Can I use Medicare for physiotherapy?
Yes, you can!
Melbourne CBD Physio is a private practice with experienced first contact practitioners, with no referral required, but you can use Medicare under certain circumstances.
In this article:
- Claiming Medicare for physiotherapy
- Am I eligible for Medicare rebates for physiotherapy? What is a chronic condition?
- When can I receive subsidised physiotherapy through Medicare?
- What do I get from my visit?
- How do I receive my rebate?
- Why do I still pay a gap?
- Our GP Referral Network
Medicare benefits for physio are available if you have a chronic condition or complex care needs. It can be accessed through a Chronic Disease Management (CDM) plan – formerly known as Enhanced Primary Care or EPC.
Physiotherapy at Melbourne CBD Physio is a highly respected treatment option for chronic pain and chronic disease management for many conditions such as:
- Osteoarthritis of the knee and hip
- Low back and neck pain
- Tendon and ligament injuries (e.g. Tennis elbow or ACL rupture)
- Joint issues such as rotator cuff tears
- Multiple sclerosis and Parkinson’s disease
- Chronic pain
It is an easy process to claim Medicare rebates at Melbourne CBD Physio. Here are the steps you can take to receive subsidised physiotherapy care.
Claiming Medicare for Physiotherapy
Medicare benefits are available to people with chronic conditions and complex care needs who are being managed by a GP using a Chronic Disease Management (CDM) plan. This was formerly known as Enhanced Primary Care or EPC.
Chronic Disease Management plans are a way for individuals to receive affordable and collaborative healthcare from an array of health professionals, such as physiotherapy.
Claiming Medicare for physiotherapy is done through subsidised visits. You still need to pay a gap fee of the consultation.
Am I eligible for Medicare rebates for physiotherapy? What is a chronic illness?
A chronic illness or injury is generally considered one that has lasted for more than 6 months, or may be expected to last longer than 6 months. A complex case is generally considered one that requires 3 or more health professionals to provide the care that you need (e.g. Physio, GP, Specialist Doctor, GP, Dietician etc). Discuss with your GP if your condition is chronic and can be managed through CDM.
When you nominate Melbourne CBD Physio for your Chronic Disease Management, your GP will complete and pass on the necessary documentation to your nominated Melbourne CBD Physiotherapist. We take the lead from there!
When can I receive subsidised physiotherapy through Medicare?
As soon as your GP has completed and sent us your CDM forms, you can book an appointment with the nominated physiotherapist in your Plan.
What do I get from my visit?
In your initial consultation Melbourne CBD Physio offers a thorough investigation into your chronic condition, how it’s affecting everyday function and what physio can achieve for you. Based on your goals, we’ll establish a clear timeline of recovery and work through a number of treatment strategies such as hands-on treatment and physical exercises. We also introduce ourselves and prepare letters for your GP and other medical/health specialists involved in your Care Team. Your Melbourne CBD Physio will outline your physiotherapy management plan with them to ensure your overall chronic health recovery is aligned and collaborative.
How do I receive my rebate?
The Medicare rebate is available for up to 5 allied health services per patient each calendar year.
You can claim a rebate of $54.60 on the spot (as of Feb 2020). We take care of the entire claims process for you:
- You pay the full fee on a Debit or Cheque card. You cannot use a Credit card for on the spot Medicare rebates.
- We immediately swipe your Medicare card to access the rebate.
- We swipe your Debit or Cheque card again. You immediately receive the rebate of $54.60 to your card.
Why do I still pay a gap?
The Medicare subsidy is often on par with or even significantly more than what most private health funds offer. If you have a chronic condition accessing a CDM plan is a smart way to access more affordable health care.
Our priority is to give you exceptional outcomes. Charging a remaining gap fee allows us the time to offer you a thorough assessment and management plan, follow up with your treatment outside of formal appointments, and align your physio treatment with treatment and opinions you’re also receiving from other medical/allied health professionals within your Care Team.
We have an amazing network of General Practitioners who we work closely with on a daily basis. If you’re unsure of the GP to help guide your chronic health condition, feel free to have a chat with the GPs within our referral network about your specific case.
Source: Australian Department of Health, ‘Chronic Disease Management (formerly Enhanced Primary Care or EPC) — GP services’, last accessed 23 February 2021, <https://www1.health.gov.au/internet/main/publishing.nsf/Content/mbsprimarycare-chronicdiseasemanagement>.