Autism assessment cost in Australia

One assessment service says its autism assessment can include an intake interview, diagnostic questionnaires, a detailed developmental case history, a clinical report of findings and a follow-up appointment to discuss results.

A paediatrician may need a number of separate visits, billed under items such as 110 and 116, to complete an assessment and make a diagnosis.

Under Medicare, only a paediatrician or psychiatrist can diagnose a complex neurodevelopmental condition.

Medicare pays back $155.85 for a first visit to a consultant physician (item 110) and $77.95 for each later visit in the same course of treatment (item 116), when the visit follows a referral. A paediatrician’s visit to write the M10 treatment plan (item 135) can be claimed once in a patient’s lifetime, and Medicare pays back $272.50 for it.

M10 items cover allied health services for patients under 25 with a suspected or diagnosed complex neurodevelopmental disorder, such as autism, or an eligible disability. M10 assessment sessions need a referral from a paediatrician or psychiatrist for a suspected complex neurodevelopmental disorder, or from a GP, specialist or consultant physician for a suspected eligible disability.

For an M10 assessment session, Medicare pays back $101.55 for a session with a psychologist and $89.50 for a session with a speech pathologist or an occupational therapist. M10 allows a maximum of 8 assessment services and 20 treatment services per patient per lifetime.

For a complex neurodevelopmental condition, treatment sessions need an M10 treatment plan from a paediatrician (item 135) or a psychiatrist (item 289).

The NDIS does not pay for diagnostic assessments. The NDIS early childhood approach helps children younger than 6 with developmental delay or children younger than 9 with disability and their families, and your child doesn’t need a diagnosis for an early childhood partner to help.

One public child development service says that wait times for its services can vary. That service says it will advise the expected wait time once your child’s referral has been accepted.

Ask the service how long the wait is for your child.

If your child loses skills they had, or you become more worried, don’t wait: see your GP or child health nurse.