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Medicare rebates and hearing loss

Medicare Rebates for Audiology Services

There are currently no audiology services, such as hearing tests or wax removal, listed as being claimable against Medicare unless patients have been referred under certain conditions by their GP or their medical specialist eg ENT or Neurologist.

GP Chronic Disease Management Plan Referrals for Audiology Issues

Patients can claim a Medicare rebate for audiology related services if their GP can provide a Chronic Disease Management Plan (CDMP) referral.

A CDMP referral provides Medicare rebates for up to 5 services from allied health professionals, including audiologists, per annum. That can be 5 services across a range of disciplines or five services from one discipline (eg audiology).

The Medicare rebate for CDMP referrals amounts to $52.95 (as at April 2019) per consult.

Individual allied health services are available to patients with a chronic condition and/or complex care needs, on referral from a GP.

In order to provide a CDMP referral, the GP will have had to have completed one of two services for the patient:

  • The GP has prepared a GP Management Plan (item 721 ) AND Team Care Arrangements (item 723) OR
  • The GP has contributed to or reviewed a multidisciplinary care plan prepared by the patient’s aged care facility (item 731)

Clarity can provide a CDMP referral form for patients to present to their GP for preparation (you can download the CDMP referral from this page).

If a GPMP has not been completed the GP will have to prepare one for the patient (there may be costs involved) before a referral can be provided OR the GP has satisfied the second option above.

As some hearing loss, tinnitus, vertigo/dizziness, excessive wax production can be chronic conditions, patients who obtain a CDMP referral may be eligible to use this referral for all audiology services related to their hearing loss.

ENT/Neurologist Referrals for Audiology Services

Medicare rebates may be claimable for audiology services if a patient has a referral from an ENT or Neurologist.

The amounts claimable vary depending on services provided but rebates are available for audiology services including: