Can you claim physio and chiro through Medicare? A plain guide for Leichhardt patients
Yes, you can, if you have a chronic condition and your GP has set up a GP Chronic Condition Management Plan. This plan can get you a Medicare rebate for up to five allied health visits a year, including physiotherapy and chiropractic. Here is how it works, what it covers, and how to use it at Incline Health in Leichhardt.
What is a GP Chronic Condition Management Plan?
It is a plan your GP writes for a health condition that has lasted, or is expected to last, six months or more. It replaced the older GP Management Plan and Team Care Arrangements from 1 July 2025.
If your plan was made before 1 July 2025, you can keep using it until 30 June 2027.
How many sessions does Medicare cover?
Medicare covers up to five allied health sessions per calendar year. That is five in total across all allied health providers, not five each.
So if you use three physio sessions and two chiro sessions, you have used your five for the year. The count resets on 1 January.
Does it cover chiropractic as well as physio?
Yes. Physiotherapy (Medicare item 10960) and chiropractic (item 10964) are both on the list, along with exercise physiology, podiatry, dietetics and others.
Your GP’s referral needs to name the type of provider you are being sent to, so ask your GP to include the service you want.
How much will I get back?
Medicare pays a set rebate for each session, currently $63.40. Most private clinics charge more than the Medicare fee, so you usually pay a gap.
At Incline Health, your first visit is an initial consultation at $150, so after the rebate your out-of-pocket cost is $86.60. Standard consultations after that are $105, so your gap is $41.60.
We process the Medicare rebate on the spot, which means you only pay the gap at the time of your appointment. You do not need to claim it back yourself.
Can I use my health fund as well?
Not for the same visit. A session is claimed through Medicare or through your private health extras, but not both.
Many people use their Medicare sessions first, then switch to their extras cover once the five are used. Check your own fund’s limits, because they vary.
Who is eligible?
You may be eligible if:
- you have a condition that has lasted, or is likely to last, six months or more
- your GP agrees a care plan is right for you and writes the plan and a referral
- your appointment is one-on-one and at least 20 minutes long
Common examples include long-term low back or neck pain and osteoarthritis. Your GP decides whether you qualify, not the clinic.
How to use your plan at Incline Health
- Book a longer appointment with your GP and ask about a Chronic Condition Management Plan.
- Ask for a referral to physiotherapy or chiropractic at Incline Health, 67 Renwick Street, Leichhardt.
- Bring the referral to your first visit, or ask your GP to send it to us.
- We report back to your GP so your care stays coordinated.
You do not need a referral to see a physio or chiro. You only need one to claim the Medicare rebate.
Not sure if you qualify?
Call us on (02) 9569 9552 or book online. We can explain your options, including Medicare, health fund extras, workers compensation and CTP.
This article is general information, not personal advice. Medicare rules and rebates change, so check Services Australia or speak with your GP.
