Do I need a referral for a paediatrician?

When should you call 000 instead?

If your child's life is in immediate danger, call 000 or go to a hospital emergency department. Situations that may need urgent help include problems with breathing, loss of consciousness, uncontrollable bleeding and fever in babies ^[8]. A paediatrician referral is for planned care, not emergencies.

Does your child need a referral to see a paediatrician?

For a Medicare rebate at the referred rate, yes. A specialist can see a patient without a referral, but the Medicare item they can bill is lower, so your out-of-pocket cost is likely to be higher ^[1]. Healthdirect notes that you'll need a referral from your doctor or another doctor to see a paediatrician ^[7].

Paediatricians are doctors with special training in caring for babies, children and teenagers ^[7]. They treat a wide range of childhood illnesses and check physical, mental and behavioural development ^[7]. Children are commonly referred for ^[7]:

• developmental or behavioural concerns, including autism and ADHD
• asthma or diabetes
• conditions such as cerebral palsy, cystic fibrosis or Down syndrome
• more complex or ongoing health problems

Who can refer your child to a paediatrician?

GPs are the main source of specialist referrals ^[1]. Other specialists can refer too, in consultation with or by notifying your GP ^[1]. Two other groups can refer to a paediatrician under Medicare rules:

• Participating midwives can refer to an obstetrician or a paediatrician, as clinical needs dictate ^[2]. A midwife's referral is valid for 12 months from the first service ^[2].
• Nurse practitioners can refer in certain circumstances ^[1].

The referring practitioner must have consulted with your child and considered whether a referral is needed ^[2]. A referral from another specialist must also name your child's GP or practice, or say that you can't or won't nominate one ^[2].

How referrals work for children

The referral is written for your child, as the patient. A parent or guardian books the GP consultation and attends with the child, whether in person or by telehealth.

It helps to bring:

• a short summary of your concerns and when you first noticed them
• reports from childcare, school or other professionals, such as a speech pathologist or psychologist
• your child's personal health record book and any previous test results
• a list of current medicines

What should the referral include?

A valid referral includes the reason for referral, relevant clinical information, the date and the referring practitioner's signature ^[1]. It can be on paper or electronic ^[1]. See what goes in a referral letter.

Does it need to name a specific paediatrician?

No. In private rooms and other community settings, a referral doesn't have to name a specialist ^[1]. If it names one, you can still take it to another paediatrician without a new referral, unless your child has already started seeing the named one ^[1]. If your child will be a private patient in a public hospital outpatient clinic billed to Medicare, it must be addressed to a named specialist ^[1].

How long does a paediatrician referral last?

The period starts from the first appointment with the paediatrician, not the date on the referral ^[1]. If your child needs ongoing care, the GP can write a referral for longer than 12 months or an indefinite one ^[1][2]. More in how long a referral lasts.

What will Medicare cover, and what will you pay?

Paediatricians set their own fees, and costs vary a lot depending on the type of care, whether it's in hospital and the paediatrician's fee, so ask before your child's first appointment ^[7]. If your paediatrician bills as a consultant physician, a first appointment is usually item 110, with a schedule fee of $183.35 and an 85% Medicare benefit of $155.85 (schedule fee updated 1 July 2026, checked November 2026) ^[3]. You pay any gap above the rebate.

Public hospital paediatric clinics are another option. Care there is covered by Medicare, so you don't pay ^[7], though you still need a referral.

Autism and other neurodevelopmental assessments

For a complex neurodevelopmental disorder such as autism, a paediatrician can bill item 135 for a comprehensive assessment and treatment and management plan, for patients under 25 ^[4]. It requires a referral, can be claimed once per lifetime, and has a schedule fee of $320.55 (checked November 2026) ^[4]. The paediatrician sends a copy of the plan to the referring practitioner ^[4]. There's a video equivalent, item 92140 ^[4].

Does private health insurance help?

Not for consultations in the paediatrician's rooms. Health insurers can't contribute to out-of-hospital treatment for Medicare services ^[6].

Can your child see a paediatrician by telehealth?

Often, yes. Medicare has permanent specialist telehealth items: first appointments can be by video, and some follow-ups by phone where clinically appropriate ^[5]. A valid referral is still needed, but not a separate one for telehealth ^[5]. Ask the practice whether your child needs to be seen in person.

The GP referral can also come from a telehealth consultation, with your child attending alongside you. Referrals can be issued electronically ^[1]. See can you get a referral online.

Getting a referral

Referral GP offers telehealth consultations, by phone or video, with AHPRA-registered Australian GPs. Parents or guardians can request a consult for their child, and the child attends with them. If it's clinically appropriate, the GP can write a referral to a paediatrician and send it electronically.

A consultation doesn't guarantee a referral. Your GP decides what's clinically appropriate.

Bulk billed for eligible patients. If you're not eligible, a consultation fee may apply, and we'll confirm it with you before your consult.

Request a specialist referral

Referral GP is not an emergency service. If your child is seriously unwell, call 000 or go to an emergency department.

This page is general information, not medical advice.