How much does physiotherapy cost and how much will I get back?

What physiotherapy costs and what you get back are two separate questions. Cost varies between clinics and with the experience of the physiotherapist you see. What comes back depends entirely on which pathway you use: a chronic condition management plan through Medicare, or the extras component of your private health cover.

Why cost and rebate are different questions

People usually ask these together, and then compare clinics on the wrong number. The fee is one thing. What you are actually out of pocket after a rebate is another, and the second is the one that affects you.

A higher fee with a strong rebate can leave you better off than a lower fee with none. Working out the gap is the only comparison that means anything.

What affects the cost

Fees vary between clinics, and they vary with the experience of the physiotherapist you are seeing. Appointment length and the type of consultation also come into it. There is no single figure across the profession, which is why a published price list tends to mislead more than it helps.

Rebates through Medicare

If you are eligible for a chronic condition management plan through your GP, there is a set Medicare rebate for physiotherapy under that plan.

Two things are worth knowing. The rebate amount is published, so you can check it rather than guess. And it changes from year to year, so a figure someone quoted you a while ago may no longer be current.

Rebates through private health extras

If you are using private health, the rebate depends on your level of cover and the type of extras you hold. Some policies return a percentage of the fee, others a fixed benefit per visit, and the amount can differ between services on the same policy.

That variation is why only your insurer can tell you accurately what you will receive. Most now have an app that shows your cover and what comes back per service, which is quicker than a phone call.

Working out your gap

Once you know which pathway applies to you and what it returns, the gap is straightforward. Ask the clinic what the fee is for the appointment you are booking, subtract what your pathway returns, and that is your actual out of pocket.

If you tell us which pathway you are on when you book, we can tell you exactly what the gap will be for your appointment.

Frequently asked questions

How much does physiotherapy cost?

It varies between clinics and with the experience of the physiotherapist you see, so there is no single figure across the profession. The more useful number is your gap, which is the fee minus whatever your rebate pathway returns. Ask the clinic for the fee for your specific appointment type.

Do I need a referral to claim a Medicare rebate for physiotherapy?

For a chronic condition management plan, yes. Your GP assesses whether you are eligible and puts the plan in place. Without a plan there is no Medicare rebate for standard physiotherapy, though you can still claim through private health extras if you hold them.

How much does Medicare give back for physiotherapy?

There is a set, published rebate for physiotherapy under a chronic condition management plan. It changes from year to year, so it is worth checking the current figure directly rather than relying on an amount someone quoted previously.

How much do I get back from private health?

It depends on your level of cover and the extras you hold. Some policies return a percentage of the fee, others a fixed benefit per visit, and amounts can differ between services on the same policy. Your insurer, or their app, will give you the accurate figure.

Can I use both Medicare and private health for the same appointment?

No, you claim through one pathway per appointment, not both. Which one leaves you better off depends on your plan and your level of extras cover, so it is worth checking both before deciding which to use.

What is a gap payment?

The gap is what you actually pay after your rebate. It is the clinic fee minus whatever Medicare or your private health returns for that appointment. It is the only number worth comparing between clinics, because the headline fee on its own does not tell you what you are out of pocket.

Is physiotherapy covered if I do not have extras?

Not through private health, because physiotherapy sits in the extras component rather than hospital cover. You may still be eligible for a Medicare rebate through a chronic condition management plan, or through workers compensation, CTP or NDIS funding depending on your circumstances.