(Also known as Enhanced Primary Care Plans)
Are therapy costs covered by Medicare?
Generally, therapy services are not covered by Medicare. However, you may be able to access a Chronic Disease Management Plan. You will need to be assessed by your doctor for eligibility who can then refer you to Superyou Therapy.
You can use the CDMP plan for up to 5 Speech Pathology, Physiotherapy or Occupational Therapy sessions and will receive a certain amount rebated per visit.
The item numbers are:
- Occupational Therapy: 10958
- Physiotherapy: 10960
- Speech Pathology: 10970
How much do I get subsidised?
As of November 2022, you will receive $55.10 back from Medicare for each session you attend. You will be required to pay the amount in full and then claim the rebate from Medicare.
Can I use my private health insurance to pay the balance?
No, this is considered “double dipping” and your private health insurance will not pay a rebate if you have already claimed with Medicare.
Should I use my private health insurance or my CDMP plan?
This is completely up to you. Check with your private health insurance company to make sure you are covered for Speech Pathology, Occupational Therapy or Physiotherapy (depending on what service you require).
Often, private health insurance companies do rebate a higher amount for assessment sessions so you may choose to use this for your initial assessment, rather than your CDMP plan.
How often can I get a new CDMP Plan?
You are eligible for 5 rebated services each calendar year. This means 5 total, not for each therapy service.
Can I use my CDMP rebates for group sessions or telehealth?
No. CDMP sessions must be individual, face to face sessions for a minimum of 20 minutes.
Can I use my CDMP rebates for travel?
No. You will be charged for the time it takes your clinician to travel to and from an appointment. You will also be charged for additional costs incurred with travelling to deliver face-to-face services (such as parking fees and the running costs of the vehicle).
We do have clinic rooms for you to attend sessions to avoid these travel costs. Please speak to our administration team or your clinician for more information. You may also find more information on the Australian Government Department of Health’s “Chronic Disease Management” PDF here.
Who can I talk to for more information?
Our team are here to answer any of your queries from 8.30am-4.30pm Monday to Friday. Please call (08) 6263 8623 or email hello@superyou.org.au.