Northside Speech

Speech pathology services for the North Canberra region | Registered NDIS Provider

Fees & Funding

Fee Schedule

All fees are subject to change on July 1, or when updates to NDIS guidelines come into effect. We will make every reasonable effort to inform you of any pricing changes.

Public system supports

Many children aged 0-6 who live in the ACT are eligible to be seen by the Child Development Service, at no cost to the child/family. CDS is able to see child who:

  • Are aged 0-6
  • Live in the ACT
  • Do not have an NDIS plan

CDS is often a family’s first contact with speech pathology, although some families choose to seek private services instead.

More information about CDS can be found on their website.

Medicare rebates

We are able to accept referrals from GPs for Medicare-rebated services. The referral is called a ‘CDM plan’, and referral forms are available here from Medicare. You will need to provide us with a completed CDM referral before we can offer you a Medicare-rebated appointment.

You will need to discuss with your GP whether you/your partner/your child are eligible for a CDM plan. Your GP will be aware of eligibility criteria.

A CDM plan will provide a small rebate (currently $55.10) for up to 5 appointments per calendar year. You will need to pay the remainder of the fee (the gap fee) out of pocket. Our current fee schedule is available on our website.

You will need to pay the full fee at the time of the appointment, and we can process your Medicare rebate to be returned to your account automatically (if you have registered your bank details with Medicare).

There are some restrictions around types of services we can provide under Medicare, as well as specific requirements of Medicare providers, so it is important that you inform us if you are planning to claim a Medicare rebate.

Private health insurance rebates

We are able to provide private health insurance-rebated services.

If you have private health insurance, you will need to review your ‘extras’ cover to determine if speech pathology is covered. Coverage varies, depending on your insurance provider and your level of cover.

PHI will typically provide a small rebate (often between $50-$80) for a limited number of appointments per calendar year (often capped by a total $ amount). You will need to pay the remainder of the fee (the gap fee) out of pocket. Our current fee schedule is available on our website.

You will need to pay the full fee at the time of the appointment, and we can process many PHI rebate claims to be returned to your account automatically (if you have registered your bank details with your insurance provider). Our payment processor is Medipass, and details of which providers we can process automatically for you can be found on their website. If your insurance is not listed, you will need to process the claim yourself.

There are some restrictions around types of services we can provide under private health insurance, as well as specific requirements of private health insurance providers, so it is important that you inform us if you are planning to claim a private health insurance rebate.

NDIS coverage

We are a registered NDIS provider, and can accept all NDIS funding management options.

To be able to claim your speech pathology service from your NDIS plan, you need to have:

  • Goals listed in your NDIS plan that are relevant to the service you are seeking from us
  • Sufficient funding available under your ‘Improved Daily Living’ (‘CB Daily Activity’) budget to pay for the service

Our fee schedule meets the requirements of NDIS providers, and is available on our website. 

There are some restrictions around types of services we can provide under the NDIS, as well as specific requirements of NDIS providers, so it is important that you inform us if you are planning to claim NDIS coverage for our services. 

If your NDIS funding is self-managed:

  • You will need to sign a service agreement (terms & conditions of service) with us
  • You will need to pay the full fee at the time of the appointment
  • After you have paid us, you will need to process your claim for reimbursement via the myplace portal

If your NDIS funding is plan-managed: 

  • You will need to sign a service agreement (terms & conditions of service) with us
  • You will need to provide us with your plan manager’s details
  • We will invoice your plan manager after your appointment, and they will pay us directly
  • We will provide you with a statement of what we have invoiced and what your plan manager has paid to us, every three months

If your NDIS funding is NDIA-managed (agency-managed):

  • You will need to sign a service agreement (terms & conditions of service) with us
  • You will need to approve a support plan with us every three months
  • We will make a ‘service booking’ on your NDIS plan, which reserves the funding that we are expecting to claim from your plan over each three month period
  • We will claim the fee for your service from the NDIA after your appointment, and they will pay us directly
  • We will release any unused funding from our ‘service booking’ at the end of each three month period, or when you discharge from services
  • We will provide you with a statement of what we have invoiced and what the NDIA has paid to us, every three months

If you run out of funding available to pay for speech pathology services, you will need to:

  1. Seek a Medicare or private health insurance rebate to help pay for services (see above)
  2. Pay us privately (see below)
  3. Or we will discharge you or return you to the waitlist.

We are unable to provide services free of charge, which includes ‘holding’ or ‘reserving’ an appointment spot.

Private pay

We welcome clients paying for services privately (out of pocket).

You will need to pay the full fee at the time of the appointment. Our current fee schedule is available on our website.

Payments for school & community visits

If you have early childhood education, school, or community visits included as part of your support plan, you will need to provide us with your credit card details to pay for this service. As we require payment at the time of the appointment, we are not able to issue invoices for later payment.

Please be aware that travel fees apply, and are included in your support plan, as per our fee schedule.

Payments for telehealth services

If you have telehealth services included as part of your support plan, we will contact you to arrange payment after your appointment.

We have part-time administrative support dedicated to invoicing and payments, currently available Tuesdays and Fridays. You should expect to receive payment instructions on Tuesday or Friday.

Our payment processor is Medipass. You can read more about them, including FAQs, on their website. 

Cancellations

At Northside Speech, we:

  • prepare for each of our client appointments properly;
  • limit the number of clients we see each day to ensure we are providing a quality service to each client;
  • only accept and start working with new clients when we can offer ongoing services that are likely to meet that client’s goals.

If you book an appointment with us and don’t turn up – or if you contact us to cancel an appointment with less than two working days’ notice – three things happen:

  • We lose the time we have spent preparing for your appointment – time we could have spent helping another client or helping you in another way.
  • We may not have enough time to reschedule another client for your appointment time, which reduces the total number of clients we can help that day. This is not fair for people on our waiting list.
  • We lose income, which makes it more difficult for us to invest adequately in our workers and resources to provide you and other clients with a quality service. In some cases, this can mean that our staff don’t get paid as much for their work as they would have had the appointment happened.

Our services and supports are most effective when we trust and value each other’s work. We know that unexpected things happen – e.g., cars break down, people get sick, important travel commitments crop up at short notice. But “no shows” and late cancellations (also known as “failures to attend” or “did not attend” (“FTAs” and “DNAs”) – particularly if they happen more than once – can interfere with our trust in each other and, over time, can affect a client’s overall quality of care. We take pride in our work and don’t want this to happen.

Consistent with the NDIS Pricing Guide, we will accept cancellations up to two business days before an appointment. A business day for us includes Monday to Friday. You must notify us by email or by telephone or by text.

If you fail to attend, cancel or seek to reschedule an appointment with less than two business days’ notice you must pay us 100% of the appointment fee. We may occasionally make exceptions on compassionate grounds, solely at our discretion.

If you fail to attend two or more appointments, or fewer than 70% of booked appointments overall, we reserve the right to discharge you and/or any person under your care from our service.

If we need to cancel an appointment for any reason, we will inform you as early as possible. We do not expect this to happen except in exceptional circumstances (e.g. speech pathologist is ill). Any planned absences (e.g. leave, professional development) have already been factored when this Support Plan was created. You will not be charged, but we will not be liable to compensate you for any other expenses you’ve incurred in connection with the appointment.

We reserve the right to amend and update this policy as needed. Any changes to this policy will be communicated to you via email. The most recent policy is always available on our website: https://northsidespeech.com.au/clinic-policies/

Money Owing and Overdue Accounts

If any money owing is more than 7 days overdue, or if you owe us $500 or more, we will suspend all services until this account is settled. This includes NDIS participants whose funding is plan-managed, and whose plan manager does not pay us within 7 days.

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