Does Medicare Cover Chiropractic?

Medicare does provide rebates for chiropractic treatment under a programme called Enhanced Primary Care or EPC. There are some conditions to qualify. You must have a chronic condition (classified as longer than six months duration) or have numerous health issues.

You must visit your GP to obtain a referral to a chiropractor. Visit your GP and ask them to prepare an EPC plan which means they must lodge 721 & 723 Medicare forms with Medicare. The doctor can either fax the forms to us on 9509 2929 or you will bring them with you on your first visit.

You are allowed up to five visits in a calendar year. If there unused they are forfeited. They cannot be carried over into the next year but the following year, you may request a new plan. You cannot claim the visits on private health insurance if there were paid by Medicare.

The five visits can be used for a variety of allied health care but only a total of five visits can be used. If you are intending to visit us for chiropractic care, it is strongly suggested you ask your GP for five visits to be nominated. We bulk bill so there are no gap payments. We can only bill Medicare once we have the forms. If you start your care with us before obtaining the Medicare referral you have to pay privately.

As well as the EPC referral your doctor will usually complete a Chronic Disease Management (CDM) plan which lists your health and treatment history enabling us to work in a Team Care Arrangement with your GP.