Chiropractic care is not covered by Medicare in the ordinary course of events. There is one pathway, and it runs through your GP: if your GP decides you have a chronic condition that would benefit from coordinated care, they may prepare a GP Chronic Condition Management Plan and refer you to allied health services under it. Chiropractic is one of the professions that can be included.

This page explains how that pathway works, what it covers and what it does not, so you know where you stand before you book. Whether a plan is appropriate for you is a clinical decision for your GP, not something we can arrange on your behalf.

What is a GP Chronic Condition Management Plan?

A GP Chronic Condition Management Plan (GPCCMP) is a structured plan your GP prepares to coordinate the long-term care of a chronic health condition. It records your diagnosis, your health goals, the treatment approach and any other practitioners involved in your care.

From 1 July 2025 this single plan replaced the previous two-part arrangement of a GP Management Plan and a separate Team Care Arrangement. If you had a plan in place before that date, it generally remains valid until 30 June 2027, after which your GP will need to move you onto the newer plan for you to keep accessing subsidised allied health services.

Who may be eligible

Eligibility is assessed by your GP. Broadly, a chronic condition is one that has been present, or is likely to be present, for six months or longer. There is no fixed list of qualifying conditions — your GP weighs your circumstances and decides whether a plan is clinically appropriate.

Where chiropractic is included in a plan, it is usually in relation to a long-standing musculoskeletal problem such as persistent low back pain, persistent neck pain, or headache arising from the neck. Your GP determines which services go into your plan.

How the referral works

Once your GP has prepared the plan, they issue a referral letter for the allied health services they consider appropriate. A few things are worth knowing about that referral:

• It is specific to the profession named on it. A referral written for physiotherapy cannot be used for chiropractic, and the reverse is also true.
• You are not tied to a particular clinic. You may take a chiropractic referral to any chiropractor registered with Medicare as an eligible provider.
• Referrals are now issued as a letter rather than the old structured form, and they no longer have to state a number of sessions.
• Bring the referral to your first appointment. Without it, we cannot process a Medicare claim.

The five-visit limit — and what it actually means

A patient with a management plan may claim up to five individual allied health services per calendar year. Aboriginal and Torres Strait Islander patients may be eligible for up to ten.

This is the point most often misunderstood, so it is worth stating plainly: the five visits are shared across every allied health profession in your plan. They are not five visits per profession. If your plan includes chiropractic and podiatry and you have already used three podiatry visits, two remain for the year in total.

The count resets on 1 January and unused visits do not carry over. Medicare does not notify you as you approach the limit, so it is your responsibility to keep track. You can check how many allied health services you have claimed this year through your Medicare online account via myGov, or through the Express Plus Medicare app.

What you pay

The Medicare rebate for a chiropractic service under a management plan is set by the Australian Government under item 10964. As at 1 July 2026 the rebate is $63.40 per visit (The amount will change each year). The amount is reviewed and indexed each July.

The rebate is a contribution towards the cost of the visit, not the full fee. The difference between our fee and the rebate is payable by you — this is commonly called the gap. Our reception team will tell you the exact out-of-pocket amount before your appointment, and we can process the Medicare claim electronically at the time of your visit so the rebate is paid back into your nominated bank account.

To be claimable, the service must be an individual consultation of at least 20 minutes with the chiropractor.

Medicare or private health insurance — not both

You cannot claim a Medicare rebate and a private health fund benefit for the same visit. If you hold extras cover, it is worth thinking about which you would rather use and when. Some patients prefer to use their private cover for chiropractic and keep their five Medicare visits for another service in their plan. Your fund can tell you what your extras cover provides.

What happens at your appointment

We will take a history and examine you in relation to the condition described in your GP’s referral, then discuss what we find and what we would suggest from here. Care under a management plan is directed at the specific condition your GP has identified.

As the referring practitioner, your GP is entitled to be kept informed. We provide a written report to your GP after your first visit and after your final visit under the referral, and at other times if there is something they should know. This is a requirement of the Medicare arrangements and it also helps keep your GP’s picture of your care current.

Common questions

Can I get a Medicare rebate for chiropractic without a care plan?

No. Outside a GP management plan there is no general Medicare rebate for chiropractic services. Separate arrangements may apply for eligible Department of Veterans’ Affairs patients and for approved workers’ compensation or motor vehicle injury claims.

Can you arrange a care plan for me?

No. Only your GP can assess whether a management plan is appropriate and prepare one. If you think a plan may be relevant to your situation, raise it at your next GP appointment.

Do I need a new plan every year?

Not usually. An existing plan stays in place, though your GP will review it periodically and may issue a fresh referral. If your referral has run out but you still have visits available in the current calendar year, ask your GP for a new referral.

Does my chiropractor have to accept the referral?

Accepting a referral is at each practitioner’s discretion. We are happy to discuss your referral with you before you book so you know what to expect.

What if I have used all five visits?

You are welcome to continue care as a private patient, or to use private health extras cover if you hold it. Your allowance resets on 1 January.

Booking with a referral

If you have a referral for chiropractic from your GP, call us on (08) 9306 4949 and let reception know it is under a care plan. We will confirm the fee, the rebate and what you will be out of pocket before you come in.

Sunset Coast Chiropractic, Unit 7 / 925 Wanneroo Road, Wanneroo WA 6065.

This page is general information about Medicare arrangements current at the time of writing. Rebate amounts and program rules are set by the Australian Government and change from time to time. It is not a substitute for advice from your GP about your own health.