Short answer: Medicare pays $63.40 per eligible physiotherapy visit under a GP chronic condition management plan with a GP referral. You can have up to 5 Medicare-rebated allied health visits a calendar year in total, and those 5 are shared across physio, chiropractic, podiatry and other allied health. The chiropractic rebate is the same $63.40.
How much Medicare pays for physiotherapy, and when
Medicare doesn't pay for every physio visit. It helps when your GP has prepared a GP chronic condition management plan for you (many people still call it a care plan or EPC) and referred you to an allied health professional.
Under that plan, the Medicare item for physiotherapy (item 10960) and the item for chiropractic (item 10964) both carry the same benefit: $63.40 per eligible visit. The same applies across the other allied health professions included in the system.
The rebate doesn't change from one visit to the next, and it's the same whether you see a physio, a chiropractor or another eligible allied health provider. What changes is the fee each clinic charges.
The provider sets their own fee, so what you pay out of pocket depends on the clinic. Ask your provider what their fee is and how they handle care plan visits.
One system, shared visits
This is the part that catches people out. The 5 visits a year aren't per profession. They're a total, shared across every allied health provider your GP refers you to under your care plan.
| Profession | Covered under a GP care plan? | Medicare rebate per eligible visit |
|---|---|---|
| Physiotherapy | Yes (item 10960) | $63.40 |
| Chiropractic | Yes (item 10964) | $63.40 |
| Combined limit | Up to 5 allied health visits a calendar year, in total | |
So if your GP refers you to a physio and a chiropractor, the visits are split between them. Other professions in the same system include osteopaths, podiatrists, dietitians, exercise physiologists, occupational therapists and more. Aboriginal and Torres Strait Islander people can be eligible for up to 10. The full list is on the Services Australia website.
For more on the visit limit, read how many visits can you have on a Medicare care plan?
How to get a care plan
- Book a longer GP appointment and tell reception it's for a chronic condition management plan.
- Your GP decides whether you're eligible. Generally it's for a condition that has lasted, or is likely to last, six months or more.
- Your GP writes your plan and a referral to the allied health provider you'll see.
- Book with your provider. Bring your referral and Medicare card.
- Pay and claim. Your provider will explain how they charge. Where you pay on the day, you claim the rebate back from Medicare.
A few more things worth knowing: a referral is valid for the timeframe written on it, or 18 months from the first service if none is stated, according to Services Australia. And you can claim a visit on Medicare or your private health extras, not both.
Physio or chiro under a care plan?
Both professions are part of the same system, with the same rebate. Which one suits you is a personal choice, and many people see whoever they feel most comfortable with. Physiotherapists and chiropractors train differently and often approach problems differently. We explain the differences honestly in what is the difference between a physiotherapist and a chiropractor?
If you'd like to use some or all of your care plan visits for chiropractic, ask your GP to refer you to a chiropractor. You're welcome to ask them to address it to Mornington Peninsula Chiropractic.
How we approach this at MPCC
We're a chiropractic clinic, not a physio clinic, but the care plan system works the same way for us. With a GP care plan and referral, Medicare pays $63.40 per eligible chiropractic visit. You pay us on the day and claim it back, and we send your GP a report.
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. Then a report of findings appointment, where we explain in plain English what we found and whether we can help.
Our fees: new patient appointment $195 ($125 when booked online through our website, new practice members only), and $95 for the report of findings and standard appointments. See Medicare care plans for exactly what to say to your GP.