Using Medicare for Allied Health Services in Australia

Many Australians living with ongoing health conditions may be able to receive Medicare rebates for selected allied health services.

This support is generally available through a GP Chronic Condition Management Plan when a patient has a chronic or terminal medical condition that would benefit from structured, multidisciplinary care.

However, Medicare does not automatically cover every allied health appointment, and receiving a referral does not always mean that the entire cost will be covered.

Understanding the eligibility requirements, referral process, available services and possible out-of-pocket costs can help you make informed decisions about your care.

What Are Allied Health Services?

Allied health professionals provide specialised healthcare services that support the diagnosis, treatment and management of medical conditions.

They often work alongside GPs, specialists, nurses and other healthcare professionals as part of a broader care team.

Depending on your healthcare needs, allied health services may include:

Physiotherapy
Podiatry
Dietetics
Exercise physiology
Occupational therapy
Psychology
Speech pathology
Audiology
Chiropractic care
Osteopathy
Diabetes education
Certain mental health services

Each allied health profession has a different area of expertise. The most appropriate service for you will depend on your condition, symptoms, treatment goals and functional needs.

Can Medicare Cover Allied Health Services?

Medicare may provide a rebate for certain allied health appointments when you meet the relevant eligibility requirements.

One of the main pathways is through a GP Chronic Condition Management Plan, commonly shortened to GPCCMP.

Under this arrangement, your GP may refer you to eligible allied health professionals when their services are relevant to managing your chronic condition.

Medicare generally provides a rebate towards the appointment fee. It does not guarantee that the service will be completely free.

Your eligibility must be assessed by a GP or another eligible medical practitioner.

What Is a GP Chronic Condition Management Plan?

A GP Chronic Condition Management Plan is a structured plan developed with your GP to help manage one or more chronic or terminal medical conditions.

A chronic medical condition is generally one that:

Has been present for at least six months
Is expected to continue for at least six months
Is terminal

There is no single list of conditions that automatically qualifies a patient.

Your GP must consider whether you would benefit from a structured approach to your care and whether allied health or other multidisciplinary services are clinically appropriate.

A GPCCMP may include:

Your current medical conditions
Your healthcare needs
Agreed treatment goals
Actions you can take to support your health
Treatments and services you may require
Referrals to allied health professionals
Arrangements for monitoring and reviewing your progress

The plan helps coordinate care between you, your GP and other healthcare professionals involved in your treatment.

What Changed on 1 July 2025?

Before 1 July 2025, eligible patients generally accessed Medicare-supported allied health services through a GP Management Plan and Team Care Arrangement.

These arrangements were replaced by a single GP Chronic Condition Management Plan on 1 July 2025.

Patients receiving a new plan will now generally receive a GPCCMP rather than separate GP Management Plan and Team Care Arrangement documents.

If you had an eligible GP Management Plan and Team Care Arrangement in place before 1 July 2025, you may continue accessing services consistent with those plans until 30 June 2027.

Your GP can explain whether your existing plan remains valid or whether you should transition to a new GPCCMP.

Who May Be Eligible?

You may be eligible for a GP Chronic Condition Management Plan if you have at least one chronic or terminal medical condition and would benefit from coordinated care.

Conditions that may require long-term management include:

Diabetes
Arthritis
Heart disease
Chronic respiratory conditions
Osteoporosis
Persistent back or neck pain
Chronic pain
Neurological conditions
Long-term mobility problems
Other ongoing medical conditions

Having one of these conditions does not automatically make you eligible for Medicare-funded allied health services.

Your GP must determine whether:

Your condition meets the relevant requirements
You would benefit from structured care
Allied health treatment is clinically appropriate
The recommended service relates to managing your condition

Eligibility is based on your individual healthcare needs rather than your diagnosis alone.

Which Allied Health Professionals Can Provide Services?

Eligible professionals who may provide services under a GPCCMP include:

Audiologists
Chiropractors
Diabetes educators
Dietitians
Exercise physiologists
Mental health workers
Occupational therapists
Osteopaths
Physiotherapists
Podiatrists
Psychologists
Speech pathologists

Aboriginal and Torres Strait Islander health workers and health practitioners may also provide eligible services under specific Medicare arrangements.

The provider must meet the relevant Medicare registration, qualification and credentialling requirements.

Not every appointment with an allied health professional will qualify for a Medicare rebate. The service must be included in the referral and must be relevant to your care plan.

How Many Allied Health Visits Can Medicare Cover?

Eligible patients can generally receive Medicare rebates for up to five individual allied health services in each calendar year.

The five services are shared across all eligible allied health professions. They are not five visits for every profession.

For example, your GP might recommend:

Three physiotherapy appointments
One podiatry appointment
One dietitian appointment

Alternatively, all five services could be allocated to one type of allied health professional when clinically appropriate.

The combination of services should reflect your healthcare needs and treatment priorities.

Your GP may recommend additional appointments, but only eligible services within the annual Medicare limit will attract a rebate under this arrangement.

Separate or additional arrangements may apply to some Aboriginal and Torres Strait Islander patients and eligible people with type 2 diabetes.

What Happens During Your GP Appointment?

Your GP will need to assess your health and determine whether a GPCCMP is appropriate.

Reviewing Your Medical History

Your GP may discuss:

Your current medical conditions
Your symptoms
Your medications
Previous treatment
Recent test results
Your physical and functional abilities
The impact of your condition on daily life
The healthcare professionals already involved in your care

Bring relevant specialist letters, test results and medication information when possible.

Discussing Your Healthcare Goals

Your GP may work with you to identify practical goals, such as:

Improving mobility
Managing pain
Improving blood glucose control
Supporting healthy eating
Reducing the risk of complications
Improving strength and balance
Supporting communication
Maintaining independence

The plan should reflect your individual priorities and healthcare needs.

Choosing Appropriate Allied Health Services

Your GP will determine which allied health services are clinically appropriate and consistent with your care plan.

A referral should identify the type of healthcare professional you need, such as a physiotherapist or dietitian.

Your GP may recommend a particular provider, but you may generally take the referral to another eligible professional of the same type.

For example, a physiotherapy referral may be used with an eligible physiotherapist, but it cannot be used for a podiatry appointment.

Do You Need a Referral?

Yes.

To receive a Medicare rebate for an eligible allied health service under a GPCCMP, you must have a valid referral from your GP or another eligible referring medical practitioner.

Booking directly with an allied health provider without the appropriate referral will generally not qualify for a Medicare rebate under these chronic condition management items.

Referrals written under a GPCCMP are valid for the period stated in the referral.

If the referral does not specify a timeframe, it is generally valid for 18 months from the date of the first service provided under that referral.

A referral may specify a particular number of appointments, although this is not always required.

Will Medicare Cover the Entire Appointment Cost?

Not necessarily.

Medicare pays a set benefit for eligible allied health services. The allied health provider can decide how much they charge.

If the provider charges more than the Medicare benefit, you will need to pay the difference. This is commonly called a gap or out-of-pocket cost.

Before booking, ask the provider:

What their full consultation fee is
How much Medicare is expected to rebate
Whether there will be an out-of-pocket cost
Whether payment is required on the day
Whether they process Medicare claims at the clinic
What their cancellation policy is

Some providers may bulk bill eligible patients, but bulk billing is not guaranteed.

Fees and billing policies can vary between practitioners and clinics.

Can You Use Private Health Insurance as Well?

You cannot claim both a Medicare benefit and a private health insurance benefit for the same allied health service.

You may be able to use private health insurance for:

A separate appointment
Additional visits after using your Medicare-supported services
Services that are not being claimed through Medicare

Your level of cover, waiting periods, annual limits and rebate amounts will depend on your insurer and policy.

Contact your private health insurer before treatment if you are unsure what is covered.

Can You Choose Your Allied Health Provider?

In many cases, yes.

A referral does not generally need to name a specific individual practitioner. However, it must specify the relevant allied health profession.

You can usually take the referral to any eligible Medicare provider within that profession.

Before booking, confirm that the provider:

Accepts GPCCMP referrals
Is eligible to provide the Medicare service
Offers the treatment you require
Has appointments available
Can explain the likely fees and rebate

Some providers may have different fees for patients attending under a Medicare referral.

How Long Is an Allied Health Appointment?

Medicare-supported individual allied health services under chronic condition management arrangements must generally last at least 20 minutes.

The exact appointment length may vary depending on:

The type of service
The provider
Your treatment needs
Whether it is your first appointment
The assessments being performed

Ask the provider how much time to allow when making your booking.

What Happens After the Allied Health Appointment?

The allied health professional is generally required to send a written report to the referring GP after the first and final service.

Additional reports may be provided when clinically necessary.

The report may include:

Assessments or tests performed
Treatment provided
Progress towards your goals
Recommendations for ongoing management
Suggestions for further treatment

This communication helps your GP coordinate your care and monitor your progress.

How Often Should Your Care Plan Be Reviewed?

Your GP may recommend reviewing your GPCCMP to assess whether it continues to meet your healthcare needs.

A review may consider:

Changes in your condition
Your progress towards treatment goals
Whether current services remain appropriate
New symptoms or diagnoses
Changes to medication
Whether additional referrals are required

Medicare-funded GPCCMP reviews can generally occur once every three months, although more frequent reviews may be possible in exceptional circumstances, such as a significant change in your condition.

A review does not automatically provide another five allied health services within the same calendar year.

How to Avoid Delays

You can make the process easier by preparing before your GP appointment.

Consider taking the following steps:

Book a longer appointment if advised by the clinic
Tell reception that you want to discuss chronic condition management
Bring an up-to-date medication list
Bring relevant specialist letters and test results
Write down your main healthcare concerns
Think about which daily activities are affected by your condition
Ask providers about fees before booking
Check how many Medicare-supported services you have already used that year
Take your referral to every relevant appointment

Do not assume that every allied health service will be covered simply because you have a chronic condition.

Frequently Asked Questions

Does Everyone With a Chronic Condition Qualify?

No.

Your GP must assess whether your condition meets the requirements and whether you would benefit from structured, multidisciplinary care.

Do I Receive Five Visits for Each Allied Health Profession?

No.

The limit is generally five individual services in total per calendar year, shared across all eligible allied health professions.

Can I Receive Five Physiotherapy Appointments?

Yes, when your GP determines that physiotherapy is appropriate and allocates the available services accordingly.

The five services may all be used with one profession or divided between different professions.

Are the Appointments Free?

Not always.

Medicare provides a set rebate. If the provider charges more than the rebate, you will need to pay the difference unless the service is bulk billed.

Can I Book Directly With an Allied Health Provider?

You can book directly, but you will need an appropriate GPCCMP referral before the service to receive a Medicare rebate under these arrangements.

Does My Referral Expire?

The referral is valid for the timeframe specified by your GP.

If no timeframe is stated, a referral written under the current arrangements is generally valid for 18 months from the date of the first service.

Can I Use an Old GP Management Plan?

A GP Management Plan and Team Care Arrangement created before 1 July 2025 may continue to support eligible services until 30 June 2027.

Speak with your GP if you are unsure whether your previous plan remains current.

Does Reviewing My Plan Give Me Five More Visits?

No.

The five-service limit applies per calendar year. Reviewing or updating your care plan does not usually create an additional allowance within the same year.

Can Allied Health Appointments Be Provided Through Telehealth?

Some eligible allied health services may be available through video or telephone appointments when the Medicare requirements are met and the provider considers telehealth clinically appropriate.

Availability varies between services and providers.

The Bottom Line

Medicare may help eligible patients access selected allied health services when managing a chronic or terminal medical condition.

Under a GP Chronic Condition Management Plan, eligible patients can generally receive rebates for up to five individual allied health services per calendar year.

These services are shared across eligible professions, and Medicare may not cover the provider’s entire fee.

If you believe allied health treatment could help you manage an ongoing condition, book an appointment with a GP at Cranbourne West Medical Centre. Your GP can assess your eligibility, discuss your healthcare goals and coordinate appropriate referrals based on your individual needs.

This article provides general information and is not a substitute for personalised medical or financial advice. Medicare eligibility, benefits and referral requirements may change. Confirm current requirements with your GP, allied health provider or Services Australia.