Referrals & paperwork

What a referral needs

If someone has handed you a referral form, this is what is on it and why. We accept referrals in any format — a letter, an email, a phone call — and for most families no referral is needed at all. The funders are less relaxed: Medicare will not pay a rebate on a referral that misses its requirements, and NDIS funding cannot be invoiced without the plan details.

What the paperwork looks like

Referral forms differ between practices, but they ask for the same things in much the same order. Nothing here has to be complete before you contact us — we can chase the rest.

Child’s details: Name, date of birth, address, and any interpreter or communication needs.
Parent or guardian: Who we contact, and on which number and email. We ring the family ourselves rather than waiting for anyone to pass a message on.
NDIS plan details: NDIS number, the plan’s start and end dates, and how the plan is managed — self-managed, plan-managed or NDIA-managed.Where to find it: The first pages of your plan, or the myplace participant portal. Your plan manager can send it to you.
Funding and goals: That Capacity Building — Improved Daily Living funding is in the plan, and the plan goals therapy should work toward.Where to find it: The Capacity Building section of your plan. We write our reports against these goals, so they are worth getting right.
Who pays the invoice: Your plan manager’s name and invoicing email, or your own details if you self-manage.Where to find it: Ask your plan manager for their invoicing email — it is often different from the one they email you from.
Clinical background: Diagnosis if there is one, other conditions, medications, relevant history. A diagnosis is not required to see an occupational therapist.
Reason for referral: What is hard day to day — dressing, handwriting, mealtimes, the playground, sitting through a mat session. This shapes the first appointment more than a diagnosis does.
Supporting reports: A copy of the NDIS plan, and any paediatric, psychology, speech or school reports. Enough that nobody repeats an assessment your child has already sat through.
Consent: Signed by a parent, guardian or nominee: permission to share the information and to start services.
Referrer’s details: Who sent it and where our letters should go. Left blank when a family refers themselves, which is allowed.

An illustration of a typical referral form, not a form to fill in. Send whatever you have — an email with your child’s name and what you are worried about is a perfectly good start.

Three documents people mix up

These arrive together and get called “the paperwork”, but they do different jobs — and only one of them is ever compulsory.

The referral

A handover of information, not a permission slip. Under the NDIS nobody has to write one — you can ring us yourself. Medicare is the exception: there, the referral is what makes a rebate payable, so it has to exist before the first session you claim.

Consent to share information

Your signature letting us talk to the people around your child — your plan manager, the school, the GP, the paediatrician. You choose who is on that list, and you can change it later.

The service agreement

What we will do, what it costs, how cancellations work, and how to end it. We set this up with you before the first session. If you are plan-managed, your plan manager may also make a service booking against your plan so the funding is held for it.

What each funder requires

Three of these pathways need nothing signed by anyone. All of them except the NDIS leave you with something to pay, so the cost is stated on every card rather than left to be discovered at the first invoice.

Self-funded

No referral required

Occupational therapy is a self-referral profession. You can ring us yourself, and nothing has to be signed by anyone first. A referral from your GP or paediatrician is still worth having — it tells us what has already been ruled out — but it is not a condition of being seen.

No referral, no plan, no approval, no waiting
Many families start here while an NDIS application is in progress

What you payYou pay the published fee in full. Nothing comes back to you unless you also hold extras cover.

NDIS

No referral required — but the plan details are

The NDIS does not require a referral to see a therapist: you choose your own providers, and you can approach us directly. What we do need is enough of the plan to invoice it correctly, because an invoice sent against the wrong budget comes back unpaid and lands with you.

Your NDIS number, and the plan’s start and end dates
How the plan is managed — we work with self-managed and plan-managed participants, as we are not NDIS-registered
That Capacity Building — Improved Daily Living funding is available in the plan
The plan goals therapy is meant to work toward, so our reports are written against them
Your plan manager’s name and invoicing email, and your support coordinator’s details if you have one
Written consent to share information with your plan manager, your support coordinator and your referrer
A service agreement, which we set up with you before the first session

What you payNo gap. We charge at the NDIS price limit and never above it, so the plan covers the session in full — until the funding for it runs out, which we watch with you.

NDIS pricing arrangements

Medicare — chronic condition management

A written referral is required, and a plan behind it

This is the pathway most often sent to us incomplete. A referral on its own is not enough: your child has to already be managed by their GP under a GP chronic condition management plan (GPCCMP), and the referral has to exist before the first session you claim against it. Since 1 July 2025 there is no prescribed form — a letter from the GP is fine — but the requirements behind it did not go away.

Your child is managed under a GPCCMP prepared by their usual GP
A written referral from that GP, signed and dated, before the first rebated session
It names occupational therapy and the number of services referred
Up to five allied health services per calendar year, shared across every allied health provider your child sees — not five with each of us
We write back to the GP after the first and last service, as the item requires
Plans made before 1 July 2025 remain a valid basis for referral until 30 June 2027

What you payA gap, every time. Medicare pays a fixed rebate per service — an amount set by the schedule, not a share of our fee — and it is well below the cost of a session. You pay the difference, and we can process the claim at the appointment so only the gap leaves your account.

Services Australia — allied health referrals

Medicare — complex neurodevelopmental disorder

A specialist referral is required

Where a child has a confirmed complex neurodevelopmental disorder or eligible disability, therapy can be claimed under the items attached to the treatment and management plan. The referral has to come from the specialist who wrote that plan — a GP cannot make it.

Referred by the paediatrician or psychiatrist who developed the treatment and management plan
The referral contributes to that plan, and says what occupational therapy is being asked to do
Up to 20 treatment services in total, shared across all allied health providers — a lifetime limit, not an annual one, so tell us what has already been used
Assessment services that contribute to the diagnosis are counted separately from the 20
Delivered individually and in person, which rules out telehealth and group sessions under these items
Age limits apply, and the referring specialist confirms eligibility

What you payA gap, every time, on the same basis as above: a fixed rebate per service, well short of the session fee. Twenty services is also a lifetime cap, so it is worth deciding with us where they will do the most good.

MBS Online — item descriptions

Private health funds

No referral required

Extras cover pays a rebate back to you, and no fund asks for a referral to do it. What matters is whether your policy names occupational therapy at all — some extras cover physiotherapy and chiropractic but not OT.

Check the policy lists occupational therapy before you rely on it
You pay us, then claim from your fund — we give you a receipt with everything they ask for
A session already covered by NDIS or a Medicare rebate cannot also be claimed from a fund

What you payA gap, every time, and a shrinking one at that. Funds pay a set amount per visit rather than a percentage, and most cap occupational therapy at an annual limit — once it is used, you are paying the full fee for the rest of the year.

Medicare and NDIS requirements change. The linked pages are the authority; this is a summary of them, written to be read before you start rather than instead of them. Our fees, and what each pathway leaves you paying, are set out onfees and funding.

If something is missing

We do not send referrals back over formatting, and we do not leave a family to find out at the first invoice that a session was never claimable. If a detail a funder requires is not there, we go to whoever holds it — the GP, the plan manager, or you — while the first appointment is being arranged. The referral keeps moving either way.

The exception is a referral we cannot act on at all: an NDIA-managed NDIS plan, which we are not registered to invoice, or a presentation outside our scope. We will say so promptly and, where we can, suggest somewhere better rather than hold it.