Fee schedule
Medicare speech pathology items and fees
Medicare's speech pathology items pay $74.55 for a chronic disease management service (item 10970, capped at 5 combined allied health visits a year) and $105.25 for a complex neurodevelopmental disorder assessment or treatment service (items 82005 and 82020), current from 1 July 2026 on MBS Online.
Last checked 25 Sep 2026 against the sources listed at the end of this page.
- Payer
- Medicare
- Effective from
- 1 Jul 2026
- Official schedule
- Source document
What changed this year
- MBS Online shows the schedule fee for all three items as last updated 1 July 2026: $74.55 for item 10970 and $105.25 for items 82005 and 82020.
- A transitional rule lets a GP Management Plan and Team Care Arrangements prepared before 1 July 2025 still support a claim on item 10970 until 30 June 2027. After that date only the newer GP chronic condition management plan format is accepted.
- The 'eligible disabilities' list that qualifies a patient under 25 for the 82000 series without a confirmed complex neurodevelopmental disorder diagnosis explicitly names stuttering and speech sound disorders (articulation and phonological disorders, childhood apraxia of speech, dysarthria) and cleft lip or palate, alongside conditions such as Down syndrome, cerebral palsy and fetal alcohol spectrum disorder.
All 3 speech pathology items
| Item | Description | Fee |
|---|---|---|
| 10970 | Chronic disease management: speech pathology service of at least 20 minutes for a patient with a chronic condition and complex care needs under a GP care plan, maximum 5 combined allied health CDM services a calendar year | $74.55 |
| 82005 | Complex neurodevelopmental disorder or eligible disability: speech pathology assessment of at least 50 minutes for a patient under 25, to assist diagnosis or contribute to a treatment and management plan | $105.25 |
| 82020 | Complex neurodevelopmental disorder or eligible disability: speech pathology treatment of at least 30 minutes for a patient under 25 with a confirmed diagnosis and a treatment and management plan in place | $105.25 |
What the three items pay
Three MBS items cover most Medicare-funded speech pathology work in a private practice. Item 10970 is the chronic disease management (CDM) item: a session of at least 20 minutes for a patient whose chronic condition is being managed under a GP plan, paying $74.55 with an 85 per cent benefit of $63.40. Items 82005 and 82020 sit in the newer Complex Neurodevelopmental Disorder and Eligible Disability group, both paying $105.25 with a benefit of $89.50.
Item 82005 is the assessment item: at least 50 minutes, used either to help a referring doctor reach a diagnosis or to contribute to a treatment and management plan once a complex neurodevelopmental disorder or eligible disability is confirmed. Item 82020 is the treatment item: at least 30 minutes, delivered against that plan, with a written report back to the referring practitioner once the course of treatment ends.
Chronic disease management: the shared five visit cap
The most common billing mistake on item 10970 is treating it as a speech pathology allowance. It is not. The five services a calendar year apply across the whole Subgroup 1 group of chronic disease management items, which covers physiotherapy, podiatry, psychology, dietetics, exercise physiology and speech pathology together. If a patient has already seen a physiotherapist twice and a dietitian once under the same GP plan, only two CDM visits are left across every remaining allied health discipline, speech pathology included.
The referral itself has to be current: a GP chronic condition management plan reviewed in the last 18 months, or, until 30 June 2027, an older GP Management Plan and Team Care Arrangements prepared before 1 July 2025.
Complex neurodevelopmental disorder items: who qualifies and the lifetime caps
Items 82005 and 82020 are for patients under 25 with a suspected or diagnosed complex neurodevelopmental disorder, such as autism spectrum disorder, or one of a specific list of eligible disabilities. For speech pathology caseloads the relevant entries are stuttering, speech sound disorders (including articulation and phonological disorders, childhood apraxia of speech and dysarthria), and cleft lip, cleft palate or cleft lip and palate, alongside broader conditions such as Down syndrome, cerebral palsy and fetal alcohol spectrum disorder.
Unlike the CDM item, these caps are per patient for life rather than per year. Assessment services (82000, 82005, 82010, 82030) share a lifetime cap of 8, and treatment services (82015, 82020, 82025, 82035) share a lifetime cap of 20, both combined across every allied health profession that can bill them. Up to 4 services can be delivered without the referring doctor's further sign off; beyond that, the referrer has to review and agree before you claim again.
Claiming and billing in Cliniko
Cliniko's Tyro Health integration handles both bulk billed and patient rebate claims for these items directly from the invoice, once your practice has a connected Tyro Health account. What Cliniko will not do is watch the lifetime caps on 82005 and 82020 for you: because those limits never reset, a note in the patient's file tracking how many assessment and treatment sessions have been claimed is the only safeguard against an accidental over-claim years into a course of care.
Claiming notes
- Item 10970 sits in a shared pool. A patient can claim a maximum of 5 services in a calendar year across every item in the Subgroup 1 chronic disease management group, which includes physiotherapy, podiatry, psychology, dietetics, exercise physiology and speech pathology items together, not 5 speech pathology visits on top of whatever the patient's other allied health providers have already claimed.
- Items 82005 and 82020 are for patients under 25 with a suspected or diagnosed complex neurodevelopmental disorder, such as autism spectrum disorder, or one of the eligible disabilities set out in MBS explanatory note MN.10.3.
- The assessment items (82000, 82005, 82010, 82030) share a lifetime cap of 8 services per patient, combined across all four professions who can bill them. The treatment items (82015, 82020, 82025, 82035) share a lifetime cap of 20 services per patient. Both caps run for the patient's life, not per calendar year.
- Up to 4 services from the same allied health provider can be delivered on the same day, and up to 4 in total without extra sign off. A 5th assessment or treatment service needs review and agreement from the referring medical practitioner, which should be recorded in the patient's notes.
- The Medicare benefit is 85% of the schedule fee, not 100%: $63.40 for item 10970 and $89.50 for items 82005 and 82020. Bulk billing waives the remaining 15% for the patient; charging a gap means the patient claims the 85% rebate themselves.
- Referrals written on or after 1 July 2025 for these items must carry the referring practitioner's name, their practice address or provider number, and the date of the referral, under the Health Insurance (Section 3C, Allied Health and Other Primary Health Care Services) Determination 2024.
Load these fees into your practice software
- Add each item under Settings, then Billable items, or bulk import a CSV with the columns Item code, Name, Price (ex. tax) and Item type, following Cliniko's billable item import process. Put the MBS item number in Item code and a name staff will recognise, for example 'Medicare 10970 CDM speech pathology', in Name.
- Cliniko's Tyro Health integration processes both bulk bill and patient (rebate) Medicare claims directly from the invoice screen, for item numbers including 10970, 82005 and 82020, once your Cliniko account is connected to a Tyro Health account.
- Cliniko does not track the 82005 and 82020 lifetime caps for you. Because those caps follow the patient for life rather than resetting each financial year, note in the patient's file how many assessment and treatment services have already been claimed, so reception does not bill a 9th assessment or 21st treatment service by mistake.
- Set up and connect Tyro Health before processing any Medicare claim. The Medicare Location ID or Minor ID that some claim types need is issued by Tyro Health, not by Cliniko.
Sources
- MBS item 10970 (chronic disease management speech pathology, at least 20 minutes) has a schedule fee of $74.55 and an 85 per cent benefit of $63.40, last updated 1 July 2026. Department of Health and Aged Care (MBS Online), checked 25 Sep 2026.
- MBS item 82005 (complex neurodevelopmental disorder assessment, at least 50 minutes, patient under 25) has a schedule fee of $105.25 and an 85 per cent benefit of $89.50, and shares a lifetime cap of 8 services with items 82000, 82010 and 82030. Department of Health and Aged Care (MBS Online), checked 25 Sep 2026.
- MBS item 82020 (complex neurodevelopmental disorder treatment, at least 30 minutes, patient under 25) has a schedule fee of $105.25 and shares a lifetime cap of 20 services with items 82015, 82025 and 82035. Department of Health and Aged Care (MBS Online), checked 25 Sep 2026.
- Eligible disabilities for the complex neurodevelopmental disorder items include stuttering, speech sound disorders (articulation and phonological disorders, childhood apraxia of speech, dysarthria) and cleft lip, cleft palate or both. Department of Health and Aged Care (MBS Online), checked 25 Sep 2026.
- A maximum of 5 chronic disease management allied health services can be claimed per patient per calendar year across item 10970 and every other item in Subgroup 1 of Group M3 combined. Department of Health and Aged Care (MBS Online), checked 25 Sep 2026.
- Referrals written on or after 1 July 2025 for chronic disease management and complex neurodevelopmental disorder allied health items must include the referring practitioner's name, practice address or provider number, and the date of referral. Department of Health and Aged Care (MBS Online), checked 25 Sep 2026.
- Cliniko's Tyro Health integration processes both bulk billed and patient rebate Medicare claims directly from the Cliniko invoice screen. Cliniko, checked 25 Sep 2026.