Fees

Our fees are comparable with other Developmental and Behavioural Paediatricians offering similar services. Paediatric Specialist consultation fees are correlated with the time spent with you and your child. You will need a Medicare Card and a current referral from your GP (valid for 12 months) to be eligible for a Medicare Rebate. The amount you will receive back from Medicare will also depend on a number of factors (length of appointment, initial versus subsequent consultation, diagnosis, complexity of problem).

For your convenience we are able to process your Medicare Rebate on the spot so you can have the money rebated directly back into your account before leaving your appointment.

Importantly, the cost of the Medical Report is included in our consultation fees, factoring in the additional time required to put this important document together.

Our reception staff will be able to advise you regarding current pricing.

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Medicare Rebates

As part of the Medicare system, every medical consultation attracts a specific Item Number that indicates the type of medical service provided, by what type of Specialist and length of time for that service provision. The Item Number then correlates to assigned Medicare Rebate amount, which is the amount of money the government refunds the patient.

In your consultations with a Developmental and Behavioural Paediatrician, the following Item Numbers will be used:

Item Number Item Descriptor Medicare Rebate
132 Initial Consultation >45 minutes $224
110 Initial Consultation <30 minutes $122
133 Follow up Consultation >45 minutes $122
116 Follow up Consultation <30 minutes $68
135 Consultation as part of Helping Children with Autism Package $224
Medicare Safety Net and Medicare Rebates

The Medicare Rebate rarely covers the Medical Specialists’ fees, leaving patients with “out of pocket “costs to pay. Out of pocket costs are calculated on the difference between the Private Specialist’s fees and the Medicare Rebate.

The Medicare Rebate system does not always correlate with the degree of professional expertise, detailed evaluation and length of time required for some complex needs patients.  It also does not cover time spent by the doctor “out of consultations” analysing results and integrating findings into a comprehensive Medical Report.

Fortunately, the Medicare Safety Net provides significant relief once the threshold has been reached. The Threshold is currently $2056 and is calculated on a calendar year to year basis. This means that when all accumulated out of pocket costs within one family reaches $2056, then all subsequent Specialists fees are Rebated at a much higher level (around 80% of the scheduled fee). This is particularly relevant to families who may have more than one child with medical needs, or who have required multiple or ongoing Specialist appointments.

Families must register as a family for the Medicare Safety Net but only need to register once. To register, download a Medicare Safety Net couples and families registration and amendment form here:

https://www.humanservices.gov.au/customer/forms/ms016

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