Does Medicare Cover Physiotherapy in Australia?

Introduction

A few weeks ago, a client called Fleet Healthcare asking if she could book her “five free physio appointments” that her GP had given her through Medicare. This isn’t uncommon — there can be some confusion around how physiotherapy is funded in Australia.

The truth is, while Medicare does offer some support for physiotherapy through a GP referral system and for other allied health services, it’s not completely free — and it’s not available to everyone.

As a practising physiotherapist and company director, I’ve seen clients come through thinking their sessions are fully covered. This blog is here to clarify how Medicare-funded physio really works — what’s covered, what’s not, and how we handle it at Fleet Healthcare.

Key Takeaways

• Medicare only covers physiotherapy through a Chronic Disease Management (CDM) plan (previously EPC).
• You must have a GP referral and a long-term health condition to qualify.
• Medicare rebates do not cover the full cost — you will usually have a gap fee.
• Fleet Healthcare processes Medicare rebates, but clients pay our normal fee upfront.
• You get up to 5 rebated sessions per year, across all allied health services.

Snapshot: At a Glance

 Rebate: ~$56 per session*.GP Referral Required
Limit: 5 sessions/year (total across allied health)
Out-of-pocket cost: Yes (gap applies)
Fleet Healthcare: Full fee upfront + rebate processed for you

Table of Contents

1. What Is CDM (previously EPC)  and How Does It Work?
2. Who Is Eligible for Medicare Physiotherapy?
3. Understanding GP Referrals and the Process
4. How Much Does Medicare Pay for Physio?
5. Fleet Healthcare’s Billing Approach
6. What If I Need More Than Five Sessions?
7. FAQs
8. Conclusion
9. Author Bio

1. What Is CDM and How Does It Work?

As a practising physio over the past decade, I’ve lost count of how many clients have asked, “So does Medicare pay for all my sessions?” The short answer is: sometimes — and only under certain conditions.

Medicare doesn’t routinely cover physiotherapy like it does GP visits. Instead, it offers limited support through what’s called the Chronic Disease Management (CDM) plan, also previously known as an EPC (Enhanced Primary Care) referral. Same system — just a new name.

This program allows your GP to refer you for up to five rebated sessions per calendar year with an eligible allied health provider, such as a physiotherapist, dietitian, podiatrist and other allied health professions. 

But here’s the key thing most people don’t realise:

Those five sessions are shared across all allied health services.

So, if you see a podiatrist twice and a dietitian once, that leaves you with only two sessions for physio in that calendar year.

Also, the CDM plan is specifically for people with chronic health conditions — meaning something that’s lasted six months or more, or is expected to. This could include conditions like arthritis, diabetes, chronic back pain, or neurological disorders.

In short, it’s a helpful system — but it’s not unlimited. The better you understand how it works, the easier it is to plan your care.

Learn more on the Services Australia website: servicesaustralia.gov.au/chronic-disease-gp-management-plans

2. Who Is Eligible for Medicare Physiotherapy?

To access Medicare-subsidised physiotherapy, you need to meet a few important criteria — and it starts with your GP.

You must have a chronic medical condition, which Medicare defines as an illness, injury, or health issue that has lasted (or is likely to last) for six months or more. This isn’t just about pain — it’s about ongoing management.

Common examples include:

• Osteoarthritis or rheumatoid arthritis
• Chronic lower back pain
• Diabetes
• Cardiovascular disease
• Chronic respiratory issues (like COPD or asthma)
• Stroke recovery or neurological conditions like MS or Parkinson’s

You don’t need to be over a certain age — eligibility is based on the nature of your condition, not how old you are.

Another requirement is that your condition needs to be managed by a multidisciplinary team. This means your GP must be working with at least two other healthcare providers, like a physiotherapist and a podiatrist, or a dietitian and a psychologist. Your GP will coordinate this using a GP Management Plan and Team Care Arrangements.

If you’re not sure whether you qualify, your best next step is to ask your GP directly or check the official Medicare CDM Guidelines from the Department of Health.

At Fleet Healthcare, we regularly work with clients who are managing chronic conditions under Medicare, NDIS. aged care funding and other funding types. We’re always happy to liaise with your GP to make sure the right paperwork is in place.

3. Understanding GP Referrals and the Process

Once your GP has determined that you’re eligible for physiotherapy under the Chronic Disease Management (CDM) plan, the next step is a formal referral.

This referral isn’t a generic letter — it’s a specific Medicare form that must be completed and signed by your GP. It outlines:

• The condition you’re receiving treatment for
• The number of sessions allocated (up to five)
• The name of your mobile physiotherapist or clinic (e.g. Fleet Healthcare)
• The treatment goals and expected outcomes

This form must be presented to your physiotherapy provider before your first appointment to allow the rebate to be processed correctly.

In most cases, your GP will also create two documents:

1. A GP Management Plan (GPMP) – outlines your chronic condition and goals
2. A Team Care Arrangement (TCA) – documents the involvement of at least two other healthcare professionals in your care

Together, these provide the foundation for your CDM plan and are a requirement for your physio sessions to be rebated.

If you want to see what the referral form looks like, Medicare provides a full guide here via Services Australia.

At Fleet Healthcare, we regularly receive these referrals and ensure a seamless experience for clients. If you’re unsure whether your paperwork is in order, our admin team can check it for you before your first appointment.

Just make sure your referral is valid for the calendar year, and you haven’t already used your allocated sessions with another allied health provider.

4. How Much Does Medicare Pay for Physio?

Here’s the part many clients are surprised to learn: Medicare doesn’t cover the full cost of a physiotherapy session at Fleet Health Care.

Under the CDM plan, the current Medicare rebate (as of 2025) for each allied health session — including physiotherapy — is approximately $56.00. However, most physiotherapy sessions cost more than that.

Example Breakdown:

Let’s say your if you had a 30 minute appointment with Fleet Healthcare, it would cost $115.00:

Description	Amount
Total session fee	$115.00
Medicare rebate	$56.00
Your out of pocket expense	$39.00

That remaining $39 is the gap between what you have paid and what you will be rebated by Medicare. 

Some physiotherapy clinics offer bulk billing, where they accept the rebate as full payment. However, this is increasingly rare, especially for mobile and community-based providers like us. Bulk billing often means shorter appointments and reduced resources — which ultimately affects care quality.

We choose not to bulk bill at Fleet Healthcare because we want to maintain our standard of longer, personalised sessions — especially for those with complex needs or mobility challenges.

You can read more about current rebate amounts and CDM guidelines on the Services Australia website.

If you’re ever unsure about your total fee and rebate amount, our admin team is happy to explain it upfront — no surprises, no stress.

5. Fleet Healthcare’s Billing Approach

At Fleet Healthcare, we believe in being transparent about fees and funding — especially when it comes to Medicare. We’re often asked, “Do you bulk bill?” and the honest answer is: no, we don’t — and here’s why.

Why We Don’t Bulk Bill

Bulk billing means accepting the Medicare rebate (around $56) as full payment. But to do that, most providers must limit the session time, cut down on travel, and reduce follow-up — and that’s not the kind of care we want to deliver.

We specialise in mobile allied health, which means we travel to you — your home, care facility, or community setting. Our sessions are longer, more thorough, and focused on practical outcomes. That model simply isn’t sustainable under bulk billing.

How We Process Medicare Rebates

Here’s what you can expect:

1. You pay our standard fee upfront.
   For example, a typical physiotherapy session might cost $115*.
2. We submit the Medicare claim on your behalf.
   No forms or follow-up needed from you.
3. The rebate is paid to your account linked with Medicare (usually within 24–48 hours)*.

We’re committed to making the process as easy as possible. If you’re not sure whether your referral is valid, or how many sessions you’ve used, our admin team can check this for you.

You can learn more about our physiotherapy services here, or contact us directly to discuss how the CDM plan applies to your care.

6. What If I Need More Than Five Sessions?

Five sessions per year — that’s the maximum Medicare will rebate through a Chronic Disease Management (CDM) plan. For many people, especially those living with chronic pain or progressive conditions, five simply isn’t enough.

So what happens when you need more?

Here are your options:

 1. Private Health Insurance

If you have extras cover as part of your private health insurance, you may be entitled to additional rebates for physiotherapy — separate from Medicare. These rebates vary depending on your policy, provider, and fund.

You can often:

• Use private cover after your CDM sessions run out
• Claim for physiotherapy if it’s listed in your extras benefits
• Access rebates instantly

We recommend checking with your fund directly or asking our admin team to assist. Many Fleet Healthcare clients use Medicare and private health across separate appointments to stretch their sessions across the year.

2. NDIS (National Disability Insurance Scheme)

If you have a permanent and significant disability, you may be eligible for NDIS funding. The NDIS can fund:

• Physiotherapy under Improved Daily Living
• Capacity-building supports
• Functional assessments and ongoing therapy

You can learn more on the NDIS official site or speak to your support coordinator.

Fleet Healthcare is a registered NDIS provider and delivers mobile physio services across Sydney — so we can work directly with you, your plan manager, and your goals.

3. Pay Privately

Some clients choose to fund additional sessions out-of-pocket for consistency.

We’re always happy to tailor your sessions to your goals — whether you’re on Medicare, NDIS, private cover, self-funded and other funding types.

7. Frequently Asked Questions (FAQs)

Q: Is physiotherapy free with a Medicare referral?
A: Sometimes. Medicare provides a rebate (around $56), but most physiotherapy sessions cost more than this. You’ll usually have an out-of-pocket “gap” to pay unless the clinic bulk bills — which Fleet Healthcare does not.

Q: How many physio sessions does Medicare cover per year?
A: You can access up to five sessions per calendar year under the Chronic Disease Management (CDM) plan. These are shared across all allied health services — not five per service.

Q: Can I split my five Medicare sessions across different services?
A: Yes. For example, your GP could refer you for 2 physiotherapy sessions and 3 podiatry sessions, depending on your needs and goals.

Q: Do I need a new referral each year?
A: Yes. CDM referrals are valid for the calendar year. If you want to continue receiving Medicare rebates next year, your GP will need to renew your plan and issue a new referral.

Q: What if I run out of sessions but still need physiotherapy?
A: You can explore other funding options like NDIS, private health insurance, self-funded and other funding types sessions with Fleet Healthcare . Our team is dedicated to collaborating with you to develop a sustainable care plan tailored to your ongoing needs.

8. Conclusion

Medicare can be a helpful starting point when it comes to accessing physiotherapy — but it’s important to understand its limits.

Through the Chronic Disease Management (CDM) plan, you may be eligible for up to five rebated sessions per year, but it’s not a free-for-all. There are referral requirements, session caps, and out-of-pocket costs unless your provider bulk bills — which many, including Fleet Healthcare, don’t.

That’s because we focus on quality care: longer appointments, mobile services, and therapy that fits your life — not the other way around.

If you’re unsure how to start, our team is here to help:

• We’ll explain the referral process
• Work with your GP
• Help you claim your rebates
• And make sure your therapy aligns with your goals

Contact us today to find out if you’re eligible or to book your first appointment. We’re ready to meet you where you are — and help you move better, feel stronger, and live with greater independence.

Author Bio

Alexander Hunt is the Founder and Managing Director of Fleet Healthcare. As a practising physiotherapist, he brings over a decade of experience working across NDIS, aged care, and mobile allied health. Alex is passionate about making high-quality care accessible — especially for those who can’t easily get to a clinic. His focus is on delivering comprehensive, personalised care that empowers individuals to achieve stronger, more independent lives within the familiar surroundings of their own homes.

 

Professional Disclaimer

The information provided in this article is for general informational and educational purposes only and does not constitute professional advice.

While we aim to ensure accuracy at the time of publication, professional standards, funding arrangements, eligibility criteria, and regulatory frameworks may change and may vary between providers and governing bodies.

Any references to funding or service access are general in nature and should be confirmed directly with the relevant provider or authority.

Fleet Healthcare Services Pty Ltd accepts no liability for actions taken based on the information provided in this article.