What do the recent changes to the Medical Benefits Scheme (MBS) mean for people living with FASD?
On 1 March 2023, Fetal Alcohol Spectrum Disorder (FASD) was added to the Medicare Benefits Scheme as an Eligible disability.
People with eligible disabilities and Complex Neurodevelopmental Disorders including FASD can now access a wider range of assessment and management services under Medicare.
This includes assessment and management by a range of health professionals such as paediatricians, psychiatrists, and allied health clinicians.
Is there an age limit?
You must be 25 years old or younger to access services for FASD under the Medicare Benefits Scheme.
Do I need a referral to access Medicare Rebates for FASD assessment or management?
You will first need a referral from your GP or psychiatrist to a specialist in order to access a Medicare-funded FASD assessment and management services. Find out more about the FASD assessment process here.
What FASD assessments are covered under Medicare and how do I access these?
Several item numbers apply to the assessment for FASD.
The first step is to see a paediatrician or child psychiatrist for initial assessment to consider the possibility of a diagnosis of FASD which might include a history, physical examination, and blood tests.
The doctor may then refer you to an allied health professional. These include occupational therapists, speech pathologists, psychologists, audiologists, optometrists, orthoptists or physiotherapists.
An individual is entitled to 8 assessment sessions by an allied health professional. Results of these assessments may contribute to the diagnosis of FASD and development of treatment and management plans.
Can I get any treatment, therapy or management for FASD that is covered by Medicare?
A paediatrician or psychiatrist will review the results of the assessments and consider which diagnoses are appropriate and what supports are recommended.
A diagnosis of FASD activates 20 Medicare funded allied health treatment sessions.
These are available in addition to those provided on existing plans, which any individual can assess, such as a Mental Health Care Plans (up to 10 session per calendar year) and a Chronic Disease Management Plans (up to 5 session per year).
Even when a diagnosis of FASD is not confirmed, children with neurodevelopmental problems can access ongoing support through Medicare if they have difficulties in at least two areas of significant neurodevelopmental function, for example language and motor skills. You can learn more about the neurodevelopmental functions and common challenges here.