How to Claim a $60 Medicare Rebate for Physio: What You Need to Know
If you’re experiencing pain, recovering from an injury, or managing a chronic health condition, seeing a physiotherapist can be life-changing.
But did you know that you may be eligible to access physiotherapy services through Medicare, saving you significant out-of-pocket costs? Please note, most physios do not bulk bill, meaning that after your Medicare rebate, there will still be a fee to cover the gap.
In this post, I’ll walk you through the ins and outs of Medicare-funded physiotherapy: who qualifies, how much you can claim, the important conditions to meet, and how to talk to your GP about getting a referral.
Let’s dive in.
What is Medicare-Funded Physiotherapy?
Medicare covers a portion of allied health services, including physiotherapy, under specific conditions. These services fall under the Chronic Disease Management (CDM) program — formerly known as an Enhanced Primary Care (EPC) plan.
In simple terms: if you have a chronic medical condition (one that has lasted, or is likely to last, six months or more), you may be eligible for a Medicare rebate for a limited number of physiotherapy sessions each calendar year.
What Conditions Are Eligible?
Medicare does not provide blanket coverage for everyone who wants physio. It specifically supports people with chronic conditions requiring multidisciplinary care.
Examples of eligible conditions include:
• Arthritis (osteoarthritis, rheumatoid arthritis)
• Chronic lower back pain
• Diabetes (especially with musculoskeletal complications)
• Heart disease
• Osteoporosis
• Chronic respiratory diseases (like COPD)
• Stroke recovery
• Ongoing balance and mobility issues
• Chronic sporting injuries
Important nuance: The definition of “chronic” isn’t rigidly about the name of a disease — it’s about how long the condition has affected your quality of life and functioning.
Even recurring issues like chronic shoulder pain, migraines with musculoskeletal involvement, or long-term postural problems could potentially qualify.
Ultimately, your GP decides if your situation meets the criteria for a Chronic Disease Management plan.
How Many Physio Sessions Does Medicare Cover?
Under a CDM plan, you can access up to five (5) allied health visits per calendar year across all allied health services — not just physiotherapy.
That means the five sessions could be divided between a physiotherapist, podiatrist, dietitian, exercise physiologist, or others if needed.
If you choose to allocate all five visits to physiotherapy, that’s absolutely fine — but you must plan this with your GP at the time the care plan is written.
How Much Does Medicare Rebate?
As of 2025, the Medicare rebate for each physiotherapy session under CDM is approximately $60.
For example:
• Physio charges $125 per session.
• Medicare rebate is $60.
• You pay the gap of $65.
At Destiny Health, we can advise you upfront about any out-of-pocket costs, and we offer Medicare claiming to make the process easier.
How to Approach Your GP
Accessing physiotherapy under Medicare starts with your GP. Here’s how to go about it:
1. Book a longer appointment.
You’ll need an extended consultation (often billed as a “complex” consultation) so your GP has time to assess your eligibility and create your Care Plan.
2. Explain your ongoing condition.
Clearly describe how long you’ve had the issue, the impact on your daily life, and any previous treatments you’ve tried.
Examples you might say:
• “I’ve had chronic knee pain for the last eight months, and it’s affecting my ability to exercise and work.”
• “My lower back pain has been constant for over a year despite seeing a massage therapist.”
3. Ask if you are eligible for a CDM plan.
Not everyone will qualify, so it’s your GP’s clinical judgment that matters. Approach it respectfully, and understand they have to meet Medicare’s guidelines.
4. Discuss allocation of services.
If you want all five sessions with a physiotherapist, let your GP know.
Once your GP writes the CDM Plan and issues the referral to your chosen physio (like Destiny Health), you’re good to go!
What Happens Next?
Once you have your GP referral:
Book your physiotherapy appointment.
Bring your Care Plan or referral paperwork to your first appointment.
Claim your rebate.
Other Important Nuances to Be Aware Of
Annual reset:
Your five visits refresh every calendar year, not from the date of your first appointment.
No rollovers:
If you don’t use your five visits in the year they’re issued, you can’t roll them over to the next year.
Review requirement:
Your GP will usually review your CDM plan every 12 months to assess whether continued allied health services are required.
Additional sessions:
Once you use up your Medicare-funded visits, you can still continue physiotherapy privately if needed, either paying fully out-of-pocket or using private health insurance if you have it.
Is Medicare-Funded Physio Right For You?
If you have an ongoing health concern and physio could help you manage it, it’s definitely worth discussing with your GP.
Medicare coverage can significantly reduce your costs and open the door to expert care that supports your long-term health.
At Destiny Health, we are experienced in working with Medicare CDM referrals.
We will design a treatment plan that fits your goals — whether that’s improving mobility, reducing pain, rebuilding strength after injury, or managing a chronic condition.
Need Help Getting Started?
Contact us at Destiny Health today. We’re happy to answer your questions, liaise with your GP if needed, and help you take your next step toward better health and wellbeing.
📞 Call us: 1300 496 362
Destinyhealth.com.au
Disclaimer:
This article provides general information and is not a substitute for medical advice. Always consult with your GP or healthcare provider to assess your individual eligibility for Medicare.
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