Australia health update
Does Medicare cover physio and other allied health appointments?
By Patrick LeachPublisher: HerDoc
Yes. Medicare can help pay for physio and other allied health appointments. One way is through a GP chronic condition management plan and referral. Under these arrangements, eligible patients can usually claim up to five individual sessions a calendar year, shared across providers. A gap fee may apply, so check eligibility with your GP and ask the provider about costs. Current Medicare rules.
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What could change?
That limit is now under review. A public consultation running from 28 October to 9 December 2026 includes a proposal to increase individual sessions from five to 12 a year, and from 10 to 17 for Aboriginal and Torres Strait Islander patients. This is a proposal, not a change you can claim now. The government must consider funding before any increase can go ahead, and the draft does not set a start date.
Who can use Medicare for these appointments?
A GP chronic condition management plan can help coordinate care for a medical condition that has lasted, or is likely to last, at least six months, or is terminal. Your GP assesses whether a structured plan would benefit you; there is no fixed list of qualifying diagnoses. Medicare care-plan eligibility.
For Medicare-supported allied health care under the plan, the service needs to help manage your condition, be included in your plan and have a GP referral. The plan must have been prepared or reviewed within the past 18 months.
If you have both a GP Management Plan and Team Care Arrangements prepared before 1 July 2025, you can continue using those arrangements until 30 June 2027. Physiotherapy item requirements.
How many sessions are covered?
The usual five-session limit runs from January to December and is shared across professions. For example, three physio appointments and two dietitian appointments would use all five. It is not five appointments with each profession.
Eligible Aboriginal and Torres Strait Islander patients can access up to 10 individual sessions per calendar year under these chronic condition arrangements. Your practice or allied health provider can check how many sessions you have already used. Current service limits.
Eligible services include physiotherapy, dietetics, podiatry, exercise physiology, occupational therapy and speech pathology, among others. The referral needs to match the type of care you are receiving. Services Australia’s full list.
Other Medicare arrangements have their own rules, including Better Access mental health treatment and group allied health services for eligible people with type 2 diabetes. The individual chronic condition session limit is not a cap on every kind of Medicare-funded allied health care. Medicare’s chronic condition care overview.
Does that mean the appointment is free?
It can be free if the provider bulk bills that service: they accept the Medicare benefit as full payment. Otherwise, Medicare may cover only part of the provider’s fee. The gap is the amount left for you to pay. How bulk billing works for allied health.
Before booking, ask the provider what they charge, what Medicare will pay and what you will pay yourself. Check that they accept your referral and can provide the Medicare-supported service you need.
Which GP should I speak with?
Contact the practice that coordinates your ongoing care. If you are registered with MyMedicare, Medicare care-plan preparation and review must be through your registered practice. Otherwise, use your usual GP or another doctor at that practice. Practice requirements.
You can ask about a particular service, or talk through what is difficult day to day and ask what your GP recommends. Have any existing plan, referral and recent allied health reports handy so you can agree on the next step together.
If a phone appointment would be easier, our article on GP care plans by phone explains the Medicare requirements.