What the GMFCS is
The GMFCS was published in 1997 by researchers at CanChild in Canada and expanded and revised in 2007 (the GMFCS E&R) to cover young people up to 18. It focuses on what a person usually does day to day, at home, at school and in the community, rather than their best possible performance in a clinic.
It is a classification, not a test with a score. A physiotherapist, paediatrician or other clinician who knows the person picks the level that best describes their usual movement, especially sitting, transfers and getting around.
The five GMFCS levels
The level descriptions change with age, because what is expected of a two year old differs from a teenager. In broad terms, for school aged children:
- Level I: walks without limitations, including stairs without a rail; speed, balance and coordination may be reduced
- Level II: walks with limitations, such as on uneven ground, long distances or crowds; may need a rail on stairs
- Level III: walks using a hand held mobility device such as crutches or a walker, and often uses a wheelchair for longer distances
- Level IV: self mobility is limited; may use powered mobility, or be transported in a manual wheelchair
- Level V: transported in a manual wheelchair in all settings, with limited ability to hold the head and body against gravity
Age bands
The expanded and revised GMFCS has separate descriptions for five age bands: before a child's second birthday, 2 to 4 years, 4 to 6 years, 6 to 12 years and 12 to 18 years. A child's level is usually fairly stable over time, which makes the GMFCS useful for planning long term support, but it can be reviewed, especially in early childhood.
Why the GMFCS level matters for the NDIS
The NDIA's List A includes cerebral palsy assessed at GMFCS level III, IV or V. If a treating professional confirms the diagnosis and level, the NDIA usually accepts that the disability requirements are met without a separate functional assessment. You still need to meet the age and residence requirements.
For cerebral palsy generally, the NDIA's preferred evidence is the GMFCS, with the Manual Ability Classification System (MACS) and the Communication Function Classification System (CFCS) as other options. People at GMFCS level I or II may still be eligible, but they need evidence of how cerebral palsy substantially reduces their functional capacity, such as a functional capacity assessment.
MACS and CFCS
The GMFCS only covers gross motor movement. Two companion systems use a similar five level format: the MACS describes how a person uses their hands to handle objects in daily activities, and the CFCS describes everyday communication. Together they give a fuller picture of how cerebral palsy affects someone's life, which helps with planning therapy, equipment and support.
Who assesses it and what it costs
A physiotherapist, paediatrician, rehabilitation specialist or occupational therapist familiar with cerebral palsy usually gives the GMFCS level, often as part of a broader assessment or review. Ask for the level and the age band to be written clearly in their report.
For NDIS participants, assessments that help plan or review supports are usually paid from Capacity Building. Physiotherapy has a 2026/27 price limit of $183.99 an hour and occupational therapy $193.99 an hour in most of Australia. Before joining the NDIS, your child's treating team in the health system can usually record the level.