July 2011.

PDF printable version Fact Sheet for Health Professionals - Better Start for Children with Disability Initiative (PDF 39 KB).

If you have any queries related to these items or difficulty accessing the PDFs above, please contact mbd.web@health.gov.au

This initiative created new items in the Medicare Benefits Schedule (MBS), and provides early intervention and individual assistance packages for children with disability, their families and carers. The Better Start for Children with Disability initiative is being implemented across the Department of Health and Ageing and the Department of Families, Housing, Community Services and Indigenous Affairs.

What is considered an eligible disability?
For the purposes of item 137, item 139 and items 82000 to 82035 eligible disability means any of the following:

• sight impairment that results in vision of less than or equal to 6/18 vision or equivalent field loss in the better eye, with correction;
• hearing impairment that results in:
  1. a hearing loss of 40 decibels or greater in the better ear, across four frequencies; or
  2. permanent conductive hearing loss and auditory neuropathy;
• cerebral palsy;
• Down syndrome; and
• Fragile X syndrome.

Medicare items for the Better Start for Children with Disability initiative

Items are available for:

• specialists, consultant physicians (item 137) and general practitioners (item 139) to diagnose and develop a treatment and management plan for children aged under 13 years;
• audiologists, occupational therapists, optometrists, orthoptists, physiotherapists, psychologists and speech pathologists to provide assessment services to collaborate with the specialist, consultant physician or general practitioner on the diagnosis and development of the treatment and management plan (up to 4 services in total per child); and
• audiologists, occupational therapists, optometrists, orthoptists, physiotherapists, psychologists and speech pathologists to provide early intervention treatment services following diagnosis (up to 20 services in total per child).

Referral requirements

An eligible allied health professional can provide disability assessment services (items 82000, 82005, 82010 and 82030) to a child where:

• the child has previously been provided with any MBS service covering items 104 to 131 (inclusive), or items 296 to 370 (excluding item 359) as provided by an eligible specialist or consultant physician; or
• the child has previously been provided with any MBS service covering items 3 to 51, as provided by a general practitioner.

An eligible allied health professional can provide disability treatment services (items 82015, 82020, 82025 and 82035) to a child where:

• the child has previously been provided with a disability treatment and management plan (item 137) by an eligible specialist or consultant physician; or
• the child has previously been provided with a disability treatment and management plan (item 139) by a general practitioner.

An allied health professional wanting to provide any of the items 82000 to 82035 must be in receipt of a current referral provided by the relevant medical practitioner.
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Allied health items for assisting with diagnosis and/or contribution to the disability treatment and management plan

• 82000 – psychology
• 82005 – speech pathology
• 82010 – occupational therapy
• 82030 – audiology, optometry, orthoptics and physiotherapy

Description of assessment items

Professional attendance provided to a child aged under 13 years where:

• the child is referred by an eligible practitioner for the purpose of collaborating with the practitioner for the diagnosis of the child; and/or
• the child is referred by an eligible practitioner for the purpose of contributing to the child’s disability treatment plan, developed by the practitioner;
• the eligible practitioner is a specialist, consultant physician or general practitioner;
• the allied health provider attending the child is registered with Medicare Australia as meeting the eligibility requirements for the provision of these services;
• the child is not an admitted patient of a hospital; and
• the service is provided to the child individually and in person, and the service lasts at least 50 minutes in duration.

Up to 4 services may be provided to the same child on the same day. These items are limited to a maximum of 4 services in total per child consisting of any combination of 82000, 82005, 82010 and 82030 provided by any combination of allied health professionals. A written report must be provided to the referring medical practitioner after providing the assessment services.

Allied heath items for early intervention treatment of an eligible disability:

• 82015 – psychology
• 82020 – speech pathology
• 82025 – occupational therapy
• 82035 – audiology, optometry, orthoptics and physiotherapy

Description of treatment items

Professional attendance provided for treatment of an eligible disability for a child aged under 15 years where:

• the child has been diagnosed with an eligible disability;
• the child has received a disability treatment plan (while under 13 years) as prepared for the child by an eligible practitioner (under item 137 or item 139);
• the child has been referred by an eligible practitioner for services that are consistent with the disability treatment plan;
• the eligible medical practitioner is a specialist, consultant physician or general practitioner
• the allied health provider attending the child is registered with Medicare Australia as meeting eligibility requirements for the provision of these services;
• the child is not an admitted patient of a hospital; and
• the service is provided to the child individually and in person, and the service lasts at least 30 minutes in duration.

Up to 4 services may be provided to the same child on the same day. These items are limited to a maximum of 20 services in total per life time, consisting of any combination of items 82015, 82020, 82025 and 82035, provided by any combination of allied health professionals. Within the 20 services provided, a course of treatment will consist of the number of services stated on the child’s referral (up to a maximum of 10). A written report must be provided to the referring medical practitioner after completion of each course of treatment.

Who can access these services?
Children with an eligible disability can access these services:

• if their condition is being managed by an eligible specialist, consultant physician or general practitioner under a disability treatment and management plan and that disability treatment plan is complete prior to the child's 13th birthday;
• if they are under 15 years of age for treatment services; and
• the child has not already accessed services under the Helping Children with Autism program.

More information

Further information on the Better Start for Children with Disability items can be obtained by visiting the MBS Online website: http://www.mbsonline.gov.au/
Inquiries can be directed to mbsonline@health.gov.au or (02) 6289 1555.
Further information on the Better Start for Children with Disability initiative is available at www.health.gov.au
Provider registration forms can be obtained from Medicare Australia on 132 150 or at www.medicareaustralia.gov.au
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