If you are living with chronic or persistent pain from arthritis, back issues, fibromyalgia and other long-term health conditions, osteopathy can be a real lifeline.
If cost is a barrier that is keeping you from benefiting from osteopathy as part of your pain management, then you will be pleased to know that there are ways to access medicare funding and rebates for this vital health service.
Claiming For Osteopathy Through Medicare
So how does Medicare cover osteopathy and how do you access these funds? Firstly, you must meet the criteria outlined under Medicare’s chronic disease management allowances.
The main criteria you must meet to qualify for these allowances are:
- You have a chronic medical condition that has been (or is likely to be) present for six months or longer, for example, asthma, cancer, cardiovascular disease, diabetes, musculoskeletal conditions and stroke.
- Your chronic medical condition requires multidisciplinary care with a GP and at least two other health care providers. GP, orthopaedic surgeon and an osteopath.
You then need to send this care plan to your chosen Osteopath or have your GP do this on your behalf.
Be careful when selecting your osteopath as to be eligible for the rebate, your Osteopath must be in private practice and formally registered with Medicare Australia. If you are unsure who to see in your area, your GP will be able to provide recommendations.
Limitations Of The Medicare CDM Program
While Medicare will cover some of the costs of your treatment by an Osteopath under the CDM program, they only allow for up to 5 rebated consults per calendar year.
Under the CDM you can also access services from other Allied Health practitioners including physiotherapists, podiatrists, speech therapists, psychologists or dietitians. No matter which practitioner you see, the 5 consults per calendar year will apply.
To renew your access to the CDM each year, you simply need an updated referral and CDM plan from your GP.
How Is The Rebate Processed?
As our practice does not bulk-bill, you will be billed the full fee for your consultation upfront at the conclusion of your appointment. We will then lodge this with Medicare who will reimburse you $56.00 into your bank account that is registered with Medicare.
The gap fee is the difference between the allowable rebate and our fees. You cannot claim both Medicare and private health insurance for the same appointment.
For more details about the fees billed for our Osteopath services, please visit our dedicated Osteopathy page.
How Much Is The Rebate?
For each of your appointments under the CDM, you are eligible for a rebate of $56.00 (based on published 2021/2022 allowances). This amount is subject to change and at Medicare’s discretion.
Reporting Requirements
For your CDM benefits to continue, your chosen Osteopath will send a written report to your GP after the first and last consultation, or more frequently if clinically necessary.
Our reports include details of any assessments we have carried out, diagnosis, treatment provided, recommendations for future management and more.
Receive Quality Care With Inspire
At Inspire Health And Medical, our Osteopaths have completed a minimum of five years of tertiary study and are registered with AHPRA. They are committed to delivering holistic care that seeks to improve the performance of your neuro-musculoskeletal system.
Through a variety of techniques, our lead Osteopath Dr Emily Collins will help to reduce your pain and enhance daily function for a more comfortable, fulfilling life. Osteopaths may perform neurological and orthopaedic examinations, manual therapy such as massage, stretching, dry needling, manipulation and prescribe exercise programs for long term relief and management.
Experience an enhanced level of care with Inspire Health and Medical and put your CDM rebate to the best use. Call today on 1300 947 477 to learn more.
