Short answer: Whether a chiropractor bulk bills is up to each clinic. Medicare helps with chiropractic under a GP chronic condition management plan, paying $63.40 per eligible visit, up to 5 allied health visits a year. At MPCC, a GP care plan can cover part of your care, DVA is billed directly, and X-rays we refer for are bulk billed.
What bulk billing means for a chiropractor visit
Bulk billing is when a provider accepts the Medicare rebate as full payment for a service, so there's nothing to pay on the day. You'll see it most often at GPs and imaging clinics.
For chiropractic, Medicare only pays a rebate in one situation: when your GP has put you on a chronic condition management plan (still widely called a care plan or EPC) and referred you to a chiropractor. Without that plan and referral, there's no Medicare rebate to bulk bill against. Each clinic decides for itself how it charges for care plan visits, so if bulk billing matters to you, ask the clinic directly.
When you're comparing clinics, it helps to ask a few simple questions:
- What does a care plan visit cost, and what will I pay after the Medicare rebate?
- What's included in the first visit, and how long does it take?
- Do you claim health funds on the spot with HICAPS?
- If I need X-rays, where do I go and will I pay anything?
Clear answers to those questions tell you far more than the words "bulk bill" on their own.
Chiropractor bulk bill or not: what Medicare actually covers
| Medicare care plan | Detail |
|---|---|
| Rebate | $63.40 per eligible chiropractic visit (Medicare item 10964) |
| Visits | Up to 5 a calendar year, in total across all allied health |
| Shared with | Physio, podiatry, dietitians, osteopaths and other allied health |
| You need | A GP chronic condition management plan and a GP referral |
For the step-by-step, read can I claim a chiropractor on Medicare? For how the 5 visits work across a year, see how many visits you can have on a Medicare care plan.
How funding works at MPCC
Medicare GP care plan
A GP care plan can cover part of your care. With a GP chronic condition management plan and a referral, Medicare pays $63.40 per eligible visit. You pay us on the day and claim the rebate back, and we send your GP a report. Our Medicare care plans page explains exactly what to say to your GP.
X-rays are bulk billed
We only refer for X-rays when your history and check point to them. The imaging clinic we refer to bulk bills X-rays our chiropractors request.
DVA: billed directly
Gold Card holders, and White Card holders for accepted conditions: with a GP referral, we bill DVA directly, so there's nothing to pay at the desk for covered care. See DVA.
Private health extras
If your extras cover includes chiropractic, claim on the spot with HICAPS and just pay the gap. Your rebate depends on your fund and level of cover. You can claim a visit on Medicare or on your health fund, not both.
WorkSafe and TAC
You can come in under a WorkSafe or TAC claim. We don't bill the schemes: you pay us on the day and claim it back. See WorkSafe and TAC.
How we approach this at MPCC
However you're paying, your care starts the same way. Your first visit is a new patient appointment: your story, posture pictures, and a thorough chiropractic, orthopaedic and neurological check of your spine, joints and nerves, taking 30 to 40 minutes. Whether you're adjusted on the first visit is up to the clinical judgement of your chiropractor. Often more testing comes first.
Your second visit is a report of findings appointment. We explain what we found in plain English, whether we can help, and, if we can, what care involves and what it costs. No surprises.
Our fees: new patient appointment $195, or $125 when booked online through our website (new practice members only, one per person). Report of findings and standard appointments are $95.
Not sure how you'd pay? Call us on 03 9787 8518 and Michelle or Mercedes will talk it through with you.