If your child has a disability or neurodevelopmental condition, you may be eligible for a Medicare-funded therapy session. Two key options are:
- Complex Neurodevelopmental Disorder and Disability (CNDD) plan
- General Practitioner Chronic Condition Management Plan (GPCCMP).
This guide explains what these plans are, who can refer you, eligibility criteria, and how to apply.
What is the CNDD Medicare Plan and Who is Eligible?
The CNDD medicare plan helps families access diagnosis, management planning and therapies for eligible conditions.
Within the CNDD plan, an individual can access up to 20 subsidised appointments across their lifetime as long as they qualify under the following eligibility guidelines:
- The participant is under the age of 25,
- They have not accessed all of the sessions within the allocated 20 sessions (capped at 20 across a lifespan) and
- Be diagnosed with at least one eligible disability or a complex neurodevelopmental disorder, including, but not limited to:
- Autism
- ADHD
- Intellectual Disability
- Childhood Major Depressive Disorder
- Diagnosed Sight Impairment
- Hearing Impairment
- Deafblindness
- Cerebral Palsy
- Down Syndrome
- Fragile X Syndrome
- Prader-Willi Syndrome
- Williams Syndrome
- Angelman Syndrome
- Kabuki Syndrome
- Smith-Magenis Syndrome
- CHARGE Syndrome
- Cri du Chat Syndrome
- Cornelia De Lange Syndrome
- Microcephaly
- Rett’s disorder
- Foetal Alcohol Spectrum Disorder
- Lesch-Nyhan Syndrome
- 22q Deletion Syndrome
What Therapies are Covered Under CNDD?
Within this plan, you can use CNDD plan sessions for the following services as align with the referring doctors’ management plan:
- Speech Pathology
- Occupational Therapy
- Psychology
- Physiotherapy
- Exercise Physiology
- Dietetics
- Audiology
- Optometry
- Orthoptics
Who can refer for CNDD?
- GPs – can refer to your child through a CNDD plan if there is already a qualifying disability. Unfortunately, at this stage, GP’s are unable to refer individuals with the single diagnosis of a neurodevelopmental disorder through this plan.
- Paediatricians or Psychiatrists – can refer for diagnosis support, OR if your child already has a diagnosed disability or neurodevelopmental disorder.
Alternatively, families may wish to access the GPCCMP.
What is a GPCCMP?
These plans were previously known as enhanced primary care plans or chronic disease management plans.
The GPCCMP is the updated version of these referrals, allowing access to up to five allied health service appointments across a calendar year.
Which therapies can you access with a GPCCMP?
Allied Health Services that can provide treatment or management under this referral type include:
- Aboriginal Health Workers
- Audiologists
- Chiropractors
- Diabetes Educators
- Dietitians
- Exercise Physiologists
- Mental Health Workers
- Occupational Therapists
- Osteopaths
- Physiotherapists
- Podiatrists
- Psychologists
- and Speech Pathologists
How to access a referral through the GPCCMP?
- Book an appointment with your GP
- Discuss your child’s eligibility (must have a chronic condition or complex care needs)
- Your GP will create a management plan and provide referrals for the required therapies
Quick Tips for Parents and Guardians:
- Ask your GP or paediatrician about CNDD and GPCCMP funding early.
- Keep track of how many sessions you may have used either across the year or in total.
- Make sure the referrals include all the required information and that they are signed.
- Plan how you would like to use the sessions and consider spreading them across different therapies if needed.
For support in navigating the world of Medicare and paediatric therapies, please feel free to contact us at 9088 7585, send an enquiry through our website or via email!
