Fees and rebates
Medicare rebates for chiropractic care
Yes, but only through a care plan. Chiropractic is not automatically covered by Medicare. Where your GP puts you on aGP Chronic Condition Management Plan (GPCCMP), Medicare contributes to a limited number of allied health visits a year, and chiropractic can be one of them.
This page covers who qualifies, what you get back, how to ask your GP for a plan, and the things that most often go wrong.
$63.40
Rebate per session
10964
MBS item
5
Visits per year
6+ months
Condition lasting
Rebate current as at 1 July 2026. Medicare indexes it each 1 July.
What you actually pay
You pay the consultation fee on the day. The clinic submits your claim to Medicare electronically at the same time, and the rebate is deposited into your nominated bank account, usually within one to two business days.
Our chiropractic appointments are not bulk billed.Medicare provides a set rebate for eligible allied health appointments rather than covering the full fee, so there is a gap on every appointment. The figure below is what that gap comes to here.
| Standard consultation | $78.00 |
| Medicare rebate, item 10964 | − $63.40 |
| Gap payable by you | $14.60 |
Who qualifies
You may be eligible if:
- You have a chronic condition that has lasted, or is expected to last,6 months or more
- Your GP agrees chiropractic care belongs in your management plan
- You are not currently a resident of a residential aged care facility, different arrangements apply there
Since 1 July 2025 the old requirement to involve two or more collaborating providers has been removed. Your GP can refer you to chiropractic directly.
Conditions that commonly qualify
There is no fixed list. Whether a condition qualifies is your GP's clinical judgement. These are the presentations that commonly come up in a chiropractic context:
- Ongoing neck or back pain
- Sciatica or nerve-related pain
- Arthritis or degenerative joint changes
- Persistent musculoskeletal problems
- Postural syndromes or repetitive strain injuries
- Headaches or migraine linked to musculoskeletal causes
How to get a plan
The plan comes from your GP, not from this clinic, and it has to exist before your first rebated appointment.
- 1
Book a longer appointment with your GP
Say you want to discuss whether you are eligible for a GP Chronic Condition Management Plan. Ask for a long consultation, preparing a plan takes more than a standard appointment.
- 2
Your GP assesses your condition
To qualify, your condition needs to have lasted, or be expected to last, at least 6 months. Since 1 July 2025 your GP can refer you directly, the old requirement to involve two other providers has gone.
- 3
Your GP prepares the plan and a referral letter
Referrals are no longer submitted on a structured Medicare form. It is a standard letter, which can be signed and sent electronically.
- 4
Ask for a copy of the referral
The clinic needs it before your first rebated appointment. Some GPs send it directly, but having your own copy saves a phone call.
The item numbers your GP claims
Not numbers you need, but knowing them makes the request concrete if you are unsure how to ask.
- Item 965Preparation of a GPCCMP
- Item 967Review of a GPCCMP, every three months where clinically appropriate
EPC, CDM, GPCCMP, three names, one pathway
If your GP or a previous clinic used a different acronym, they were describing the same thing at a different point in time. The program has been renamed twice; what it does has not changed.
The original program. Still the name many patients use.
Required two separate documents, a GP Management Plan (GPMP) and Team Care Arrangements (TCA), with input from at least two other providers.
Rolls the GPMP and TCA into one plan, and drops the requirement to involve two other providers.
Things that catch people out
- Rebates cannot be backdated. The plan and referral must exist before the appointment.
- You cannot claim Medicare and private health for the same visit. Compare the two, if your extras cover pays more than $63.40, claiming through HICAPS may leave you better off, and it does not use a plan visit.
- The 5 visits are shared across every allied health service on your plan, not 5 per service.
- The year is a calendar year. Unused visits do not carry over; the count resets each 1 January.
What to bring to your appointment
- Your referral letter, if your GP has not already sent it
- Your Medicare card
- The bank account details Medicare has for you, if they have changed
- Any relevant imaging or reports
If a chiropractor is not the right answer
A care plan does not commit you to anything. The chiropractors here screen at the assessment and will say so rather than treat. If specialist care is the next step, you will get a detailed letter outlining our findings and recommendations, including the specialist we believe is best suited to your needs, so the plan can be redirected rather than wasted.
Every consultation fee and item code is on the fees page. For anything about your own Medicare record, Services Australia is the source, servicesaustralia.gov.au , or check your remaining visits in the Medicare app or through myGov.
Frequently asked questions
Is chiropractic covered by Medicare?
Not automatically. Medicare contributes to chiropractic only through a GP Chronic Condition Management Plan, a plan your GP prepares for a condition that has lasted, or is expected to last, at least 6 months. With a plan and a written referral in place, Medicare pays $63.40 per session under MBS item 10964, for up to 5 allied health visits a calendar year.
How much will I actually pay?
A standard consultation is $78.00. You pay that on the day, Medicare rebates $63.40, and the gap to you is $14.60. The rebate goes to your nominated bank account, usually within one to two business days.
Do you bulk bill chiropractic appointments?
No, our chiropractic appointments are not bulk billed. Medicare provides a set rebate for eligible allied health appointments, rather than covering the full appointment fee. For eligible patients with a GP Chronic Condition Management Plan, the Medicare rebate is $63.40 (item 10964). Our appointment fee is $78.00, leaving a $14.60 gap after the Medicare rebate. We can process your Medicare claim at the clinic, so you don't need to lodge it yourself. The rebate is generally paid directly into your nominated bank account within a day or two.
Can I use Medicare and my private health fund for the same visit?
No. You choose one or the other for a given appointment. It is worth comparing: if your extras cover pays more than the Medicare rebate, claiming through HICAPS may leave you better off, and it does not use up one of your five plan visits.
Can I choose which chiropractor I see?
Yes. Since 1 July 2025 a referral only has to name the type of service, chiropractic, rather than a specific practitioner, so you can take it to any eligible registered chiropractor. Even where your GP suggests someone, you are not obliged to see them. You can ask your GP to keep the referral provider-neutral or to name your preferred chiropractor; either is acceptable.
Do the five visits have to all be chiropractic?
No. The 5 visits are shared across every allied health service on your plan. You might have three chiropractic and two physiotherapy, for instance. Your GP decides what the plan includes. Aboriginal and Torres Strait Islander patients are eligible for up to 10 visits a calendar year.
I was on an EPC or CDM plan years ago. Is it still valid?
If you had a GP Management Plan and Team Care Arrangement in place before 1 July 2025, those remain valid until 30 June 2027. You do not need to switch immediately. After that your GP prepares a GPCCMP instead.
Can the rebate be backdated?
No. Your plan and referral must be in place before the appointment. Medicare rebates cannot be backdated, so a visit before the paperwork exists is a private appointment, claimable on private health cover, but not on Medicare.
How long does my referral last?
18 months from your first session, unless your GP specifies otherwise. Your plan itself should be reviewed by your GP, typically every three months where that is clinically appropriate.
What if I use all five visits and still need care?
You continue as a private patient and claim on your private health cover through HICAPS at the desk, or you go back to your GP to discuss whether a review changes anything. The plan year resets each 1 January.
Ready to book?
Bring your referral and Medicare card, and reception will handle the claim at the desk. Not sure whether your plan covers chiropractic? Call (03) 9388 8237 and ask.