Rebates | Autism Assessment Specialists

Assessment Rebates

Medicare Rebate

Medicare Rebates for Neurodevelopmental Assessments (Under 25 Years Old)

If you or your child is under 25 and requires an assessment for a neurodevelopmental condition, you may be eligible for a Medicare rebate to help cover part of the cost.

What’s Included?

The rebate can help cover the cost of:

Initial interviews with the young person and/or parent
Reviewing background history and previous reports
Standardised testing (e.g. cognitive, adaptive functioning, autism assessments)
Clinical observations and interpretation
A detailed written report for your referring specialist

How Many Sessions Are Covered?

Up to 4 Medicare-rebated sessions per lifetime are available
These sessions can include up to 4 hours of assessment time in total
The rebate amount is approximately $88–$101 per session, depending on the service provided

How Do I Access This?

To be eligible:

You must be under 25 years of age at the time of the assessment
You need a referral from a paediatrician or psychiatrist
The assessment must assist with diagnosis or treatment planning

If you're unsure where to start:

Speak with your GP about your concerns
Ask for a referral to a paediatrician or psychiatrist
Once referred, contact our clinic to book an appointment

If an assessment is needed, you may:

Be eligible for a Medicare rebate through a paediatrician or psychiatrist referral (under specific assessment item numbers for those under 25)
Be able to use NDIS funding (if already a participant with relevant Capacity Building supports)
Choose to proceed as a privately paying client

Please note that Medicare rebates provided under a Mental Health Care Plan (MHCP) do not cover the cost of psychological assessments.

NDIS Assessment Costs

The NDIS may cover the cost of an assessment in specific circumstances, but it is not guaranteed in all cases.

When Does the NDIS Cover the Cost of an Assessment?

The NDIS may fund assessments if you are already an NDIS participant and your current plan includes funding under the following categories:

1. Capacity Building – Improved Daily Living (Support Category 15)

This funding is designed to build skills and independence. It can be used for:

Functional capacity assessments
Therapy assessments to inform supports or interventions
Cognitive or psychological assessments if recommended by your support team
Report writing that supports goals, planning, or reviews

If the assessment is related to your functional needs, therapy planning, or helps guide support provision, it may be claimable under this category.

2. Plan Review Preparation

If a therapist recommends updated assessments to support your NDIS plan review, this may be covered by the therapy hours already allocated in your current plan. In this case, therapists must document the need and ensure the use of funds aligns with NDIS goals.

When NDIS Does Not Cover Assessment Costs:

Access Requests (Pre-NDIS application): The NDIS does not fund assessments required to determine initial eligibility (e.g. autism, ADHD, cognitive, psychological diagnoses) before a participant is approved.
Assessments without prior approval or allocation: If your current plan does not include enough funds under the appropriate category, you may need to self-fund.

What You Can Do:
If you're unsure whether your plan includes assessment funding:

Speak to your Support Coordinator or Local Area Coordinator (LAC)
Review your current plan under "Capacity Building – Improved Daily Living"
Request a service agreement outlining the number of hours needed

Private Health Insurance

Private health insurance may cover a portion of the cost of clinical assessments, if you hold extras cover that includes psychology services. However, not all private health funds cover assessment related services, and the rebate amount varies significantly depending on the provider and policy.