Medicare physiotherapy and EP in Brisbane may be available for eligible patients with a GP Chronic Condition Management Plan (formerly known as a GP Care Plan).

Under Medicare rules, eligible patients can receive rebates for physiotherapy and accredited exercise physiology when referred by their GP.

Who Is Eligible for Medicare Physiotherapy?

You may be eligible if:

• You have a chronic medical condition lasting 6 months or longer, and
• Your GP has prepared a Chronic Condition Management Plan, and
• You have been referred to physiotherapy or exercise physiology under that plan.

Eligibility is determined by your GP under Medicare guidelines.

How Many Medicare Sessions Can I Claim?

Medicare allows up to 5 allied health sessions per calendar year under a Chronic Condition Management Plan.

Important:

• The 5 sessions are shared across all allied health providers combined.
• They are not 5 sessions per provider.
• Sessions reset on 1 January each year.

If you use 3 sessions for physiotherapy and 2 for exercise physiology, your annual allocation is exhausted.

Medicare Physiotherapy (MBS Item 10960)

Medicare item 10960 applies to physiotherapy services delivered under a GP referral.

Physiotherapy may focus on:

• Pain management
• Mobility restoration
• Strength and stability training
• Rehabilitation after injury or surgery

Learn more about our physiotherapy services.

Medicare Exercise Physiology (MBS Item 10953)

Medicare item 10953 applies to accredited exercise physiology services under a GP referral.

Exercise physiology may support:

• Chronic disease management
• Diabetes and metabolic conditions
• Cardiovascular health
• Long-term strength and conditioning
• Functional capacity improvement

Learn more about our exercise physiology services.

Do I Pay a Gap?

Medicare provides a fixed rebate amount per session. If our consultation fee exceeds the rebate, you will pay the remaining difference (the “gap”).

The Medicare rebate does not usually cover the full consultation fee.

Can I Claim Medicare and Private Health Insurance Together?

For a single appointment, you generally claim either:

• A Medicare rebate, or
• A private health insurance rebate.

You cannot claim both for the same service on the same day.

If you have used your Medicare sessions, you may continue treatment under private health insurance extras if your policy allows.

What to Bring to Your Appointment

Please bring:

• Your valid GP referral
• Your Medicare card
• Any relevant medical reports or imaging

Without a valid referral, Medicare rebates cannot be processed.

Other Funding Pathways

If Medicare is not suitable, other pathways may apply:

• Private health insurance rebates
• WorkCover physiotherapy
• CTP physiotherapy
• DVA physiotherapy
• NDIS funding

What to Do Next

First, speak with your GP about whether you qualify for a Chronic Condition Management Plan. Next, obtain your referral. Then book your appointment so we can assess your needs and develop an appropriate physiotherapy or exercise physiology plan.

References

1. Services Australia. Chronic Condition Management allied health services (MBS items 10950–10970). https://www.servicesaustralia.gov.au/chronic-disease-management-allied-health-services
2. Australian Government Department of Health. Medicare Benefits Schedule (MBS) Online. http://www.mbsonline.gov.au/