Chiro under Medicare for First Nations Australians

Are you aware that First Nations Australians are eligible to receive up to 10 sessions of Chiropractic or allied health treatment each year under medicare for management of chronic conditions when referred through your GP? 

It is generally well understood that up to 5 treatments can be claimed through medicare each year for management of chronic conditions with a referral for Medicare Care Plan, also referred to as EPC (Enhanced Primary Care) or CDM (Chronic Disease Management) plans.

From the 1st March 2024 there have been changes made to the allied health referrals for First Nations Australians under Medicare. A total of 10 appointments can be referred, either as a combination of 5 care plan visits and 5 allied health services for First Nations Australians, or simply the full 10 visits under the allied health for First Nations scheme.

In fact, the Medicare Care Plan Referral Program in general was revamped as of 1 July 2025, rebranding into the GPCCMP or GP Chronic Condition Management Plan. 

How does the referral for Chiro under Medicare for First Nations Australians Work?

To receive a referral to be able to claim up to 10 appointments under medicare, all you need to do is visit your GP or family doctor and discuss your eligibility for referral under the appropriate schemes.

It is important to note that it is up to the judgment of your GP as to whether or not you will be eligible for either a care plan or allied health for First Nations Australians referral. Generally these programs are for patients with a chronic medical condition, such as chronic back pain, neck pain or another musculoskeletal condition ongoing for 6 months or more.

Are the 10 sessions bulk billed under medicare?

At Fortitude Chiropractic, patient’s will incur a gap fee when claiming treatment under medicare care plans and allied health referrals for First Nations Australians. This means you will be required to pay our standard consult fees in full, and we will process a Medicare claim on your behalf. You will receive a rebate through Medicare, meaning that in effect you only pay the difference out-of-pocket. Here is a useful page on our website with information about out-of-pocket fees for Medicare care plans. 

What is a medicare care plan?

Medicare Care Plans, also known as GP chronic condition management plans (GPCCMP), Enhanced Primary Care (EPC) or Chronic Disease Management Plans (CDM) is a  Medicare Program that allows GP’s to plan and coordinate treatment for patients with a chronic medical condition. If patients are suffering with chronic musculoskeletal conditions such as chronic neck or lower back pain, the GP may refer for up to 5 allied health sessions including Chiro each calendar year. These plans require a GP referral. 

For more info on care plans check out our blog about Medicare covered Chiropractic services.

Want to find out more about how we can help?

If you’d like more information about how Medicare Care Plans or Allied Health Referrals for First Nations Australians work or already have your referral, contact us today!

If you’re looking to understand how chiropractic treatment works under other government schemes and referrals, including DVA, ICWA, and WorkCover, see more useful information here.

Our Scarborough Chiropractic team is here to help you get out of pain and back moving again. You can Book Online instantly through our website.

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