Medicare for Physiotherapy
Physiotherapy and Clinical exercise have been proven to be one of the best managements for chronic conditions such as osteoarthritis, diabetes, low back pain, tennis elbow, rotator cuff tears, tendinopathies, etc.
Can you get medicare rebates for physiotherapy?
Short answer, YES you can use Medicare rebates for physiotherapy services!
You will need to be referred to us by your GP, who will then give you an EPC form for you to bring to us on your first consultation.
You are entitled to 5 Allied Health appointments per year, it can be 5 physiotherapy sessions, or 3 physio and 2 podiatrist, etc. They also do not roll over to the next calendar year, so you will have to obtain a new referral from your GP then.
We do not bulk bill for consultations. There is a gap fee that needs to be covered by patients for the consultations.
How does it work?
Step 1 – Visit a GP about your chronic complex condition.
Step 2 – Your GP approves your eligibility, fills in the paperwork, and gives you a CDM/ EPC form at the end of your consultation.
Step 3 – You arrange your appointment with us and come in for your treatment!
Step 4 – After the treatment, you will pay the consultation fee in full.
Step 5 – Then we lodge your claim to Medicare and process the rebate back into your bank account or debit card. This rebate is most often a lot higher than what most private health funds will give you.
Physiotherapy is covered under Medicare Benefits Schedule Item 10960.
The correct terminology is CDM (Chronic Disease Management) or EPC (Enhanced Primary Care). It covers physiotherapy for a patient with chronic conditions requiring complex care. Chronic condition refers to any issues that have been present for at least six months.
At times, signs and contributing factors are present for quite a while before symptoms start to appear, so it can be tricky and is normally therefore decided on a case by case basis. Complex means your condition requires three or more healthcare professionals to care for you, this might include your GP, physio, podiatrist, the list goes on.
What could go wrong in medicare rebates?
Assuming you are eligible for Medicare and fit the eligibility, and your GP has nominated Movement Laboratory Physiotherapy as your preferred provider, there shouldn’t be a problem with the claim.
If the claim keeps getting declined, we kindly ask you to ring Medicare and have them rectify whatever the problem is.