Does Medicare Cover Physio? The GP Care Plan Explained

It is one of the most common questions we hear: does Medicare cover physio? The short answer is not usually, but there is an important exception. If you have a chronic condition and your GP puts you on a GP chronic condition management plan, Medicare pays a rebate for up to 5 allied health sessions a year, and physiotherapy can be some or all of them.

The rules changed on 1 July 2025, so much of what you may have read about “care plans” or “EPC plans” is now out of date. This guide explains the current arrangements, who is eligible, what the rebate is, and how to get started. It is general information only, not medical or financial advice. Your GP and Services Australia can confirm what applies to you.

The short answer

• Medicare does not cover standard physiotherapy on its own.
• With a GP chronic condition management plan and a referral from your GP, you can claim a Medicare rebate for up to 5 allied health services per calendar year.
• From 1 July 2026, the rebate for a physiotherapy service under a plan is $63.40 (the schedule fee is $74.55).
• Each service must last at least 20 minutes.
• If your physio charges more than the rebate, you pay the difference, known as the gap.

What changed on 1 July 2025

Until mid-2025, GPs used two separate items to set up chronic disease care: a GP Management Plan and Team Care Arrangements. Many people called these “CDM” or “EPC” plans. On 1 July 2025 they were replaced by a single GP chronic condition management plan.

If you already had a GP Management Plan and Team Care Arrangements prepared before 1 July 2025, you can keep using them to access allied health services until 30 June 2027. Referrals written before 1 July 2025 stay valid until all the services they cover have been used.

Referrals are now written as a referral letter. A referral written on or after 1 July 2025 is valid for the length of time your GP specifies, or, if no timeframe is given, for 18 months from the date of your first service under it.

Who is eligible?

To claim allied health services under a plan, you need:

• A chronic condition. That is a medical condition that has been, or is likely to be, present for at least 6 months, or is terminal.
• Complex care needs managed by your GP. There is no official list of eligible conditions. Your GP uses their clinical judgement to decide whether you would benefit from a structured plan.
• A current plan. A GP chronic condition management plan prepared or reviewed in the last 18 months, or an older plan made before 1 July 2025 (until 30 June 2027).
• A referral. Physiotherapy must be recommended in your plan, and your GP must refer you for it.

Long-term conditions such as arthritis, osteoporosis, diabetes or Parkinson’s disease often fit this description, but eligibility always comes down to your GP’s assessment.

How many sessions, and what is the rebate?

You can claim up to 5 Medicare-supported allied health services per calendar year, from January to December. The 5 services are shared across all allied health types. You could use all 5 for physiotherapy, or split them, for example 3 physio and 2 podiatry sessions. Telehealth allied health services under a plan count towards the same 5.

From 1 July 2026, the Medicare schedule fee for a physiotherapy service under a plan (MBS item 10960) is $74.55, and the rebate is 85% of that fee: $63.40.

What you actually pay depends on your physio’s fee:

• Bulk billed: if your physio bulk bills, they accept the Medicare benefit as full payment and you pay nothing.
• Privately billed: if they charge more than the rebate, you pay the fee, claim the rebate, and the difference is your gap.

Always ask about the fee and any gap before your first appointment. Our pricing and funding page explains how we handle Medicare plan visits.

Can I use my plan for physio at home?

Your GP’s referral to physiotherapy can be taken to any physiotherapist you choose. Khy Physio is a mobile practice, so if you use your plan sessions with us, your physio comes to you at home. A gap fee may apply, and we will confirm it before you book.

For people with limited mobility, a home visit can make those 5 sessions far more useful. Your physio can see the stairs, chairs and bathroom you use every day and set a home program you can keep doing between visits.

Making your 5 sessions count

Five sessions a year is not a lot, so it pays to use them well:

• Be clear about your goals. Walking to the shops, getting up from a low chair or managing stairs are all good, measurable goals.
• Ask for a home exercise program. Most of your progress happens between sessions, so a program you can do on your own is essential.
• Space your sessions sensibly. Your physio can suggest a schedule that leaves time to practise and progress between visits.
• Know your other options. If you need more than 5 sessions, you may be able to use private health insurance, pay privately, or use other funding such as the NDIS, DVA or Support at Home if you are eligible. See our guide to physiotherapy funding options and what a home visit physio costs.

Getting started, step by step

• Step 1: book a longer appointment with your GP and let them know you would like to discuss a chronic condition management plan.
• Step 2: talk through your goals, and ask for physiotherapy to be included in your plan if it would help.
• Step 3: get your referral letter. Check how long it is valid for.
• Step 4: book with your physio and have your referral and Medicare card ready.
• Step 5: keep your GP in the loop. Your physio sends your GP a written report, so everyone involved in your care stays informed.

Frequently asked questions

Do I need a referral to see a physio at all?

No. You can see a physiotherapist privately without a referral. You only need a GP referral to claim the Medicare rebate under a plan, or for some other funding such as DVA. Our article on whether you need a referral to see a physio explains when one is required.

Is my old “EPC” or “CDM” plan still valid?

If your GP Management Plan and Team Care Arrangements were prepared before 1 July 2025, you can keep using them until 30 June 2027. After that, you will need a GP chronic condition management plan. Your GP can check your plan history.

When do my 5 sessions reset?

The limit is per calendar year, so it resets on 1 January.

Can I use my referral with any physio?

Yes. A referral to physiotherapy can be taken to any physiotherapist you choose. It cannot be used for a different type of service, such as chiropractic.

What if I have already used my 5 sessions?

You can keep seeing your physio privately, claim through your private health extras if you have them, or use other funding you are eligible for. Talk to us about the most practical option for you.

Ready to use your plan?

If you have a GP chronic condition management plan, or think you might be eligible, we can help you make the most of it with physiotherapy in your own home across Melbourne and the Geelong region. Make a referral or contact our team on 03 8824 0712 and we will confirm your costs before your first visit.

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