Navigating the NDIS can feel overwhelming — especially when you’re already juggling the demands of supporting a child with additional needs. At South Eastern OT, we work with NDIS families every day, and we want to make the funding side as simple as possible.
Here’s a plain-English guide to using NDIS funding for your child’s occupational therapy in South East Melbourne.
Can my child access NDIS funding for OT?
Yes — occupational therapy is one of the most commonly funded supports under the NDIS for children. Paediatric OT falls under the Capacity Building budget, specifically under Improved Daily Living (support category 15). Some children may also access OT funding under Improved Relationships (support category 9) for social and emotional regulation goals.
To access NDIS funding, your child must first be approved as an NDIS participant. Children under 7 may be eligible for the Early Childhood Approach (previously Early Childhood Early Intervention) even without a formal diagnosis.
Does my child need a diagnosis for NDIS?
For children under 7, the Early Childhood Approach means you may be able to access supports without a formal disability diagnosis — if there is evidence of developmental delay or disability. For children aged 7 and over, a diagnosis or functional impact evidence is generally required for NDIS access.
If your child doesn’t have a diagnosis yet, speak with your GP about the pathway to assessment. In the meantime, you may still be able to access OT through Medicare (see below).
What NDIS support categories cover OT?
The main NDIS support categories relevant to paediatric OT are:
- Improved Daily Living (15-04-0128-1-3) — covers assessment, therapy and skill-building for daily living, fine motor, self-care and sensory processing goals
- Improved Relationships (09-10-0128-5-3) — can cover OT when therapy goals relate to social skills and emotional regulation
- Assistive Technology — may cover equipment such as pencil grips, weighted vests or seating supports recommended by an OT
- Home Modifications — for OT recommendations related to making the home environment safer or more accessible
How do I use NDIS funding at South Eastern OT?
We work with all three NDIS management types:
- Plan-managed — invoices go through your plan manager. No out-of-pocket costs for services within your NDIS plan.
- Self-managed — you pay us directly and then claim reimbursement through the NDIS portal.
- NDIA (agency) managed — we invoice the NDIA directly via the provider portal. We are a registered NDIS provider.
The NDIS price guide sets maximum rates for OT services, and we invoice in line with these rates.
What about Medicare?
If your child doesn’t have NDIS funding, or while you’re waiting for NDIS access to be approved, you may be able to access OT through a Medicare Chronic Disease Management (CDM) plan, also called an Enhanced Primary Care (EPC) plan.
To access this, your child needs a referral from their GP. Medicare rebates up to 5 allied health sessions per calendar year. The OT visit isn’t free — there’s a gap — but the rebate provides meaningful cost relief.
Can I use private health insurance for OT?
Yes, if your private health policy includes extras cover with an allied health benefit. The amount varies significantly by insurer and policy — check with your fund about your specific OT benefit and waiting periods.
Getting started
If you’re unsure about your child’s funding options, please reach out. We’re happy to talk through NDIS, Medicare and private health pathways during a free 15-minute phone consultation — no pressure, just practical information to help you make the right decision for your family.
South Eastern OT serves families across Narre Warren, Berwick, Cranbourne, Pakenham, Officer, Dandenong and the wider South East Melbourne region.