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Medicare Care Plans
If you have a chronic health condition, you may be eligible for Medicare-subsidised allied health sessions through a GP care plan. Also known as a Chronic Disease Management (CDM) or Enhanced Primary Care (EPC) plan, this pathway provides up to 5 rebated sessions per calendar year with our physiotherapists, exercise physiologists, or occupational therapists.
How It Works
What Is a Medicare Care Plan?
A Medicare Care Plan is created by your GP for patients living with a chronic condition that has lasted (or is expected to last) 6 months or more. Your GP assesses your health needs, develops a management plan, and provides a referral for up to 5 allied health sessions per calendar year under Medicare.
These sessions are subsidised by Medicare, and at Nexus Health Group we offer gap-free billing for eligible services — meaning there may be no out-of-pocket cost to you. Your 5 sessions can be split across different allied health disciplines depending on your needs.
Conditions That Qualify:
- Chronic back or neck pain
- Arthritis and joint conditions
- Diabetes (Type 1 and Type 2)
- Heart disease and cardiovascular conditions
- Chronic respiratory conditions
- Neurological conditions
- Chronic musculoskeletal conditions
- Any condition lasting 6+ months
Services Available Under Medicare
Your 5 Medicare sessions can be used for any of our three disciplines, or split between them based on your needs.
Physiotherapy
Hands-on treatment for chronic pain, musculoskeletal conditions, and post-surgical rehabilitation. Our physios will assess your condition, provide manual therapy, and develop a home exercise program to manage your symptoms between sessions.
Exercise Physiology
Exercise-based management of chronic conditions including diabetes, heart disease, arthritis, and obesity. Our EPs design safe, structured programs that help you build strength, manage your condition, and improve your overall health — all backed by the latest evidence.
Occupational Therapy
Support for daily living, home safety, and functional independence. If your chronic condition is affecting your ability to perform everyday tasks, our OTs can provide practical strategies, equipment recommendations, and environmental modifications to help.
Getting Started
How Medicare Care Plans Work
The process starts with your GP. Here’s what to expect from referral to treatment.
01
See Your GP
Book an appointment with your GP and ask about a Chronic Disease Management (CDM) plan. Your GP will assess your condition, create a management plan, and provide a referral for allied health services. This may require a longer appointment.
02
Book with Us
Contact us with your GP referral and Medicare card details. We’ll schedule your first appointment and let you know about any gap fees before you attend. We offer gap-free billing for eligible services.
03
Receive Treatment
Attend up to 5 Medicare-rebated sessions per calendar year with our allied health team. We’ll provide a thorough assessment, develop a personalised plan, and send progress reports back to your GP to support ongoing management of your condition.
Common Questions
Medicare Care Plans FAQs
What conditions qualify for a Medicare Care Plan?
Any chronic condition that has lasted or is expected to last 6 months or more. Common examples include arthritis, chronic back pain, diabetes, heart disease, asthma, obesity, and neurological conditions. If you’re unsure whether your condition qualifies, ask your GP — many conditions are eligible.
How many sessions do I get?
Medicare provides rebates for up to 5 allied health sessions per calendar year under a CDM plan. These 5 sessions are shared across all allied health providers — so if you see a physio, EP, and OT, the sessions are drawn from the same pool of 5. Your plan resets each January.
Is there an out-of-pocket cost?
We offer gap-free billing for eligible Medicare services, which means there’s no out-of-pocket cost for most patients. For services where a small gap applies, we’ll let you know the exact amount before your appointment so there are no surprises. You can also use your private health insurance to cover any gap.
Can I see multiple allied health professionals?
Yes. Your 5 sessions can be split across different disciplines based on your needs. For example, you might use 3 sessions for physiotherapy and 2 for exercise physiology. At Nexus, our team collaborates to make sure your limited sessions are used as effectively as possible.
Book with a Medicare Care Plan
If you have a GP care plan referral, contact us to schedule your first session. Not sure if you’re eligible? Ask your GP or give us a call.
Nexus Health Group 