The Short Answer: Yes, With a GP Referral
One of the most common things I hear from new patients is: “I didn’t know you could claim exercise physiology on Medicare.” It surprises people, but it’s been available for years, and for patients with chronic conditions, it can make a significant difference to what care is accessible and affordable.
The Chronic Disease Management Plan
The gateway to Medicare-funded exercise physiology is the Chronic Disease Management (CDM) Plan. This is a formal care plan your GP prepares when you have a chronic medical condition lasting, or expected to last, six months or more. Under a CDM Plan, your GP can refer you to accredited exercise physiologists for up to five Medicare-rebated sessions per calendar year.
Medicare Item Numbers for Exercise Physiology
- 10950 — Initial individual allied health treatment
- 10952 — Subsequent individual allied health treatment
- 10953–10970 — Group allied health treatments
Which Conditions Qualify?
- Type 2 diabetes and pre-diabetes
- Cardiovascular disease and cardiac rehabilitation
- Osteoporosis and osteopenia
- Obesity
- Chronic musculoskeletal conditions (back pain, arthritis)
- Cancer (during or after treatment)
- Depression and anxiety
- COPD
- Neurological conditions (Parkinson’s, stroke rehabilitation)
How to Get a GP Referral
Book with your GP and ask for a Chronic Disease Management Plan for exercise physiology. Check that the referral specifically names exercise physiology — item numbers are profession-specific and a generic referral can cause billing complications.
Gap Fees and Private Health Rebates
Medicare rebates don’t cover the full session cost in most practices. Many private health insurance funds also cover exercise physiology under extras cover — you may be able to claim both, up to the cost of the session.
Accessing Medicare Exercise Physiology at Gordon Chiropractic Rose Bay
I am an ESSA-accredited exercise physiologist in Rose Bay, Eastern Suburbs Sydney. I accept CDM Plan referrals from GPs and can see patients under Medicare, private health insurance, WorkCover, and the NDIS. The integration of chiropractic and exercise physiology under one roof means complex patients don’t need to split care between multiple providers.
Book with Dr Gordon: Ask your GP for a CDM Plan referral, then call Gordon Chiropractic & Exercise Physiology on (02) 9371 7774 or book online at gordonchiropractic.com.au.