New Medicare rebates for children and young people with stuttering, speech sound disorders and cleft conditions
For a long time, families whose children needed help with their speech had to carry the cost almost entirely on their own, unless they had an NDIS plan. If that has been your family, you will know the quiet maths that happens at the kitchen table: how many sessions can we manage this term, and what do we let go of to make them happen.
From 1 March 2026, something shifted. Medicare opened a new pathway that can help with the cost of both assessment and therapy for some children. It will not be right for every family, and it is not free therapy. But it is a real change, and it is worth understanding clearly.
What actually changed
Medicare has a group of items known as M10. From 1 March 2026, it was expanded to include children and young people under 25 who have:
Stuttering (disruptions in the flow of speech)
Speech sound disorders, which covers articulation difficulties (trouble saying certain sounds clearly), phonological difficulties (patterns of sound errors that make speech hard to understand), childhood apraxia of speech (difficulty planning and coordinating the movements for speech), and dysarthria (speech affected by muscle weakness or control)
Cleft lip and/or palate
If your child is eligible, Medicare can help pay for up to 8 assessment sessions and up to 20 treatment sessions. These are lifetime limits, not yearly ones, and they are shared across every provider your child sees under this pathway.
As of June 2026, the rebate is $87.25 per session. This amount is set by Medicare and can change. It is a subsidy, not the full fee, so there is usually a gap between the rebate and the cost of a session. Our team can tell you what your gap would be before you start.
From a speech pathology perspective
This is the part of the change made for these conditions, and it is the clearest fit. If your child stutters, is hard to understand, is working hard to make certain sounds, or has speech affected by a cleft, this pathway was designed with them in mind.
A speech pathologist can use it in two ways: to assess your child and help work out what is going on, and then to provide therapy. The assessment is not a formality. It is how we understand your child's particular pattern, and that understanding shapes everything that comes next.
How to set it up, step by step
Here is the important part. This pathway is new, and many GPs will not have heard of it yet. You are allowed to bring it to their attention. You may even like to share this page with them. These next steps are a guide for both parents and GPs.
The order of these steps matters, especially steps 2 and 3.
See your GP. Book a standard appointment. Tell them you think your child has stuttering, a speech sound disorder, or a cleft-related concern, and ask whether your child may be eligible under the M10 eligible disability pathway.
Assessment first. Ask your GP to refer your child for assessment before any treatment plan is written. A speech pathology assessment uses item 82005. Your GP can refer for up to 4 assessment sessions before a review, and up to 8 across your child's lifetime. The therapist assesses your child and sends a written report back to your GP. A note for GPs: these assessment items are designed to be used before the treatment and management plan. Claiming the plan item first removes access to them.
Diagnosis and plan. Using the therapist's report, if your GP confirms an eligible condition, they create a treatment and management plan using item 139. This is a GP item, claimable once in your child's lifetime, and at least 45 minutes long. (A specialist or consultant physician uses item 137 instead, and complex neurodevelopmental conditions are referred through a paediatrician or psychiatrist.)
Treatment referral. Your GP then refers your child for therapy, up to 10 sessions per referral and up to 20 across their lifetime. Speech pathology treatment uses item 82020. Telehealth versions exist for both.
Therapy begins. After each session, you claim the rebate from Medicare. Your therapist reports back to your GP after each course of treatment, which keeps everyone working from the same picture.
One more thing worth knowing: the speech pathologist must be registered to provide Medicare services for the rebate to apply. All our team at Hi Thrive are registered to provide Medicare services.
A note on NDIS and any Medicare rebates
You cannot claim any Medicare rebates and NDIS for the same therapy. If your child's speech pathology is already funded through NDIS, this pathway does not apply to those sessions.
Why this matters
This M10 pathway has been only very recently expanded to include stuttering, speech sound disorders and cleft conditions. This may mean that your GP may not be fully aware of its existence. If that is the case, please direct your GP to Speech Pathology Australia's article on the subject.
