Medicare Occupational Therapy (Term 4)
MEDICARE--OCCUPATIONAL THERAPY--3 Jan 2026
Medicare Benefits Schedule is found on the Australian Government website. MBS benefits are subject to change--according to MBS Online Standard Search | Medicare Benefits Schedule (health.gov.au)
Medicare (MBS) Telephone: 13 21 50 for further information
Children with an Approved Disability (Complex Neurodev; ASD) with Doctor's referral:
82025 Therapy >30 min duration (20 sessions in a lifetime for under 25s): MBS Benefit: $102.60
93036 Telehealth therapy 30+ min duration (4 sessions permitted--same day): MBS Benefit: $102.60
93033 Complex neurodevelopmental disorder and approved disability telehealth services 30 min duration (4 sessions permitted--same day): MBS benefit $102.60
93041 Complex neurodevelopmental disorder and approved disability telephone services 50 min duration (4 sessions permitted--same day): MBS benefit: $102.60
93044 Complex neurodevelopmental disorder and disability telephone services 30 min duration (4 sessions permitted--same day): MBS benefit: $102.60
Medicare Better Start for Children with an Approved Disability: Department of Health and Aged Care | Frequently Asked Questions - Better Start for Children with Disability
Case Conferences--Occupational Therapist attendance (Children with an eligible disability / complex neurodevelopmental disorder, such as ASD) with Doctor's referral:
82001 (15-19 mins) MBS Benefit: $57.00
82002 (20-39 mins) MBS Benefit: $97.95
82003 (40+ mins) MBS Benefit: $162.60
Mental Health Care Plan (Occupational therapist approved to deliver Focused Psychological Strategies FPS) with GP referral
91173 >50 min: Telehealth: MBS Benefit $102.60
91186 >50 min: Telephone: MBS Benefit $102.60
Face to Face (Mental Health Care Plan FPS) Occupational therapist with GP referral
80135 >50 min (in rooms consultation rate): MBS Benefit $102.60
80140 >50 min (out of rooms consultation rate): MBS Benefit $109.75
80125 >20 min (in rooms consultation rate): MBS Benefit $72.65
80130 >20 min (out of rooms consultation rate): MBS Benefit $102.60
Group of 4-10 participants (Mental Health Care Plan FPS) Occupational therapist with GP referral
80145 (face-to-face), 80146 (telehealth): 60 mins duration. MBS Benefit $26.00 per person (up to 10 sessions per calendar year). Travel cost may be additional.
Case Conference--Mental Health Care Plan FPS Occupational therapist attendance invited by GP:
80177: 20-39 minutes: MBS Benefit: $97.95
80178: 40+ minutes: MBS Benefit: $162.60
Parent/Carer session for Mental Health Care Plan--Occupational Therapy FPS (2 per year)
80141 >50 mins outside of consultation rooms: MBS Benefit: $132.20
80137 >50 mins at rooms: MBS Benefit: $102.60
91202 <20 mins Telephone: MBS Benefit: $72.65
91203 >50 mins Telephone: MBS Benefit: $102.60
91194 <20 mins Telehealth: MBS Benefit: $72.65
91195 >50 mins Telehealth: MBS Benefit: $102.60
Chronic Disease Management Occupational Therapy with GP referral:
(up to 5 sessions per calendar year--from January to December)
93000 Telehealth videoconference (20 mins): MBS Benefit: $72.65
93013 Telephone when video-conference is not available (20 mins): MBS Benefit: $72.65
10958 Face to Face (20 mins): MBS Benefit $72.65 (travel may be additional cost)
CDM Case Conference Occupational Therapist attendance: (at request of GP)
10955 (15-19 mins) MBS Benefit $57.00
10957 (20-39 mins) MBS Benefit $97.95
10959 (40 mins) MBS Benefit: $162.60
Chronic Disease Management Occupational Therapy--Aboriginal & Torres Strait Islander: (up to 10 sessions per calendar year) after a health check or GP Management Plan and OT referral
81330 Face to Face (20 mins): MBS Benefit $72.65 (travel may be additional cost)
93048 Telehealth (20 mins): MBS Benefit $72.65
93062 Telephone (20 mins): MBS Benefit $72.65
Eating Disorders Psychological Treatment--Occupational Therapy
82368 (20-49 mins at consulting rooms) MBS Benefit: $61.80 (40 EDPT per calendar year)
82370 (20--49 mins out of rooms) MBS Benefit: $87.25
82371 (at least 50 mins) attendance at consulting rooms. Benefit: $87.25
82373 (at least 50 mins out of rooms) MBS Benefit: $112.40
82374 (group of 6-10 patients at least 60 mins) MBS Benefit: $22.10
82375 (group of 6-10 patients by video conference/telehealth, patient is at least 15 mins therapist travel by road from therapist). MBS Benefit: $22.10
93092 (20-49 mins) attendance through video. MBS Benefit: $61.80
93095 (at least 50 mins). MBS Benefit: $87.25
93126 (20-49 mins) attendance through phone. MBS Benefit: $61.80
93129 (at least 50 mins) attendance through phone. MBS Benefit: $87.25
Eligible occupational therapists provide (items 82368-82375; 93092 and 93095; 93126 and 93129).
BUPA CODES* (provide a description of service)
H100 - Occupational Therapy Initial Consultation
H200 - Occupational Therapy Subsequent Consult
H300 - Group assessment or therapy
H601 - Occupational Therapy Individual Initial / Referred Assessment by Teleconsultation
H602 - Occupational Therapy Individual Subsequent Treatment by Teleconsultation
Other
OT01 OT initial consult in rooms
OT07--OT subsequent consult in rooms
OT02--OT Initial consult home visit
OT08--OT subsequent consult home visit
*Private Health Insurance benefits vary according to the person's level of cover, amount used, and health fund conditions/services.
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