Medicare expansion for speech pathology - What GPs and allied health providers need to know

From 1 March 2026, Medicare expanded access to rebated speech pathology services for children and young people aged under 25 through the eligible disability pathway (M10). The change means more young people may be able to access assessment and treatment when a qualifying referral and diagnosis of an eligible disability are in place.

Eligible patients may access up to eight Medicare-rebated allied health assessment services in their lifetime, and up to 20 Medicare-rebated allied health treatment services in their lifetime.

What has changed?

The list of eligible disabilities under MBS Note MN.10.3 now includes the following speech-related conditions for people aged under 25:

• Stuttering
• Speech sound disorders, including articulation and phonological disorders, childhood apraxia of speech (also known as dyspraxia, developmental verbal dyspraxia or speech apraxia), and dysarthria
• Cleft lip, cleft palate, or cleft lip and palate

The full list of eligible disabilities is set out in MBS Note MN.10.3 and applies to allied health services provided under the M10 item group.

How the pathway works

The eligible disability pathway is separate from the Chronic Condition Management (CCM) pathway and has different referral and billing requirements.

Under this pathway:

• A GP must suspect that a patient aged under 25 has an eligible disability.
• If more information is needed to support diagnosis, the GP may refer the patient for Medicare-rebated allied health assessment services, using standard GP consultation items where appropriate.
• Allied health professionals should report back to the GP after each block of assessment services, so the GP can review the patient if required.
• Assessment services support the GP’s comprehensive assessment, diagnosis and management planning.

If the GP diagnoses an eligible disability, they may complete a treatment and management plan using item 139, or item 92142 via video telehealth.

• Item 139, or 92142 via video telehealth, has a minimum duration of 45 minutes and can only be claimed once in a patient’s lifetime.
• Where the plan identifies the need for allied health treatment, the GP can refer for up to 10 Medicare-rebated allied health treatment services per referral.
• Billing item 139, or 92142, enables Medicare-rebated allied health treatment services under this pathway.

Medicare-rebated allied health services

Once a treatment and management plan is in place, patients may access up to 20 Medicare-rebated allied health treatment services in their lifetime through eligible allied health practitioners.

Eligible allied health practitioners include:

• Psychologist
• Speech pathologist
• Occupational therapist
• Audiologist, dietitian, exercise physiologist, optometrist, orthoptist, physiotherapist

All services must be delivered by eligible allied health practitioners and meet the minimum time requirements specified in the MBS.

You may find this Adelaide PHN Summary of MBS Item Numbers and Referral Requirements useful to print off and keep as a reference. 

Learn more about the MBS items supporting the assessment, diagnosis and treatment of patients with an eligible disability or a complex neurodevelopmental condition through this MBS eLearning Module

For further detail on eligibility, referral pathways and MBS item structure, please refer to the following information:

Services Australia: Requirements of services for complex neurodevelopmental conditions and eligible disabilities

DHDA: Medicare M10 services for complex neurodevelopmental conditions and eligible disabilities

MBS – Note AN.0.72 – Attendance Services for Complex Neurodevelopmental Disorders

M10 Medical Practitioner – Referral and Services Pathway

M10 Services - Referral Pathway for Allied Health Assessment Factsheet

M10 Services - Referral Pathway for Allied Health Treatment Factsheet