Updated: Oct 3
Do you need quality physiotherapy in Brisbane, Queensland? Are you concerned about the potential costs? The solution could be Australia’s Medicare and bulk billing.
Bulk billing in Australia enables patients who hold a valid general practitioner referral to get physiotherapy services without the burden of additional expenses. The physiotherapist bills the government directly, so the patient is not liable for the costs.
In this article, we look at bulk billing and Medicare in more detail, how these payment options work, as well as how you can receive high-quality care while saving money at our Indooroopilly physiotherapy clinic.
Bulk Billing and Medicare for Physiotherapy
Physiotherapy is one of the many healthcare services covered by Medicare, Australia’s publicly funded healthcare scheme. Medicare will cover some physiotherapy-related costs, providing Australians with increased access to these services.
How Does Medicare Work with Physiotherapy Services?
The process begins with consulting your general practitioner. Your GP will determine whether you need to see a physiotherapist and/or another specialist to treat your condition. Depending on your GP’s assessment, you will receive a referral for treatment from an allied health physiotherapist. Your referral will also include details about any chronic medical conditions you may have.
You can book an appointment with a Medicare-accepted physiotherapist as soon as you have your GP referral. Medicare will cover the cost of the services, however, note that Medicare does not cover all physiotherapy services and treatments. So, always ask about Medicare, bulk billing, and what exactly is covered whenever you schedule an appointment.
What is Bulk Billing?
Bulk billing is a payment system used by accredited healthcare providers to bill Medicare for the services provided to eligible patients. Consequently, patients can avoid incurring any out-of-pocket expenses. With bulk billing, you give your consent to swipe your Medicare card, and your physiotherapist is compensated with a set fee for the service and/or consultation.
Bulk Billing for Physiotherapy: How it Works
As per Services Australia, physiotherapists (item 10960) can claim Medicare benefits for eligible patients. To make a claim (and get the rebate), the allied health physiotherapist must engage in a consultation with the eligible patient for at least 20 minutes.
All consultations must be one-on-one and in-person, and it should be noted that Medicare does not typically cover telehealth consultations, home visits, or group physiotherapy sessions (i.e. group treatments). Your physiotherapist will verify your eligibility via Australia’s Health Professional Online Services’ (HPOS) Medicare Benefits Schedule (MBS) online checker.
Individuals qualify for bulk billing if they are under a GP management plan (GPMP). The GPMP is also known as the Enhanced Primary Care (EPC) plan, which dictates the number of physiotherapy sessions that Medicare permits – generally up to five appointments per calendar year.
It’s important to note that these sessions include both physiotherapy and podiatry, which means that you would have three physiotherapy consultations and two podiatry visits covered by Medicare, or five physiotherapy visits, and so on. It’s worth highlighting that your individual physiotherapy treatment may involve more sessions than the five sessions covered by Medicare.
The Medicare rebate will be accepted as the complete payment for the physiotherapist’s services. So, you won’t have any out-of-pocket expenses or need to make any gap payments. Note that bulk billing typically covers general treatments and consultations, although specialised services or treatments might still require some additional costs that you would need to pay.
Do I need a concession card for bulk billed physiotherapy?
No worries if you don’t have a concession card! While other clinics often require a valid concession card or Department of Veterans Affairs (DVA) card for bulk billing eligibility, AlignHC clinics do not. The only thing you need is an EPC plan referral from your GP.
Bulk Billed Physiotherapy Services in Brisbane
Physiotherapy sessions related to chronic conditions and individuals with complex care needs or multidisciplinary plans are the most frequently bulk billed allied health appointments. MBS Online defines chronic medical conditions as conditions that are present for six months or more. MBS Online provides the following examples: asthma, cancer, cardiovascular illness, diabetes mellitus, musculoskeletal conditions, and stroke.
Even if you don’t need chronic disease management (CDM) or complex care, it’s still a good idea to check if you’re eligible for bulk billing with your GP and/or physiotherapist.
Medicare and Bulk Billing Benefits
There are several advantages to choosing a bulk billing physiotherapist in Brisbane:
- Cost savings: The Medicare rebate enables bulk billing physiotherapists to offer accessible treatment options with very low or no out-of-pocket expenses, which makes essential care more affordable for patients.
- Simple billing process: Bulk billing allows the physiotherapist to bill Medicare directly, so patients do not need to make any upfront payments or claim a rebate later.
- Quick access to care: Medicare’s bulk billing system streamlines the payment process, meaning individuals can access essential physiotherapy care without delays.
- Ongoing care: Bulk billing enables patients with chronic conditions or limited financial means to maintain regular visits to their physiotherapist, ensuring ongoing care and management of their health.
At Align Health Collective in Brisbane, QLD, our highly experienced physios understand how bulk billing and Medicare can help you with your overall standard of living, which is why we are dedicated to providing our patients with efficient, stress-free payment processing.
We offer a range of effective, tailor-made physiotherapy treatment plans, customised to suit your individual needs. Contact us today to schedule a consultation and take the first step towards healing.
Frequently Asked Questions
What do Medicare bulk billed physiotherapy appointments include?
A Medicare bulk billed physio appointment will generally include an initial consultation, diagnosis, and treatment plan developed by the physiotherapist and other relevant specialists in the physiotherapy clinic. In most cases, the consultation includes a comprehensive assessment as well as a detailed review of your medical history.
Following the assessment, the physiotherapist will determine the appropriate treatment plan for your specific needs. This plan might involve one or multiple visits to address and manage your condition. Remember, not all physio treatments and services are covered under Medicare, so it is essential to consult with your physiotherapist about your options.
How are bulk billed and standard appointments different?
The primary difference between a bulk billed and a standard appointment is in how the payment is processed. In a bulk billed appointment, the physiotherapist charges the Medicare Benefits Schedule (MBS) fee for the consultation, and Medicare covers the entire cost. As a result, bulk billed appointments leave you with no out-of-pocket expenses.
On the other hand, during a standard appointment, the physiotherapist may charge a fee above the Medicare rebate amount, and you will be responsible for paying the difference. This difference, known as the “gap”, varies depending on factors such as the specific physiotherapist or clinic and the service provided. Some individuals also opt for additional private health insurance to cover gap payments.
How much is the Medicare rebate for physiotherapy?
The Medicare rebate amount varies based on the type of service provided to you. To find out about the exact rebate amount you are entitled to, you should contact Medicare or check their website.
Does Medicare cover the full cost of physiotherapy appointments?
While Medicare offers coverage for many physiotherapy services, it may not always cover the full fee for the appointment. The amount reimbursed to the physio by Medicare is determined by the MBS fee for the specific service provided.
In some cases, physiotherapists may charge more than the MBS fee, leading to a gap payment that the patient would need to cover. However, many Medicare-accepted physiotherapists opt for bulk billing, effectively covering the entire cost of the appointment without out-of-pocket expenses for the patient.
