Is Physiotherapy Covered by Medicare in 2024?

Discover the Answer To "Is Physiotherapy Covered Under Medicare?"

Navigating the healthcare system in Australia can be complex, especially when trying to understand what services are included under Medicare. For patients seeking Physiotherapy services, it's crucial to know how these are covered and whether or not you'll receive the Medicare rebate. At Brisbane Livewell Clinic, we're committed to providing you with clear information to help you access the Physiotherapy care you need, especially when it comes to understanding Medicare coverage.

Medicare Coverage for Physiotherapy Services

Medicare, Australia's public health insurance scheme, offers coverage for some physiotherapy services. This coverage is designed to ensure that Australians can access essential healthcare without facing financial hardship.

However, the extent of coverage for physiotherapy services can vary based on your specific circumstances, the type of Physiotherapy you need, and the reasons you are seeking Physiotherapy. It's therefore essential to understand your entitlements to Medicare benefits and how to access them.

Eligibility for Medicare Rebates

To be eligible for a Medicare rebate for Physiotherapy services, patients typically need a referral from their GP to a specific Physiotherapist under a plan such as the Chronic Disease Management (CDM) plan. This plan is designed to support patients with chronic or terminal medical conditions, including those requiring long-term Physiotherapy management for particular conditions.

When asking the question of "Is Physiotherapy Covered Under Medicare?", the answer is yes - in some circumstances and particularly if you have a chronic or terminal health condition. Generally, seeing a Physiotherapist for, say, your injured knee or aching arm or shoulder ache is unlikely to be covered by Medicare. However, you may be entitled to a refund for part of the costs of a Physiotherapy consultation under your private health insurance. 

How to Access Medicare Rebates for Physiotherapy

Here are the steps to take to claim for your Physiotherapy sessions under Medicare:

• GP Referral: Your first step is to consult with your GP. Discuss your health concerns and the potential benefits of Physiotherapy. If your GP agrees that Physiotherapy is necessary, they can either prepare a Chronic Disease Management plan or amend your existing CDM Plan to include Physiotherapy.
• Preparation (or Revision) of your Chronic Disease Management Plan: Your GP may ask you to book a separate appointment so they can draft your CDM plan. Under the CDM plan, you may be eligible for Medicare rebates for up to five Allied Health Services per calendar year, which can include Physiotherapy sessions. Note that you may not receive the Medicare rebate on 5 Physiotherapy sessions if you have other Allied Health Services you are using under a current CDM plan.
• Consultation at Brisbane Livewell Clinic: With your GP's referral, you can then book a consultation with Ciaran Caldwell at our Wavell Heights Clinic. Ciaran focuses on Musculoskeletal Physiotherapy, Sports Physiotherapy, and Paediatric Physiotherapy. He can provide the targeted support you need, whether it's for sports-related injuries, musculoskeletal issues, or your child's movement and structural health. Discover our Physiotherapy Brisbane services.
• Send our Clinic your CDM plan: Before your consultation with Ciaran, we ask that you send us your CDM plan, so we can enter it into our system and so Ciaran can review it before you meet.
• Swipe your Medicare card: After your consultation, our friendly Reception staff will ask you to tap your Medicare card on our HICAPS machine. This will allow us to process your Medicare claim for you, so you can receive the payment of the Medicare rebate directly into your bank account. Alternatively, our staff will provide you with the invoice for Physiotherapy services so you can claim payment of the rebate from Medicare yourself through MyGov. 

Maximising Your Medicare Benefits

To make the most out of your Medicare benefits for Physiotherapy:

• Regularly review your Chronic Disease Management plan with your GP to ensure it is up to date, is valid each calendar year, and continues to meet your health needs.
• Keep track of the number of sessions you've attended to avoid exceeding the annual limit under Medicare.
• Discuss any changes in your condition with both your GP and your Physiotherapist to adjust the CDM plan and your Health Plan as needed.

Some Useful Resources

• Medicare Australia
• Australian Physiotherapy Association
• Department of Health
• Chronic Disease Management Patient Information
• HealthDirect Australia
• My Aged Care
• National Health Services Directory
• Australian Institute of Health and Welfare

Conclusion

Understanding your Medicare coverage for Physiotherapy services is essential for accessing the care you need without undue financial stress. At Brisbane Livewell Clinic, we're here to assist you through this process, both on the administration side, the claiming side, and through expert support from our Physiotherapist, Ciaran Caldwell.

Whether you're dealing with a sports injury, a musculoskeletal condition, or seeking paediatric physiotherapy, we're here to support your health and wellbeing.

For more information or to book an appointment, please call Brisbane Livewell Clinic on (07) 3861 5881. Let us help you navigate your Medicare coverage to ensure you can receive the Physiotherapy care you need.