How to access physiotherapy through Medicare
In Australia, you can see a physiotherapist without a GP referral by paying privately or through your private health insurance. However, if you have a chronic condition, your GP can create a GP Management Plan (GPMP) that includes a referral to a physiotherapist with Medicare rebates for up to 5 allied health sessions per calendar year.
At NewDoc, the GP consultation to assess your condition and create a GP Management Plan is bulk billed for eligible Medicare patients. The plan and physiotherapy referral are emailed to you after the consultation. You can then contact a physiotherapist of your choice to book your sessions.
When your GP may refer you to a physiotherapist
Your GP may recommend physiotherapy for a range of musculoskeletal conditions. Common reasons for a physiotherapy referral include chronic back pain, neck pain, shoulder injuries, knee problems, post-surgical rehabilitation, and sports injuries. Physiotherapy is often recommended as a first-line treatment before considering more invasive options such as injections or surgery.
For many musculoskeletal conditions, your GP will first manage your symptoms with appropriate pain relief, activity modification advice, and a physiotherapy referral. If your condition does not improve with conservative management, your GP can then arrange imaging or an orthopaedic referral if clinically appropriate.
GP Management Plans and Team Care Arrangements
A GP Management Plan is available for patients with chronic or complex conditions that have been present for at least 6 months or are expected to last at least 6 months. Common qualifying conditions include chronic back pain, osteoarthritis, fibromyalgia, and post-surgical rehabilitation. Your GP will assess whether your condition qualifies during the consultation.
In some cases, your GP may also create a Team Care Arrangement (TCA), which involves coordination between multiple health professionals. Under a TCA, Medicare provides rebates for up to 5 allied health sessions per calendar year. These can be allocated across different providers such as physiotherapists, exercise physiologists, and dietitians based on your individual needs.
What to expect from physiotherapy
At your first physiotherapy appointment, the physiotherapist will assess your condition through a physical examination, discuss your symptoms and medical history, and develop a treatment plan. This plan typically includes a combination of hands-on treatment, exercise prescription, and education about managing your condition at home.
Physiotherapy treatment may include manual therapy (joint mobilisation and soft tissue massage), therapeutic exercises to improve strength and flexibility, dry needling for muscle pain and tension, taping or bracing for support, and advice on posture, ergonomics, and activity modification. The number of sessions required depends on your condition and how you respond to treatment.
Costs and Medicare rebates
The GP consultation to create your GP Management Plan is bulk billed at NewDoc for eligible Medicare patients. For physiotherapy sessions under a GPMP, Medicare provides a partial rebate for each session. Some physiotherapists bulk bill under Medicare, meaning there is no out-of-pocket cost. Others charge a fee above the Medicare rebate, and you pay the difference as a gap.
If you have private health insurance with extras cover, you may be able to claim a larger portion of your physiotherapy costs through your insurer. Private physiotherapy sessions without a GPMP or insurance can vary significantly depending on the practitioner and location.
Getting your referral through telehealth
Book a consultation on the NewDoc website and select a convenient time. During your video or phone consultation, the GP will discuss your symptoms, examine your range of motion where possible, and assess whether a GP Management Plan with a physiotherapy referral is appropriate. The GP can also provide pain management advice and prescriptions during the same consultation.
After the consultation, your GP Management Plan and physiotherapy referral are emailed to you. You can then contact a physiotherapist of your choice, provide the plan, and book your Medicare-rebated sessions. If you need additional treatment after your 5 allied health sessions, your GP can discuss other options including private sessions or a review of your management plan.