Speech pathologists

Last updated:

21 March 2024

Find the information you need to deliver and claim for speech pathology services to Veteran Card holders.

If you’re a member of the veteran community, see Speech pathology services.

DVA Forms
Become a DVA health care provider
Services covered by Veteran Cards – Gold and White
Referrals and treatment cycle
DVA Provider Notes
Schedule of Fees
Claiming
Your obligations
Common compliance issues
Prior approvals
Rehabilitation Appliances Program (RAP)
Residential Aged Care Facilities (RACF)
Useful links

DVA Forms

Visit Provider forms to access all the forms you need to do business with us. This includes forms for prior approvals, RAP orders and claims.

Become a DVA health care provider

Services covered by Veteran Cards – Gold and White

Please check What a DVA health card covers for full details about card entitlements to ensure your client’s condition is covered.

A Veteran Card – Gold or White covers speech pathology treatment that is clinically necessary:

for all conditions, if the patient holds a Veteran Gold Card
for specific, accepted conditions only, if the patient holds a Veteran White Card.

If you are unsure whether a DVA client is eligible to receive chiropractic services, contact us on 1800 550 457.

Referrals and treatment cycle

If you are treating a Veteran Card holder, they will need a valid referral from their GP. For an initial treatment cycle, the referral could alternatively come from a:

medical specialist
treating hospital doctor
hospital discharge planner.

Under DVA treatment cycle arrangements, a referral to an allied health provider will last up to 12 sessions or one year, whichever ends first.

Once a treatment cycle has ended, the client needs a new referral from their GP before you can provide further treatment. The client can have as many treatment cycles as their GP determines are clinically necessary.

Please note the treatment cycle does not apply to ‘LSVT LOUD’ item numbers SH28 and SH29, which cover 18 speech pathology sessions for eligible DVA clients. ‘Evaluate Clinical Assessment’ items SH21-27 are also exempt.

Veteran Card holders with severe or complex needs may have tailored referral arrangements through the At Risk Client Framework, approved by their usual GP.

For full details about the treatment cycle and referral arrangements, please check Treatment cycle information for allied health providers.

DVA Provider Notes

By accepting a patient’s Veteran Card – Gold or White, you agree to follow the Notes that apply to your profession.

The Notes are legally binding, and it is your responsibility to become familiar with them. They are divided into two sections, and you need to comply with both.

Section 1: General notes for allied health providers

Section 2: Notes specific to speech pathologists

Please also refer to:

Referrals and treatment cycle
Schedule of Fees
Claiming.

Schedule of Fees

The Schedule of Fees – (Speech Pathologists) defines the treatments and services you can provide to DVA clients and the payment amounts you can claim.

By accepting a Veteran Card – Gold or White, you agree to accept the DVA fee as full payment. You cannot charge the Veteran Card holder any ‘gap’ fee.

For your profession’s up-to-date schedule, visit DVA Fee Schedules.

Claiming

Visit Provider claiming for full details on how to claim payment from us.

Please note you are responsible for your provider number and you will be accountable for any claiming errors.

If someone else submits claims on your behalf, you should ensure they do not make any mistakes.

Your provider number cannot be shared, and multiple providers cannot claim under the one provider number. The provider who owns the number will bear the consequences of misuse.

For invoicing and billing enquiries, call 1300 550 017.

Your obligations

Each year we review unusual provider claiming, which may result in an education process or financial recoveries.

For full details about complying with DVA requirements, please refer to Provider compliance.

Common compliance issues

Before you treat a DVA client, please check the Schedule of Fees and Notes for full details about limits and restrictions on speech pathology services.

Some common compliance issues include the following. Please note these are not exhaustive and you must check the Schedule of Fees for complete details about your profession’s Schedule of Fees item numbers.

Location of services

The item numbers are different depending on whether you treat the client at:

your clinic
the client’s home
other locations such as a residential aged care facility (RACF) or hospital.

You need to use the correct item number for the location where the service was provided.

For example, if you assess a DVA client who lives in a RACF, use item number SH15 for conducting the assessment, and:

SH25 if you complete the evaluation at the RACF
SH21 if you return to your clinic to complete the evaluation.

Initial consultation and assessment services

You can only use the ‘Conduct clinical assessment’ item number for initial consultations and other assessments, such as when you are conducting a:

detailed case history
language assessment
swallowing assessment.

This item must not be used for treatment services.

You can only use the ‘Evaluate clinical assessment’ item number for evaluation and reporting services such as:

scoring, analysing and evaluating assessments
writing in-hospital and RACF charts
formulating patient care plans
writing letters back to the GP.

You can only claim an ‘Evaluate clinical assessment’ item number along with a ‘Conduct clinical assessment’ claim.

After the initial consultation, you can use the clinical assessment item numbers again if a client clinically requires further assessment or evaluation, such as:

a high level language assessment
a review swallowing assessment.

Treatment Services

You can use the ‘Consultation’ item number to:

prepare for a treatment session
conduct a treatment session
write up progress notes.

You cannot claim for any treatment services using the ‘Evaluate clinical assessment’ and ‘Conduct clinical assessment’ item numbers.

‘Out of rooms’ loading

If you need to provide a service away from your clinic, we will pay you an ‘Out of rooms’ loading.

We will pay the loading automatically as long as you use the correct item number for the client’s location (such as the client’s home or an aged care facility).

You do not need to claim separately for the loading.

Kilometre allowance

We may pay a kilometre allowance if:

you are not a mobile provider
you have a fixed practice location
there is a genuine need to visit a client at home
your client’s home is more than 10 km from their nearest speech pathology clinic.

We will only pay the allowance for the part of your trip that is more than 10 km from the practice nearest to the client.

Prior approvals

In exceptional circumstances, you may claim payment for treatments not included in the Schedule of Fees, if they:

can be clinically justified for the client’s referred condition
are evidence-based.

You must ask us for prior approval before providing the treatment.

To submit a request, please complete the D1328 Treatment Prior Financial Approval Request Form and email it to health.approval [at] dva.gov.au (health[dot]approval[at]dva[dot]gov[dot]au).

For inquiries, contact us on 1800 550 457.

Rehabilitation Appliances Program (RAP)

Speech pathologists can prescribe aids and appliances to eligible Veteran Card holders through the RAP National Schedule of Equipment.

The item must be clinically necessary and support the patient’s referred condition.

You cannot supply these items yourself. You need to place an order through RAP, using the relevant RAP Form. The items will be supplied by a DVA-contracted RAP supplier.

Residential Aged Care Facilities (RACF)

From 1 October 2022, access to allied health care services and the Rehabilitation Aids Program (RAP) was expanded to eligible DVA clients in residential aged care, regardless of their care level.

For full details, please refer to DVA Provider News article, All veterans in age care now eligible to access allied health services.