If you are a doctor or allied health professional and would like to refer a client to us, please feel free to print out the referral sheet below. Please include any clinically relevant information and some contact details so we can keep you informed of your client’s progress.

Is physio covered by Medicare?

In short YES. However there are conditions to this.

You must see your GP to see if you are eligible for a specific referral called a Medicare GP Chronic Disease Management Plan (GPCCMP) This may also be referred to as an EPC or Care Plan. Only if you have a GPCCMP referral will your visit be partially by Medicare.

HOW DO I QUALIFY FOR A GPCCMP PLAN?

The GPCCMP plan was introduced to help create a plan of management for people with chronic or terminal conditions. A Chronic Disease Management Plan is a means for General Practitioners (GPs) to assist in the management of the health and well-being of patients with chronic or terminal medical conditions.

You may be able to get a GPCCMP referral for up to 5 Physiotherapy / Allied Health sessions per calendar year if you have a chronic medical condition (a medical condition that has been or will be present for a minimum of 6 months)

HOW MANY VISITS WILL IT COVER?
You can be covered for up to 5 visits per calendar year. This is determined by your GP and it will be noted on your GPCCMP plan.

'MY GP SAID THAT I WOULD GET 5 FREE VISITS'

The most common misconception about the GPCCMP process is that it is totally free but this isn’t quite true. At Vital Action Physio we charge you a heavily discount rate of $89.50 and you will receive a rebate of $63.40 from Medicare.

One way of looking at it is that the rebate amount for Medicare is usually larger than a private health insurance rebate, so whilst not free, it is still good value when you consider the cost of private health Insurance premiums.

NB: if you have reached the Medicare Safety Net level for the year because you have paid a lot of out of pocket costs, the rebate goes up significantly, so the gap would be minimal.

HOW DOES THE MEDICARE REBATE PROCESS ACTUALLY WORK?

If you have a valid GPCCMP, you are responsible for paying the full amount at the time of your appointment. If you would like to receive the rebate into your bank account, this can be done at the time of the consult or you can submit the invoice to Medicare yourself.

Unlike with a GP visit, Medicare doesn’t pay the rebate into a credit account for allied health services. If you do not have a savings/debit card then the paperwork is sent to Medicare and processed manually into their account listed with Medicare (via BSB and Acct number). This can take up to 28 days.

02 7251 1475
admin@vitalactionphysio.com.au