Medicare care plans for chiropractic, physio and podiatry

A GP Chronic Condition Management Plan is the main way Medicare contributes to allied health treatment in Australia. It was formerly called an Enhanced Primary Care plan, or EPC, and a lot of people still call it that.

It is frequently misunderstood in ways that lead to an unpleasant surprise at the counter, so here is how it actually works.

What it is

A management plan prepared by your GP for a chronic medical condition. Where allied health treatment forms part of that plan, the GP can refer you for a limited number of subsidised sessions.

The GP decides whether you qualify. A clinic cannot put you on one, and neither can you request one directly from Medicare.

Who is eligible

Broadly, someone with a chronic medical condition — one that has been, or is likely to be, present for six months or longer — that is being managed by their GP and that requires a team-based approach.

Common examples include osteoarthritis, chronic back pain, diabetes with foot complications, and other long-term musculoskeletal conditions. Whether your situation qualifies is a clinical judgement for your GP.

The rebate

As at July 2026, Medicare rebates $63.40 per session.

Two things that surprise people:

Bulk billing is not available at Brunswick Health. You pay the practitioner’s fee on the day and the rebate is paid into your bank account, usually within one to two business days. So a physiotherapy consultation costs you the full fee on the day, and the fee less the rebate after the rebate arrives.

The rebate is fixed, not a percentage. It does not scale with the fee.

The five-session limit, and what people get wrong about it

You are entitled to a maximum of five allied health sessions per calendar year.

The part that catches people out: that is five sessions in total across all allied health services, not five per discipline. Two physiotherapy sessions, two podiatry sessions and one dietitian session uses the whole allocation.

Also worth knowing:

• The allocation resets on 1 January, and unused sessions do not carry over
• Sessions used with a different provider count against the same five
• Five sessions is rarely a complete course of treatment for anything. It is a contribution, not a funding model

What you need to bring

• The referral form from your GP — specifically the allied health referral, not just the care plan document
• Your Medicare card
• Your bank details registered with Medicare, so the rebate can be paid

Without the referral form the session cannot be claimed, and the clinic cannot generate one retrospectively.

Using it alongside private health insurance

You cannot claim both Medicare and your private health fund for the same session. Choose one per visit.

Which is better depends on your cover. If your extras policy pays more than $63.40 per session for that service, use the fund. If it pays less, or your annual limit is used up, use the care plan.

A common approach is using the five Medicare sessions when the extras limit has run out later in the year, which requires nothing more than telling reception which one you want to use on the day.

What it does and does not cover

Covered: chiropractic, physiotherapy, podiatry, and other eligible allied health services provided by a registered provider, for the condition named in the plan.

Not covered: treatment for an unrelated condition, group sessions in some circumstances, and anything beyond the five-session allocation.

At Brunswick Health, chiropractic, physiotherapy and podiatry are all eligible.

Other funding routes

If a care plan is not available to you, several others may be:

• Private health extras cover, claimed on the spot through HICAPS — the most common route by a wide margin
• WorkSafe Victoria for work-related injuries — paid on the day, with the invoice submitted to the insurer for you
• TAC for transport accident injuries, handled the same way
• DVA referrals, billed directly to DVA with nothing to pay on the day
• NDIS, for supports related to a disability, depending on how your plan is managed

Where to start

Book an appointment with your GP and ask whether a Chronic Condition Management Plan is appropriate for your condition. Take a note of what treatment you are seeking and why.

If you would like to know what a particular appointment costs you after a rebate before committing, the full fee schedule with item codes is published on this site. Under a care plan the Medicare rebate is the fixed $63.40, so the fee less that amount is what the visit costs you. For a private health rebate, quote the item code to your fund and they will tell you what your policy pays — funds only discuss a policy with the member named on it, so that is the one call the clinic cannot make for you.