How allied health will be funded under the current model is still being determined.
Information on the proposed funding models for registered aged care and home-based care can be found in the following.
The Australian National Aged Care Classification (AN-ACC) is a new assessment model allocating Commonwealth funding and subsidy to Residential Aged Care (RAC) settings. It has been designed to replace the existing Aged Care Funding Instrument (ACFI), operating within Australian residential care facilities since 2008.
AN-ACC Class 1 is a special classification. It is for eligible residents who enter permanent residential aged care to receive planned palliative care at, or near, end of life.
This includes residents who transfer from residential respite care to permanent residential care at the same service. A resident with AN-ACC Class 1 does not need an AN-ACC assessment.
Reforming in-home aged care
This website outlines the various actions and works underway around the reform of home-based aged care services including information about the Support at Home Assessment Trial Advisory group and the associated ‘Living Lab’ trial of the proposed assessment tool.
Aged care reform webinar
The new Support at Home Program is due to commence in July 2025. The program will support senior Australians to remain independent and in their own homes for longer. The webinar is for Senior Australians and their families and carers, health or aged care professionals, aged care assessors, peak bodies and Commonwealth Home Support Programme (CHSP), Home Care Package (HCP), Short-Term Restorative Care (STRC) and residential respite providers.
Ageing and Aged Care Engagement Hub
The Department of Health and Aged Care's Aged Care Engagement Hub directs you to current engagement opportunities and activities via the ‘Get Involved’ tab.
Aged care newsletter
This newsletter provides updates on reform work and sector changes.
As people age, they may require additional medical care to manage chronic conditions or maintain their overall health. This can include the services of allied health professionals such as physiotherapists, occupational therapists, speech therapists, and dietitians. These services can be costly, but many older adults still residing at home (including in a retirement living facility), may be eligible for funding or reimbursement to help cover the costs.
One common way to access funding for allied health services is through Medicare. Medicare is a federal health insurance program that provides coverage to people aged 65 and over, as well as some younger people with certain disabilities or health conditions. Medicare covers some allied health services, including physical therapy, occupational therapy, and speech therapy when accessed under plans such as a Chronic Disease management plan. However, Medicare rebates are unlikely to cover the cost of services fully, and so it is likely that you may want to consider charging a ‘gap’ payment.
Since July 1st, 2022, the Medicare benefits scheme has extended its provision of reimbursement for telehealth items.
To bill under Medicare, allied health professionals must:
Services Australia has Medicare information for allied health professionals, including eligibility requirements and guides on bulk billing. Its Health Professional Education Resources Gateway also has guides on MBS items for allied health professionals.
Medicare benefits schedule, referrals and claiming
Another option for funding allied health services is through private health insurance. Many private health insurance plans offer coverage for allied health services, but the amount of coverage can vary widely depending on the client’s policy. It is important to advise clients to check with the insurance provider to understand what services they are covered for, and at what level of reimbursement.
The following links also provide a pdf guide to private healthcare item numbers and what services can be claimed under each.
The Pharmaceutical Benefits Scheme (PBS) aims to improve medication access and affordability for all Australians. For people with palliative needs, the PBS can provide a more extensive range of subsidised medicines and, in some instances, increased quantities. Critically, prescribers may need to become more familiar with these, and the pharmacist has the opportunity to promote these.
In addition to subsidising dispensed medicines, the PBS funds a limited range of formulations for prescribers to carry with them on home visits. This functionality is called the PBS prescriber bag. It is available for all prescribers providing care for people living in their homes or a residential aged care home.
Page updated 09 February 2024