How many PT sessions will Medicare pay for?

How many PT sessions will Medicare pay for? Medicare covers up to 5 allied health sessions per calendar year, and that includes physiotherapy sessions. These sessions fall under what is now called a GP Chronic Condition Management Plan (GPCCMP), which replaced the old GP Management Plans and Team Care Arrangements on 1 July 2025.

But there are rules. You need a GP referral, you need a chronic health condition, and those 5 sessions are shared across all allied health services. So if you use 2 of those sessions on a podiatrist, you only have 3 left for physio.

Here is everything you need to know about how the system works, what you will pay, and how to get the most out of your sessions.

What is a GP Chronic Condition Management Plan?

A GP Chronic Condition Management Plan (GPCCMP) is a care plan your GP creates to help manage a health condition that has lasted 6 months or longer. This plan replaced the old Enhanced Primary Care (EPC) plans and the combined GP Management Plan (GPMP) and Team Care Arrangements (TCA) system as of 1 July 2025, according to Services Australia.

Under this plan, your GP can refer you to allied health professionals like physiotherapists, exercise physiologists, dietitians, podiatrists, and others. Medicare then provides a rebate for up to 5 of these sessions each calendar year.

The plan is designed for people with ongoing conditions. Think chronic back pain, arthritis, diabetes, heart disease, or neurological conditions like Parkinson’s disease. If your condition is something short term, like a sprained ankle from weekend sport, this plan does not apply.

How many physio sessions does Medicare cover per year?

Medicare covers 5 individual allied health sessions per calendar year. You can use all 5 for physiotherapy, or you can split them across different allied health services based on what your GP recommends.

For example, your GP might refer you for 3 physiotherapy sessions and 2 dietitian sessions. That adds up to 5 total. Once those 5 are used, Medicare will not cover any more allied health sessions until the next calendar year starts in January.

There is one exception. Aboriginal and Torres Strait Islander patients can access up to 10 individual allied health sessions per calendar year under the same program, according to the Medicare Benefits Schedule.

Each session must be at least 20 minutes long and must be done face to face with the allied health professional. Group sessions do not count toward these 5 individual sessions.

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How much does Medicare pay per session?

As of July 2025, the Medicare rebate for an allied health session like physiotherapy is $61.80 per session (MBS item 10960). This amount gets reviewed each year when the government applies indexation to the Medicare Benefits Schedule.

The rebate covers part of the cost, not all of it. Most physiotherapy clinics in Australia charge between $80 and $150 per session, according to multiple provider surveys. That means you will usually pay a gap fee, which is the difference between what the clinic charges and what Medicare pays back.

Here is a quick example of how the numbers work for a standard physio session.

1. The clinic charges $100 for a 30 minute session
2. Medicare rebates you $61.80
3. Your out of pocket cost is $38.20

Some clinics do bulk bill, which means they accept the Medicare rebate as full payment and you pay nothing. Bulk billing for allied health is less common than it is for GP visits, but it does exist. Ask the clinic before you book.

Who can you see with Medicare allied health sessions?

Your 5 Medicare allied health sessions can be used with any of these registered professionals.

1. Physiotherapists
2. Exercise physiologists
3. Dietitians
4. Podiatrists
5. Chiropractors
6. Osteopaths
7. Psychologists
8. Occupational therapists
9. Speech pathologists
10. Audiologists
11. Diabetes educators
12. Mental health workers

The professional must have a Medicare provider number and meet the qualification requirements set by Services Australia. Your GP decides which type of allied health professional you should see based on your condition and your care plan.

You can use all 5 sessions with the same type of professional, or mix and match across different ones. Under the new GPCCMP system from July 2025, you can also choose your preferred provider within the type of service your GP has referred you to, even if the referral names a specific practitioner.

How do you qualify for Medicare allied health sessions?

You need to meet all of these requirements to get Medicare rebated allied health sessions.

1. You have a chronic medical condition that has lasted (or is expected to last) at least 6 months
2. Your GP has prepared a GP Chronic Condition Management Plan (GPCCMP) for you
3. Your GP has written a referral to the allied health professional
4. You have not already used your 5 allied health sessions for the calendar year

Common conditions that qualify include arthritis, chronic back pain, diabetes, asthma, heart disease, osteoporosis, depression, and neurological conditions. Your GP makes the call on whether your condition meets the criteria.

The GPCCMP can be prepared once every 12 months and reviewed every 3 months if needed. Referrals issued from 1 July 2025 are valid for 18 months from the first service date, but the 5 session cap resets every calendar year on 1 January.

What changed on 1 July 2025?

The Australian Government replaced the old GP Management Plans and Team Care Arrangements with a single GP Chronic Condition Management Plan (GPCCMP). Here is what changed and what stayed the same.

What changed.

1. GPs now issue a standard referral letter instead of the old EPC referral form
2. There is no requirement for allied health providers to confirm acceptance of the referral
3. Referrals do not need to specify the number of services
4. The system has been simplified into one plan instead of two separate documents

What stayed the same.

1. You still get 5 allied health sessions per calendar year (10 for Aboriginal and Torres Strait Islander patients)
2. You still need a GP referral
3. You still need a chronic condition lasting 6 months or more
4. The rebate amount per session stays the same (indexed annually)

If you had a GP Management Plan and Team Care Arrangement in place before 1 July 2025, you can continue using those plans until 30 June 2027. After that date, you will need to transition to the new GPCCMP to keep accessing allied health services through Medicare.

Can you get more than 5 sessions per year?

No. Medicare caps allied health sessions at 5 per calendar year (or 10 for Aboriginal and Torres Strait Islander patients). There is no way to get additional Medicare funded allied health sessions beyond this limit.

If you need more than 5 sessions, here are your options.

1. Use private health insurance extras cover to help pay for additional sessions
2. Pay out of pocket at the full clinic rate
3. Ask your GP about state or territory funded programs that may provide extra sessions
4. Check if your condition qualifies for other Medicare programs, like the Better Access initiative for mental health (which provides separate sessions with psychologists)
5. Look into group allied health sessions, which are available separately for people with type 2 diabetes (up to 8 group sessions per year on top of the 5 individual sessions)

You cannot claim both Medicare and private health insurance for the same session. It is one or the other.

Are these sessions the same as mental health sessions?

No. The 5 allied health sessions under a GPCCMP are separate from the mental health sessions available under Medicare’s Better Access initiative.

Under Better Access, you can access up to 10 individual sessions per calendar year with a psychologist, social worker, or occupational therapist for mental health treatment. These require a separate Mental Health Treatment Plan from your GP.

You could use both programs at the same time if you qualify for each one. For example, you might use 5 allied health sessions for physiotherapy under your GPCCMP and 10 mental health sessions with a psychologist under Better Access. They come from different parts of the Medicare Benefits Schedule and do not overlap.

How do you make the most of your 5 sessions?

Five sessions per year is not a lot, especially for managing a chronic condition. Here is how to get the most value from each session.

1. Talk to your GP about which allied health services will give you the best results for your specific condition before they write the referral
2. Use your first session to get a full assessment and a take home exercise or management plan you can follow between sessions
3. Space your sessions out across the year instead of using them all at once, so you have ongoing professional support
4. Ask your allied health provider for a written report after your sessions, which they are required to send to your GP after the first and last visit
5. Track how many sessions you have used through MyGov or by calling Medicare on 132 011
6. Combine Medicare sessions with private health insurance funded sessions if you have extras cover, to get more appointments across the year (just not for the same appointment)

Your allied health professional must provide a report to your GP after the first and last session. This keeps your GP informed about your progress and helps with planning your next year of care.

Frequently Asked Questions

Is physiotherapy free with Medicare? Not usually. Medicare provides a rebate of $61.80 per session (as of July 2025), but most physio clinics charge more than that. You pay the gap between the clinic fee and the rebate. Some clinics bulk bill, which means no out of pocket cost, but this is uncommon.

Do I need a new referral every year? Under the new GPCCMP system, referrals are valid for 18 months from your first service date if no expiry is listed. Your 5 session allocation resets each January. Your GP may need to review your plan and issue a new referral when your current one expires.

Can I use all 5 sessions for the same service? Yes. You can use all 5 sessions for physiotherapy, or all 5 for exercise physiology, or split them however your GP recommends. Under the updated GPCCMP rules from July 2025, you have more flexibility in choosing how to use your sessions.

What if I see a provider who does not bulk bill? You pay the full fee to the clinic, then claim the Medicare rebate back. Many clinics process this on the spot using a HICAPS or Tyro terminal, so the rebate goes straight back onto your debit card. You can also claim through MyGov or the Medicare app.

Can I use Medicare and private health insurance for the same session? No. You must choose one or the other for each individual session. You cannot combine Medicare and private health insurance rebates for a single appointment.

What happens if I have used all 5 sessions and need more treatment? You pay the full cost out of pocket, use private health insurance if you have extras cover, or ask your GP about other funded programs. Medicare will not cover additional sessions beyond the 5 per year cap.

Do the 5 sessions carry over to the next year if I do not use them? No. Unused sessions do not roll over. The allocation resets to 5 every January, and you need a valid referral and current care plan to access them.

Can I choose my own allied health provider? Yes. Even if your GP’s referral names a specific provider, you can choose any Medicare registered provider within that profession. For example, if the referral says physiotherapy, you can go to any physiotherapist with a Medicare provider number.

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