Medicare Rebates: Can I Get A Medicare Rebate For Physiotherapy?

Physiotherapy is such a vital treatment option for so many conditions, including chronic pain, arthritis, fibromyalgia and back pain, and there are ways to access Medicare rebates and funding.

To be able to access things like Medicare rebate for physiotherapy should be really easy, but unfortunately Medicare rebates are not always that simple!

We want to be able to help you access the help that you need, as quickly as you can, and as experts who see the above types of conditions all the time, we would love to help explain the Medicare rebate process a little more.

It can be a really simple process once you understand it, so let us help you wrap your head around Medicare and how it can work for your physiotherapy needs.

medicare rebate physiotherapy

(To see the video that we produced to answer these questions, head to our Facebook Page HERE>>>)

CAN I GET A MEDICARE REBATE FOR PHYSIOTHERAPY?

The short answer, is YES!

The long answer is yes, but there are a few conditions.

A Medicare rebate for physiotherapy can be accessed under the EPC Program, which is the Enhanced Primary Care Program.

Firstly, you must meet the criteria, and that is generally centred around ‘chronic’ conditions, meaning something that you have suffered with for more than 3 months.

Secondly, you need to have the appropriate referral form from your GP, who needs to send you to a specific physiotherapy clinic (hopefully us, we’d love to help!)

 

HOW MANY VISITS WILL THE MEDICARE EPC REBATE COVER?

The Medicare EPC Program allows for a total of up to 5 rebated consults to any referred allied health practitioner, per year.

That could include physiotherapy, dietetics, podiatry, speech pathology, etc.

So, for instance, your GP might refer you for 3 physiotherapy consults, and 2 podiatry consults.

This number is renewed each calendar year, but you will need a new referral each year.

HOW MUCH DOES THE MEDICARE REBATE COVER?

The current Medicare rebate (as at June 2016) is $52.95 per physiotherapy consult, regardless of the specific service that you choose.

That means that the rebate is $52.95 for an initial consult, and any subsequent review consults that you might be recommended for as well.

Unfortunately, we cannot bulk bill Medicare for physiotherapy at our practice, so there will always be a small gap payment.

Generally, this is around $40 for your initial consult (which is 60 mins of comprehensive assessment, diagnosis, planning and treatment) and around $25 for any subsequent consults.

HOW DOES THE MEDICARE EPC REBATE PROCESS WORK?

It is a tricky little process – the joys of working with a government body!

At our practice, what you need to do is actually pay the full fee upfront yourself first, and then we can process the Medicare rebate and get it back to you on the spot.

Specifically, here are the steps:

  1. You need to pay the full fee on a DEBIT card
  2. We swipe your Medicare card and access the $52.95 rebate for you
  3. We swipe your DEBIT card again, and put the $52.95 back onto that card on-the-spot.
  4. (You cannot use a CREDIT card for this process)

SUMMARY

To wrap it all together:

  • Yes, you can get a Medicare rebate for physiotherapy, using the EPC Program
  • You need a specific doctor’s referral, and the right type of physical condition
  • You can get $52.95 rebate for up to 5 visits per year
  • There will always be a small gap fee
  • We can process the rebate on-the-spot, straight back onto your debit card

If you have any questions at all regarding the EPC process – please call or email us via the Contact Us page, and we are more than happy to answer them.

Alternatively, get to your GP ASAP and ask for a referral to see a physiotherapist who can help you get moving well, feeling great, pain free and back to doing what you love!

(To see the video that we produced to answer these questions, head to our Facebook Page HERE>>>)

6 Comments. Leave new

  • Can I use medicare and private health insurance for the difference?

    Reply
    • Hi Dave, unfortunately Medicare do not allow you to use private health insurance at the same time. If you run out of Medicare appointments, you can then use your private health after that. One or the other, as per Medicare, unfortunately!

      Reply
  • Hello I had really bad lower back pain, so I booked sport physiotherapy for my back, I paid $ 110 for initial senior consultation fees for the first time.
    I went today same physio for second time, they charged $105.. So my question is, I don’t have private insurance. So can I get a Medicare rebate for physiotherapy? Please let me know. Thank you. Here is my email ( [email protected]) From Tsering

    Reply
    • Jack O'Brien
      June 11, 2021 10:47 am

      Hi Tsering, as per the article, you need to see your GP for a Medicare referral (if you meet the criteria). All the best!

      Reply
  • Jennifer woods
    May 23, 2021 9:28 am

    I do physio at my local doctor I got my first five free visits now I’m paying for my visits mine is on going treatment as I got problems with my neck with discs nerve pain etc shoulders etc didn’t know u can claim physio on Medicare I pay 80.00 each fornight

    Reply

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