Relief That’s Rebated: Osteopathy and Medicare
- Xavier Grech - Osteopath at Prom Health
- 2 hours ago
- 3 min read
AI images often are perplexing... so is Medicare. So we have tried to make sense of recent changes to Medicare plans and osteopathy.
From 1 July 2025, Medicare has updated how people with chronic and long-term conditions access rebates for allied health care, including osteopathy. These changes introduce a simpler, more flexible system for coordinating care with your GP while continuing Medicare support for eligible osteopathy treatment at Prom Health.
What Is a GP Chronic Condition Management Plan?
Medicare has replaced older care plans (GP Management Plans and Team Care Arrangements) with a single plan called the GP Chronic Condition Management Plan (GPCCMP).
The GPCCMP allows your GP to coordinate your care and refer you to eligible allied health providers, including osteopaths at Prom Health.
Existing GPMP or Team Care Arrangement plans remain valid until 30 June 2027, but new referrals after this date require a GPCCMP [1].
Eligibility for Medicare-Rebated Osteopathy
To qualify for Medicare rebates at Prom Health:
You must have a chronic or long-term condition that has been present (or is likely to be) for 6 months or more, or a terminal condition.
Your condition must be managed by a GP through a GPCCMP that has been prepared or reviewed within the last 18 months [2].
Your GP determines whether your condition and treatment needs are appropriate for a care plan and rebated osteopathy.
Conditions That May Qualify
Medicare does not provide a fixed list, but common examples where osteopathy may be included are:
Persistent neck, back, shoulder, hip, or knee pain
Arthritis (e.g., osteoarthritis, rheumatoid arthritis)
Ongoing musculoskeletal injuries
Post-surgery rehabilitation or joint replacement recovery
Chronic tension headaches or migraines
Postural or movement-related issues
Fibromyalgia or chronic fatigue
Pregnancy-related musculoskeletal pain
Your GP will assess eligibility based on your individual health needs [2].
How Many Medicare‑Subsidised Osteopathy Sessions Can You Access?
Standard provision: up to 5 allied health sessions per calendar year, including osteopathy, physiotherapy, podiatry, dietetics, etc [3].
Exceptional circumstances: Your GP can authorise additional sessions if there is a significant change in your clinical condition. The claim must note either “exceptional circumstances” or “significant change in clinical condition” [4].
Medicare rebates cover approximately $61.80 per osteopathy session (item 10966), with any gap payment payable at Prom Health [3,5].
How to Access Medicare-Rebated Osteopathy at Prom Health
See Your GP: Discuss your chronic condition and whether a GPCCMP is appropriate.
GP Prepares the Plan: Your GP creates or reviews a GPCCMP and provides a referral letter for allied health services, including osteopathy.
Book Your Appointment at Prom Health: Bring your referral. We process your Medicare rebate, and you pay the remaining gap fee.
Ongoing Care: Rebates and sessions reset each calendar year. Exceptional circumstances allow for additional visits if clinically needed.
Common Questions
Q: Can I mix allied health services?Yes — the 5 standard sessions per year apply across all allied health providers. You could use some sessions for osteopathy and others for physiotherapy, podiatry, or dietetics [3].
Q: What if my health condition changes?Your GP can review or update your GPCCMP more frequently if there is a significant change in your clinical condition [4].
Q: What if I already have a care plan?Existing plans are valid until 30 June 2027. After that, you’ll need a GPCCMP for new allied health rebates [4].
Q: Can I use private health insurance too?Medicare rebates cannot be claimed alongside private health fund rebates for the same session. Some patients use Medicare rebates for the first sessions and then use private health cover for additional sessions if needed [2].
Why Choose Osteopathy at Prom Health?
Our osteopaths provide hands-on, personalised care for chronic musculoskeletal conditions. When coordinated through a GPCCMP, osteopathy can help:
Reduce pain and inflammation
Improve movement, posture, and function
Support recovery after surgery or injury
Enhance overall quality of life
Medicare rebates make this care more accessible and affordable.
Ready to Book?
If you think osteopathy could help with your chronic condition, ask your GP about a GP Chronic Condition Management Plan. Once your referral is ready, Prom Health is here to support you.
📞 Phone: 03 5959 1900📅 Book online: https://promhealth.au/book
References (Vancouver style)
Services Australia. MBS billing rules for GP Chronic Condition Management Plans. 2025. Available from: https://www.servicesaustralia.gov.au/mbs-billing-rules-for-gp-chronic-condition-management-plans?context=20
Royal Australian College of General Practitioners (RACGP). Chronic disease management: FAQs for GPs. 2023. Available from: https://www.racgp.org.au/FSDEDEV/media/documents/Advocacy/CDM-FAQs.pdf
Australian Government Department of Health. MBS item 10966: Chronic disease management – Individual allied health services. 2025. Available from: https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=10970&qt=item
Services Australia. MBS billing rules for GP Chronic Condition Management Plans – exceptional circumstances. 2025. Available from: https://www.servicesaustralia.gov.au/mbs-billing-rules-for-gp-chronic-condition-management-plans?context=20
Australian Government Department of Health. Upcoming changes to chronic disease management framework – Overview. 2025. Available from: https://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/650f3eec0dfb990fca25692100069854/35bc9280594efa33ca258c9200126149/$FILE/PDF%20Version%20-%20Upcoming%20Changes%20to%20Chronic%20Disease%20Management%20Framework%20-%20Overview.PDF
