Private Health Insurance | Therapy for Kids Perth | Allied Health Extras Cover Perth
Funding

Private Health Insurance
Extras Cover

We accept private health insurance extras for occupational therapy, speech pathology, psychology, and physiotherapy. Claims are processed on the spot via HICAPS — no paperwork required.

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How It Works

Using your extras cover

Allied health services — including occupational therapy, speech pathology, psychology, and physiotherapy — fall under the extras component of your private health insurance (sometimes called ancillary or general treatment cover), not hospital cover.

If your policy includes extras cover for allied health, your health fund may contribute a rebate towards the cost of your child's sessions at Therapy for Kids Perth. We process claims on the spot via HICAPS — simply tap your health fund card at the time of your appointment and the rebate is applied immediately. You pay only the difference between our fee and your fund's benefit.

No referral is required to access our services under private health insurance extras.

All major health funds accepted

We accept all major Australian private health funds via HICAPS, including Medibank, Bupa, HBF, HCF, NIB, and others. Your fund must have your clinician registered as a recognised provider — contact your fund before booking if you're unsure.

Claims processed on the spot

We use a HICAPS terminal, so your rebate is processed at the time of your appointment. You'll know immediately how much your fund has contributed, and you pay only the gap.

We are not able to provide a quote on rebates. The amount you can claim depends entirely on your individual policy, your level of cover, and your remaining annual limits. Please contact your private health fund directly before your appointment to confirm your entitlements, waiting periods, and applicable benefits.

HICAPS Item Numbers

Item numbers for each service

The item numbers below are the official HICAPS item numbers for each discipline, sourced directly from HICAPS item guides developed in conjunction with the relevant Australian professional peak bodies. These are the item numbers we use when processing your claim through our HICAPS terminal. Please share these with your fund when checking your entitlements.

Psychology

Source: HICAPS Psychologists Item Number Guide (developed with the Australian Psychological Society)

Item Description
100 Individual Assessment
200 Individual Treatment / Management (subsequent session)
300 Individual Treatment / Management — Couple or Family
400 Group Treatment
Source: HICAPS Psychologists Item Number Guide — developed in conjunction with the Australian Psychological Society.

Occupational Therapy

Source: HICAPS Occupational Therapists Item Number Guide (developed with OT Australia)

Item Description
100 Initial Individual Assessment / Treatment
200 Individual Assessment / Treatment — Subsequent to Initial
250 Individual Assessment / Treatment — Long Consultation (over 30 minutes)
300 Group Assessment / Treatment
Source: HICAPS Occupational Therapists Item Number Guide — developed in conjunction with OT Australia.

Speech Pathology

Source: HICAPS Speech Pathologists Item Number Guide (developed with Speech Pathology Australia)

Item Description
310 Initial individual consultation / assessment — up to 45 minutes
320 Initial individual consultation / assessment — 46 to 90 minutes
330 Initial individual consultation / assessment — over 90 minutes
340 Subsequent individual consultation / assessment / treatment — up to 45 minutes
350 Subsequent individual consultation / assessment / treatment — 46 to 90 minutes
360 Subsequent individual consultation / assessment / treatment — over 90 minutes
370 Group treatment — up to 45 minutes
380 Group treatment — 46 to 90 minutes
390 Group treatment — over 90 minutes
Source: HICAPS Speech Pathologists Item Number Guide — developed in conjunction with Speech Pathology Australia.

Physiotherapy

Source: HICAPS Physiotherapists Item Number Guide

Item Description
500 Assessment Consultation
505 Subsequent Consultation
506 Long Subsequent Consultation (2 areas)
560 Group Consultation
582 Neurological Rehabilitation
Source: HICAPS Physiotherapists Item Number Guide.

Please note: Providing these item numbers does not constitute a quote on rebates. The benefit your fund pays for each item varies between funds and policies. Please contact your private health insurer directly, quoting the relevant item number, to find out exactly what your policy covers and how much you can expect to receive back.

Before You Book

What to know before your first appointment

Private health insurance extras cover comes with a number of rules that vary between funds and policies. Here are the most important things to check with your fund before your first appointment.

Waiting periods

Most extras policies include a waiting period before you can claim for allied health services — typically 2 months, though this varies. If you have recently taken out or upgraded your policy, check whether your waiting period has been served.

Annual limits

Extras cover includes an annual limit for each service type — the maximum your fund will pay across all claims for that service in a calendar year. Once your limit is reached, no further rebates are payable until the new year.

Level of cover

Not all extras policies cover all allied health services. Speech pathology, for example, is not included in all policies. Check your specific level of cover to confirm which services are included.

Provider recognition

Your fund must recognise your clinician as a registered provider. Most major funds recognise our clinicians, but we recommend confirming with your fund before booking — particularly for psychology and speech pathology.

Gap payments

Our fees may exceed your fund's schedule fee, meaning a gap payment will apply. The gap is the difference between our fee and your fund's benefit. This is paid directly to us at the time of your appointment after your HICAPS claim is processed.

Telehealth claiming

Some funds allow extras claims for telehealth sessions; others do not. If your child's sessions will be delivered via telehealth, confirm with your fund whether telehealth claims are accepted under your policy before booking.

Checklist

Before your first appointment

We recommend contacting your private health fund to confirm the following before attending your first appointment.

  • Confirm your extras policy includes the relevant service (OT, Speech, Psychology, or Physio)
  • Check that any waiting period for that service has been served
  • Ask how much your fund pays per session for the relevant HICAPS item number
  • Check your remaining annual limit for that service
  • Confirm that telehealth claims are accepted if sessions will be online
  • Bring your health fund card to your appointment for HICAPS processing

Have a question?

Phone

08 6384 7041

Email

admin@therapyforkidsperth.com.au

WhatsApp

0466 927 600

Admin hours

Monday – Friday, 8:00am – 5:00pm
Common Questions

Frequently asked questions

Here are the questions families most often ask about using private health insurance at Therapy for Kids Perth.

Do I need a referral to use my private health insurance extras?

No. You do not need a GP referral to access our services under private health insurance extras. You can book directly and your rebate will be processed via HICAPS at the time of your appointment.

Can I use private health insurance and Medicare for the same session?

No. There are restrictions on co-claiming — you cannot use both private health insurance and Medicare for the same session. For any given appointment, you can claim through one funder only. However, you can switch between funders between sessions — for example, using Medicare for some appointments and private health insurance for others. If you're unsure which is most beneficial for your situation, we recommend speaking with both your GP and your health fund.

Can I use private health insurance for assessments?

Some assessments may attract an extras rebate depending on your policy. The HICAPS item numbers listed above include assessment items for each discipline. Contact your fund and provide the relevant item number to confirm whether your policy covers assessments and how much you can claim.

What if my fund is not listed on the HICAPS terminal?

HICAPS is partnered with all major Australian private health insurers. If for any reason your fund cannot be processed on the spot, you can pay in full at the time of your appointment and submit your receipt directly to your fund for reimbursement. Please contact your fund for instructions on how to do this.

My annual limit has been reached — can I still continue sessions?

Yes. Once your annual limit is exhausted, sessions continue on a self-funded (private pay) basis. Many families also use NDIS funding or Medicare alongside or instead of private health insurance. Get in touch if you'd like to discuss funding options for ongoing care.

Ready to book or have a question?

Get in touch and our admin team will help you confirm your extras entitlements and get your child's appointment booked.

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