What is the Medicare M10 – Item Group?

From 1 March 2026, Medicare has expanded eligibility under the M10 item group to include children and young people under 25 with:

• Stuttering
• Speech sound disorders (articulation disorder, phonological disorder, childhood apraxia of speech, dysarthria), and/or
• Cleft lip and/or palate.

Eligible individuals may access up to 8 assessment sessions and up to 20 treatment sessions (lifetime cap before age 25) under the M10 pathway, with a valid referral from a GP, consultant physician or specialist.

The current Medicare rebate is $87.25 per session (subject to change), helping to subsidise the cost of both assessment and treatment. This expansion applies rebates to a broader range of speech conditions than were previously eligible under M10.

This pathway sits alongside the GP Chronic Disease Management (CDM) plan and can be used in addition to CDM services where eligibility criteria are met.

How do I access the CDM plan?

Medicare rebates can help reduce the out-of-pocket cost of assessment and therapy. To access this M10 pathway you need to:

• Be under 25
• Have stuttering, a speech sound disorder or cleft lip/palate, and
• Have a referral from a GP, consultant physician or specialist.

If you’re unsure whether this applies, our team can help clarify the next steps.

I have been referred to you on an M10 plan, how does it work?

You will need to provide us with your referral form. Prior to accessing Medicare rebates, a GP assessment is required (typically a 45-minute appointment) to confirm eligibility and determine whether referral under M10 items is appropriate. In some cases, the GP may also request a report from the speech pathologist if further information is needed to support diagnosis of a speech sound disorder or communication difficulty.

Once referred, you may be eligible to access up to 10 rebated sessions under your Medicare plan (M10 items), subject to GP approval and registration with Medicare.

Therapy sessions at Therability Speech Pathology must be paid in full upfront. A Medicare rebate of $87.25 per service applies. An invoice will be provided for you to claim your rebate via Medicare online or in person.

After the initial 10 sessions, a review is required. A progress report will be completed and sent to your GP. Your GP will review progress and, if appropriate, approve a further 10 sessions under the same plan (up to the lifetime allocation).

Where can I access further information?

For more information relating to the Medicare M10 please visit their website.