Are you looking for physiotherapy services in Melbourne, Victoria? Are you worried about the cost of your treatment? Well, Australia’s Medicare and bulk billing options may be just what you need.
Bulk billing in Australia is a system that patients who have a valid referral from a general practitioner can use to receive physiotherapy services without any out-of-pocket expenses. This is possible because the physiotherapist bills the government directly, so the patient is not responsible for any 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 Melbourne physiotherapy clinic.
Understanding Bulk Billing and Medicare in Physiotherapy
Medicare, a publicly funded universal healthcare system in Australia, covers a wide range of healthcare services, including physiotherapy. Medicare supports some of the costs related to physiotherapy services, making physiotherapists more accessible to Australians.
How Medicare Works in Physiotherapy
The first step is to consult your GP, who will decide if you require treatment from an allied health physiotherapist. Your GP will give you a referral, which will outline the services you require. Additionally, if you suffer from a chronic medical condition, your GP will include how you can benefit from allied health services.
When you have your referral, you can schedule appointments with Medicare-accepted physiotherapists and their services will be covered by bulk billing. It’s important to note that Medicare does not cover all physiotherapy services, so when you book your appointment, be sure to ask about Medicare and bulk billing coverage.
What is Bulk Billing?
Bulk billing is a payment system that qualified healthcare providers use to bill Medicare directly for the services they provide to eligible patients. In this way, patients can avoid paying any out-of-pocket expenses.
When your physiotherapist bulk bills, you will give your consent to swipe your Medicare card, and your physiotherapist will receive a fixed fee for the service and/or consultation.
How Does Bulk Billing Work for Physiotherapy?
Services Australia notes that physiotherapists (item 10960) may claim Medicare benefits for eligible patients. To claim, the allied health physiotherapist must consult with the eligible patient for at least 20 minutes.
Physiotherapy consultations must be conducted one-to-one and in person. It’s important to note that Medicare does not normally cover telehealth consultations, home visits, or physiotherapy sessions with more than one patient (group treatments). Your physiotherapist will confirm your eligibility using Australia’s Health Professional Online Services’ (HPOS) Medicare Benefits Schedule (MBS) online checker.
Individuals are eligible to be bulk billed if they are on a GP management plan (GPMP), aka Enhanced Primary Care plan (EPC). The EPC plan defines the number of sessions that Medicare allows – typically up to five appointments per calendar year. These appointments include both physiotherapy and podiatry, meaning that you could have three physiotherapy sessions and two podiatry visits covered by Medicare, or five physio visits, etc. It’s worth noting that while Medicare covers five visits per year, your specific physiotherapy treatment may require more sessions than Medicare covers.
Your physiotherapist will accept the Medicare rebate as the full payment for their services. This means that you will not have to pay any gap fees or out-of-pocket expenses. Bulk billing usually covers general treatments and consultations, however, specialised services or treatments may still require some out-of-pocket costs.
Do I need a concession card?
No concession card? No problem! Whereas other physiotherapy clinics may require a valid concession card or Department of Veterans Affairs (DVA) card to be eligible for bulk billing, our patients do not. All you need is the EPC plan referral from your GP and you will be eligible for bulk billing at our clinic.
Bulk Billed Physiotherapy Services in Melbourne
The most common bulk billed physiotherapy sessions are related to chronic conditions and individuals with complex care needs or multidisciplinary plans. However, bulk billing applies to many physiotherapy treatment plans, so even if you don’t need chronic disease management (CDM) or complex care, you should still get in touch with your GP to see if you may be eligible for bulk billing.
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.
Medicare and Bulk Billing Benefits
There are several advantages to choosing a bulk billing physiotherapist in Melbourne:
- 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 Melbourne, VIC, 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.
