FREQUENTLY ASKED QUESTIONS
-Medicare
What is an Medicare Referral?
An Medicare referral (also known as a Chronic Disease Management plan or CDM plan) is a referral from your GP that allows you to access Medicare-rebated allied health services when you have a chronic or complex health condition that needs ongoing management.
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In physiotherapy this means Medicare can rebate up to 5 sessions per calendar year with an allied health professional, such as a physiotherapist, when the right referral and documentation are in place.
Who is eligible for Medicare-rebated physio under CDM?
You may be eligible if you:
✔ Have a chronic or complex medical condition (e.g. back pain, arthritis, post-surgery rehab)
✔ Need ongoing allied health support
✔ See a GP who assesses that ongoing physio services are required
Your GP must decide it’s clinically appropriate and prepare the referral accordingly.
How many physiotherapy sessions are covered?
Under the current Medicare rules:
âž¡ You can claim up to 5 allied health sessions per calendar year
These 5 sessions can be split among various allied health services (e.g. physio, podiatry, dietetics), not just physio.
Example:
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3 physio sessions
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1 podiatry session
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1 dietitian session
= 5 total Medicare-rebated allied health services
What do I need to get Medicare rebates for physiotherapy?
.To receive a Medicare rebate you generally need:
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GP Management Plan (GPMP) — a plan your GP prepares with you
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Team Care Arrangement (TCA) — documentation supporting referrals to allied health
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A referral to physiotherapy specifying up to 5 Medicare-rebated session​
These must generally be completed before your physio services start.
How much will I be rebated?
Medicare covers part of the cost of each session — not the full fee.
💡 The rebate depends on:
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The Medicare schedule fee set by the government
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The fee the physiotherapist charges
Most clinics charge above the Medicare schedule fee, so there is often a gap payment you pay yourself.
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Example:
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Cost of physio appointment (30 minutes) ~$100
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Medicare rebate: ~$61.80
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âž¡ You would then pay the remainder (gap) yourself, which is $38.20
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Can I use an Medicare session for hydrotherapy?
Yes, however this would incur an additional cost, due to the extended consultation time.