Medicare Rebates

Medicare doctor holding stethoscope
Doctor holding stethoscope

Medicare Rebates: Can I Get A Medicare Rebate For Physiotherapy?

At K Point Rehabilitation we do Medicare Treatment Plans and we want the whole process to be as clear and easy as possible. So, this is an explanation of how the Medicare rebate works in a nutshell:

  1. You need your GP’s referral, and being affected by a chronic (>3 months) physical condition;
  2. You can get a minimum of 58.00$ rebate per visit for up to 5 visits per year;
  3. You’ll pay the full amount on the spot and then be refunded to your bank account;

You can call our physiotherapist Enrico Massidda (DPT) to talk about possible solutions.

CAN YOU EXPLAIN THE DETAILS, PLEASE?

#1 In order to access the program you must be affected by a chronic condition. We consider chronic a condition that lasts more than 3 months.

#2 You need a referral from your GP. Your GP Is free to indicate a specific physiotherapy clinic but they are happy to respect your preference. So, if you are already a patient of K Point Rehabilitation, and you would like the cost of the treatment to be partly covered by Medicare, speak with your GP and feel free to suggest to us! Your doctor will give you a letter that you’ll bring us. I will reply to your doctor in writing with a report of the first and last appointments. a bit more paperwork for me, but also the chance to approach your problem in teamwork with your doctor.

DOES IT MEAN THAT I CAN HAVE A REBATE FOR AS MANY TREATMENTS AS I NEED?

Well, the Medicare EPC program gives you a maximum of 5 rebated treatments per year to be divided among the allied health practitioners. That means that if you need, for instance, a dietician or a chiropractor, they will be included in the 5 treatments per year.

So, no, unfortunately, you don’t have 5 physio plus 5 chiros plus 5 dieticians, etc,

It could seem not too much, but it helps a lot of people, believe me!

Every year you have 5 treatments, but if you don’t use them at the end of the year, they expire and you cannot use them in addition to the 5 of the following year. What a pity! I know!

HOW MUCH DOES MEDICARE COVER FOR A SINGLE CONSULTATION?

The current rebate is 58.00 for a physiotherapy consult, regardless of the full price of the single consultation. At K Point Rehabilitation we apply concession prices for Senior or Disability Card holder. The Medicare rebate will be applied to the concession price and not to the full price. For instance, a 30 minutes physiotherapy consultation concession price is 102$ – 58.00 = ONLY 44.00 out of pocket!

Unfortunately, at K Point Rehabilitation we do not bulk bill Medicare for physiotherapy.

HOW ARE THE PAYMENTS/REBATES PROCESSED?

It could appear a bit complicated but I’ll do my best to make it simple!

The payment/rebate is processed through the same HICAPS device that is used for Health Funds rebates, but with 2 important differences:

  1. With a Health Fund card, you pay only the gap amount and you can use a credit card.
  2. With Medicare, you initially pay the full amount and you must use a DEBIT card as a CREDIT card is not accepted by Medicare.

Medicare will refund you the 58.00$ directly to your bank account (sometimes in just a few hours) Simple enough? Actually, the most important thing to remember is that you must use a debit card.

SUMMARY

Yes, we do Medicare rebates for physiotherapy, through the EPC Program;

You need your GP’s referral, and being affected by a chronic (>3 months) physical condition;

You can get a minimum of $58.00 refund per visit for up to 5 visits per year;

You’ll pay the full amount on the spot and then be refunded to your bank account;

For any questions about Medicare rebates or other issues, feel free to contact me at [email protected]

You can also find more information on the Department of Health website.