Can I claim a medicare rebate for physio?

YES – you can claim a medicare rebate for physiotherapy!

We want to help you get out of pain and medicare rebates can make it easier to come in for treatment.

It’s pretty straightforward.

There are some basic steps that you have to complete before claiming a medicare rebate for physio. It is sometimes called a CDM (Chronic Disease Management) and used to be known as an EPC (Enhanced Primary Care).

1/- You will need to have what is called a chronic and complex musculoskeletal condition. A chronic condition is a diagnosis that you have had for longer than 3 months, or is likely to last more than 3 months (eg – arthritis), and the complex bit means that there are 3 or more health practitioners caring for you (eg your GP, Specialist, Surgeon, Physio, Dietician, Psychologist etc). If you think you fit the criteria, chat to your GP.

2/- Your GP has to ‘approve’ your case and then complete the forms to put you on a Chronic Disease Management Plan (CDM for short).

3/- You come to Brightside for excellent treatment. Similar to seeing a GP, once you have paid the full invoice, we can claim $58.30 (correct in 2024) back for you.

The best bit is we can do it for you so you don’t have to visit a medicare office. AND

The rebate is usually higher than what most private health funds will give you.

WIN-WIN!

WHAT ELSE DO I NEED TO KNOW?

Here is some extra info to help understanding the process

1/ You can have 5 ‘Allied Health’ consultations per calendar year. These 5 visits restart in January each year, however you will need a new referral from your GP every January.

2/ You will need a debit card to process the refund. Medicare will not allow us to process your rebate onto a credit card (this is a common issue!)

3/ If you have a problem with the rebate on the spot (this happens occasionally) – there is always the option of going into a medicare office in person or processing it on the medicare app.

4/ Unfortunately we cannot bulk bill medicare rebate patients. We are similar to many GP practices, you will need to pay the invoice up front and claim back the rebate.

5/ Your physio will need to write to your GP as part of the medicare plan as this is a requirement from medicare. It also improves comms between doctors and physios

6/ You cannot claim both a medicare rebate AND a private health claim for a consultation. Mostly the medicare rebate is a higher amount so we often recommend that you use this first and then if you need more treatment, to then use your private health insurance.

7/ If you don’t use all your sessions (up to 5) in the calendar year you can use them the year after but remember you can only use 5 (total) in a year! For example if Anne uses 3 of her 5 sessions in 2023 she can use the other 2 in 2024 but will only be allowed another 3 for 2024 if she gets a new referral from her GP.

We look forward to helping you!