Physio on a Medicare Care Plan: Who Qualifies and How It Works
Is Physiotherapy Covered by Medicare? Do I get Medicare Rebate for Physiotherapy?
What Is a Medicare Care Plan for Physiotherapy?
A Medicare Care Plan is a government-funded initiative designed to help Australians with chronic or complex health conditions access allied health services — including physiotherapy — at a subsidised cost. You might hear it referred to by different names, such as:
GP Management Plan (GPMP)
Chronic Disease Management Plan (CDMP)
Enhanced Primary Care Plan (EPC) (an older term still commonly used)
Despite the different names, they all refer to the same program under Medicare.
The purpose of a care plan is to support individuals who require ongoing, coordinated care from a team of healthcare providers. If your GP determines that your condition meets the criteria, they can prepare a care plan and refer you to allied health professionals like physiotherapists.
Through this plan, Medicare provides rebates for up to five allied health sessions per calendar year. This means eligible patients can receive partial funding (typically around $60.35 per session) for physiotherapy and other allied health services, helping reduce the out-of-pocket cost of managing chronic conditions.
At Ducker Physio in Adelaide, we accept Medicare referrals under this program and work closely with GPs to ensure your treatment aligns with your overall care plan.
Who Is Eligible for a Medicare Care Plan?
To be eligible for a Medicare Care Plan that includes physiotherapy, you must have a chronic medical condition that has lasted — or is likely to last — six months or more. This includes health issues that are ongoing, require regular management, or impact your daily activities and quality of life.
In some cases, eligibility also extends to individuals with complex care needs, meaning your condition requires coordinated support from multiple healthcare providers (e.g. a GP, physiotherapist, podiatrist, and/or dietitian).
Ducker Physio in Salisbury has a fully equipped gym for rehabilitation and therapy. We are currently accepting new patients under the Chronic Disease Management Plan (CDMP).
Importantly, you must be assessed and referred by your GP. They will determine whether your health condition meets the criteria and then create a GP Management Plan (GPMP). If suitable, they’ll also prepare a Team Care Arrangement (TCA) that allows you to be referred to allied health services like physiotherapy.
💡Common Conditions That May Qualify for a Care Plan
Chronic back or neck pain
Arthritis or joint conditions
Post-surgery rehabilitation
Osteoporosis or balance issues
Long-term sports or work-related injuries
Neurological disorders (e.g. Parkinson’s disease, stroke recovery)
If you're unsure whether your condition qualifies, the best step is to speak with your GP. They’ll evaluate your medical history and determine if you’re eligible for Medicare-funded physiotherapy support.
How Many Physiotherapy Sessions Are Covered by Medicare?
Under Medicare's Chronic Disease Management (CDM) program, eligible patients can access up to five (5) subsidised allied health services per calendar year, which can include physiotherapy. These sessions are shared across all eligible allied health services, such as physiotherapy, podiatry, dietetics, and others. For instance, you might allocate all five sessions to physiotherapy or divide them among different services, depending on your healthcare needs and your GP's recommendations.
Each physiotherapy session under this program must be at least 20 minutes in duration to qualify for the Medicare rebate. As of 2025, the Medicare rebate for each physiotherapy session is $60.35. It's important to note that these five sessions are a capped allowance under Medicare for each calendar year. If you require additional physiotherapy sessions beyond the five subsidised ones, you'll need to cover the full cost of those sessions or use private health insurance if available.
To access these Medicare-subsidised physiotherapy sessions, you must be assessed and referred by your GP, who will determine your eligibility based on your medical condition and care needs.
What’s the Process for Getting a Physio Referral Under Medicare?
To get a physiotherapy referral under Medicare, start by visiting your GP. They’ll assess whether your condition is chronic or complex and, if eligible, create a Care Plan (GPMP). Your GP will then provide a referral for physiotherapy, giving you access to up to 5 Medicare-subsidised sessions per year. Bring your referral form, Medicare card, and any relevant medical documents to your first physio appointment.
Does Ducker Physio Accept Medicare Care Plans?
Yes — Ducker Physio accepts Medicare Care Plans, including GPMP (General Practitioner Management Plan) and EPC (Enhanced Primary Care) referrals. If your GP has provided a valid referral under a Chronic Disease Management Plan, you can access up to 5 subsidised physiotherapy sessions per calendar year at our clinic.
We welcome Medicare patients at both of our Adelaide locations:
Magill Clinic – Serving the eastern suburbs
Salisbury Clinic – Located in Adelaide’s northern suburbs
Please note: While the Medicare rebate currently covers $60.35 per session, there will be a small gap fee of $20.00 per session. We’re happy to discuss costs with you before your first visit, so there are no surprises.
Mark Ducker is performing physiotherapy on a patient in Adelaide.
How to Make the Most of Your 5 Medicare-Funded Physio Sessions?
While Medicare provides a valuable rebate for up to five physiotherapy sessions per calendar year, these appointments can go quickly. That’s why it’s important to get the most out of every visit. Here are some practical ways to maximise the value of your Medicare-funded physiotherapy:
✅ 1. Start With a Thorough First Consultation
Bring any relevant medical reports, referrals, and a clear description of your symptoms. This helps your physiotherapist assess your condition accurately and develop a targeted treatment plan from day one.
🏋️ 2. Stick to Your Home Exercise Program
Physiotherapy doesn’t end when you leave the clinic. Your physio will likely give you tailored exercises to do at home. Following these consistently can significantly boost your recovery and reduce the need for extra sessions.
📅 3. Space Out Sessions Strategically
Instead of using all five sessions in a short period, consider spacing them out — for example, every 2–3 weeks. This allows time to apply advice, track progress, and update your treatment plan based on results.
💳 4. Use Private Health to Extend Your Care
If you have private health insurance with extras cover, you may be able to continue treatment after your Medicare sessions are used up — reducing out-of-pocket costs and maintaining continuity of care.
📆 5. Review Your Plan Annually With Your GP
The Medicare care plan resets every calendar year. If your condition is ongoing, schedule a yearly check-up with your GP to reassess your needs and renew your eligibility for another five sessions.
Can I Use Private Health and Medicare Together?
No — you can’t claim both Medicare and private health insurance for the same physiotherapy session. You must choose one or the other for each individual appointment.
However, you can use both in a complementary way. For example:
Use your 5 Medicare-subsidised sessions first (with a valid GP referral).
Then continue treatment using your private health insurance extras cover once those sessions are used.
How to Book a Medicare Physiotherapy Appointment at Ducker Physio?
Ready to get started with your Medicare-funded physiotherapy? Booking an appointment at Ducker Physio is quick and easy.
We accept valid GP referrals under Medicare Care Plans (GPMP/EPC) and offer personalised treatment plans for a wide range of chronic conditions.
📞 Call Us Today:
Magill Clinic: (08) 8333 0322 (option 1)
Salisbury Clinic: (08) 8283 3760 (option 2)
🌐 Book Online Anytime here
We offer fast appointment availability, with many patients able to book mostly the same day Monday to Friday from 8.30am - 6.30pm. Whether you're managing long-term pain, recovering post-surgery, or supporting a chronic health condition, our experienced team is here to help you make the most of your Medicare Care Plan.