Rebates, referrals and what you pay on the day

Physiotherapy is a primary contact profession, so most people at Second Creek book directly without a referral of any kind. Where things get genuinely confusing is what a referral does or does not change about what you pay, because that depends on which of four different paths you are actually on, and clinics are not always clear about which one applies to you.

What follows is the mechanics of each path, plainly. What none of it includes is a dollar figure, because rebate amounts and covered-visit limits are set entirely by your health fund, Medicare or the relevant agency, not by this clinic, and quoting one here would only be wrong for most people reading it.

Four ways an appointment gets paid

What it is

A chronic disease management plan is a Medicare arrangement your own GP sets up, not something a physiotherapist can organise for you. It is for people managing a long-term condition where allied health input, physiotherapy included, forms part of ongoing care. Your GP decides whether you meet the criteria.

What your GP controls

Two things: whether you are eligible at all, and how many allied health visits are covered in that calendar year across every allied health service you use, not just physiotherapy. Once those visits are used, later appointments in the same year go back to the standard fee.

What we cannot tell you

The rebate amount Medicare pays per visit, or how many visits your GP will approve. Both are set by Medicare and your own doctor respectively. Bring the referral to your first appointment and we will bill it correctly on the day; the rest is a conversation for your GP.

Checking with your health fund first

If you are claiming through HICAPS instead, three things are worth confirming with your fund before you book: whether physiotherapy is included in your extras cover, your annual benefit limit for it, and how much of that limit you have left this year. Most extras policies do not require a referral for physiotherapy, but a small number do, so it is worth the two-minute call.