Private Health Insurance Funding
Rebates for Speech Pathology and Occupational Therapy
Private health insurance can help reduce the out-of-pocket cost of allied health services, including Speech Pathology and Occupational Therapy. Many Australian health funds include cover for these services, though what you can claim depends on your level of cover.
You don’t need a GP referral to use private health insurance for assessment or therapy at Chatterbox, and we offer on-the-spot HICAPS claiming to make things easier.
What Can I Claim?
Most health funds provide a rebate for:
- Speech Pathology assessments and therapy
- Occupational Therapy assessments and therapy
- Face-to-face or telehealth sessions (depending on your fund)
Coverage varies between providers and plans. Before your appointment, it’s a good idea to check:
- Whether your fund includes cover for the service
- If your plan includes telehealth (online therapy)
- How much rebate you’ll receive per session
- Your annual limits or remaining benefits
How It Works
Here’s what to expect when using your private health insurance:
- Book your session with your chosen Chatterbox therapist (no GP referral needed)
- Bring your health fund card to your appointment (or check your app has digital claiming access)
- Pay in full on the day
- We process your claim instantly via HICAPS (if eligible), and you only pay the gap
- Prefer telehealth? We’ll provide a receipt so you can claim directly with your fund
Please note: Not all funds support HICAPS for all services. If your provider isn’t listed or your card doesn’t swipe, we’ll give you an invoice to claim directly.
Using Your Rebate
- You can use private health once any waiting periods set by your fund have been completed.
- Rebates vary, but most families get between $20–$70 back per session
- You can’t use private health insurance to pay the gap on a Medicare rebate (e.g. GP Chronic Condition Management Plan or Helping Children With Autism.) You need to choose one or the other.
- Your fund might ask for item codes when checking your coverage. Commonly used item codes include:
- Speech Pathology: 320 (assessment), 340 (therapy)
- Occupational Therapy: 100 (assessment), 250 (therapy)
Frequently Asked Questions
Can I use private health and Medicare for the same session?
No, you’ll need to choose one or the other. You can’t claim both Medicare and private health insurance for the same allied health service.
Can I use private health insurance to top up a Medicare rebate?
No. Private health funds don’t allow you to claim the gap between the Medicare rebate and your therapy fee. It’s one or the other- not both.
How do I know if I’m covered for Speech Pathology or Occupational Therapy?
Check your health fund’s website, app, or contact them directly to confirm your level of extras cover. Commonly used item numbers include: Speech Pathology: 320 (assessment), 340 (therapy) and Occupational Therapy: 100 (assessment), 250 (therapy)
Is there a waiting period before I can claim therapy?
Some funds have a waiting period when you first join or change your extras cover. Contact your fund to find out if this applies to your policy.
Do I need a GP referral to access therapy with private health insurance?
No. You can access Speech Pathology or Occupational Therapy using private health cover without seeing a doctor first.
How much will my private health insurance cover for therapy?
This depends on your specific policy and provider. Every health fund is different, so we recommend contacting your fund directly or checking your online member portal for details on your extras cover, limits, and rebates.
What happens if my fund says Chatterbox isn’t registered?
All Chatterbox therapists are registered with major health funds. If your fund can’t find us, please get in touch. Occasionally, new or updated provider systems cause issues, but we’ll do our best to resolve it quickly so you can access the rebate you’re entitled to.
Can I claim through HICAPS on the day?
Yes! We offer on-the-spot claiming through HICAPS for most major health funds. Just bring your physical or digital health fund card with you. We’ll swipe it at reception, and you’ll only need to pay the gap.
How do I check if my health fund is registered with HICAPS?
Visit the HICAPS website for a list of participating health funds. If you’re unsure or your fund isn’t listed, it’s best to contact them directly.
What if my private health fund doesn’t use HICAPS?
If your fund isn’t linked with HICAPS, that’s okay. We’ll provide you with a receipt after your session so you can submit a claim through your health fund’s app, website, or member portal.
Need more info?
That’s okay, we’re here to help you figure it out.