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Medicare Rebates: Can I Get A Medicare Rebate For Physiotherapy?

Physiotherapy is such a vital treatment option for so many conditions, including chronic pain, arthritis and back pain, and there are ways to access Medicare rebates and funding.

To be able to access things like Medicare rebate for physiotherapy should be really easy, but unfortunately Medicare rebates are not always that simple!

We want to be able to help you access the help that you need, as quickly as you can, and as experts who see the above types of conditions all the time, we would love to help explain the Medicare rebate process a little more.

A Chronic Disease Management Plan (CDM) (Formerly known as Enhanced Primary Care Program EPC) is a care plan initiated by a GP’s referral to a physiotherapist or exercise physiologist for the management of their condition.

It can be a really simple process once you understand it, so let us help you wrap your head around Medicare and how it can work for your physiotherapy needs.

CAN I GET A MEDICARE REBATE FOR PHYSIOTHERAPY?

The short answer, is YES!

The long answer is yes, but there are a few conditions.

A Medicare rebate for physiotherapy can be accessed under the Chronic Disease Management Plan (CDM).

Firstly, you must meet the criteria, and that is generally centred around ‘chronic’ conditions, meaning something that you have suffered with for more than 3 months.

Secondly, you need to have the appropriate referral form from your GP, who needs to send you to a specific physiotherapy clinic (hopefully us, we’d love to help!)

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HOW MANY VISITS WILL THE MEDICARE CDM REBATE COVER?

The Medicare CDM Program allows for a total of up to 5 rebated consults to any referred allied health practitioner, per year.

That could include physiotherapy, dietetics, podiatry, speech pathology, etc.

So, for instance, your GP might refer you for 3 physiotherapy consults, and 2 podiatry consults.

This number is renewed each calendar year, but you will need a new referral each year.

HOW MUCH DOES THE MEDICARE REBATE COVER?

The current Medicare rebate (as at Nov 2019) is $53.80 per physiotherapy consult, regardless of the specific service that you choose.

That means that the rebate is $53.80 for an initial consult, and any subsequent review consults that you might be recommended for as well.

Unfortunately, we cannot bulk bill Medicare for physiotherapy at our practice, so there will always be a small gap payment.

Generally, this is around $40 for your initial consult  (which is 40 mins of comprehensive assessment, diagnosis, planning and treatment) and around $30 for any subsequent consults .

However, if you have reached the Medicare safety net threshold for the year you will be entitled to an even greater amount!!

HOW DOES THE MEDICARE CDM REBATE PROCESS WORK?

It is a tricky little process – the joys of working with a government body!

At our practice, what you need to do is actually pay the full fee upfront yourself first, and then we can process the Medicare rebate and get it back to you on the spot.

Specifically, here are the steps:

  • Yes, you can get a Medicare rebate for physiotherapy, using the EPC/CDM Program
  • You need a specific doctor’s referral, and the right type of physical condition
  • You need a specific doctor’s referral, and the right type of physical condition
  • You can get $53.80 rebate for up to 5 visits per year
  • You can get $53.80 rebate for up to 5 visits per year
  • There will always be a small gap fee
  • We can process the rebate on-the-spot, straight back onto your debit card

If you have any questions at all regarding the EPC process – please call or email us via the Contact Us page, and we are more than happy to answer them.

Alternatively, get to your GP ASAP and ask for a referral to see a physiotherapist who can help you get moving well, feeling great, pain free and back to doing what you love!

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