Medicare CDM Plans Explained
Last updated September 2026. Check current figures with your GP when discussing a Medicare CDM
If your GP has just mentioned a “care plan,” or you’ve got a chronic condition and you’ve heard Medicare can help pay for physio, chiro or exercise physiology, here’s the short version: if you have a health condition that’s been around (or is likely to be around) for six months or more, your GP can refer you for up to five Medicare-subsidised allied health sessions per calendar year. That allocation is shared across physio, chiro, exercise physiology, podiatry, dietetics and other allied health services — not five sessions each. Medicare pays a set rebate per session, and most clinics, including ours, charge a gap on top of that.
What is a chronic disease management plan?
The scheme used to be called a Chronic Disease Management (CDM) plan, and before that an Enhanced Primary Care (EPC) plan — you’ll still see both names used interchangeably, including by us in places, because that’s what most people search for. As of 1 July 2025, it was formally renamed the GP Chronic Condition Management Plan (GPCCMP), and the process was simplified: your GP no longer needs to arrange a separate Team Care Arrangement alongside it.
Whatever it’s called, the mechanics are the same: your GP documents your condition and care goals, then refers you to allied health providers. That referral is what unlocks the Medicare rebate for your physio, chiro or EP sessions. If you already had an old-style GP Management Plan or Team Care Arrangement in place before July 2025, it keeps working under transition arrangements until 1 July 2027 — you don’t need to rush out and replace it.
Who qualifies for a CDM care plan?
Eligibility is broader than most people assume. There’s no fixed checklist of approved conditions (it comes down to your GP’s clinical judgement) but the general test is a condition that has been present, or is likely to persist, for six months or longer. In practice, that covers things like:
- Diabetes (type 1 or 2)
- Osteoarthritis and other joint conditions
- Chronic or recurrent back pain
- Osteoporosis
- Cardiovascular disease
- Chronic pain conditions
- Obesity
- Neurological conditions such as Parkinson’s disease
To put it simply: knee arthritis that’s been building for a year comfortably qualifies. Last week’s calf strain from Saturday sport doesn’t, that’s an acute injury, and it’s a different funding conversation (private fees or health fund extras, not Medicare).
How many physio sessions does Medicare cover?
This is the part that trips people up, so it’s worth being precise.
| Feature | Details |
|---|---|
| Sessions per calendar year | Up to 5 individual allied health sessions (10 for Aboriginal and Torres Strait Islander patients) |
| Shared across | All allied health disciplines combined — physio, chiro, EP, podiatry, dietetics, psychology, etc. |
| Resets | Each calendar year (1 January), regardless of when your plan was made |
| Carries over? | No — unused sessions don’t roll into the next year |
| Type 2 diabetes extra | A separate allowance of up to 8 group allied health sessions per year, if your GP assesses you as suitable |
The catch that catches people out: it’s five sessions total, not five physio sessions plus five EP sessions. If you use two sessions on a podiatrist for diabetic foot care, you’ve only got three left for physio or EP that year. Your GP decides how the referral allocates them, but you can ask for the split you actually want.
How much is the Medicare rebate for physio or exercise physiology?
As of the most recent indexation, the Medicare rebate for a CDM-referred allied health session is $63.40. That’s the rebate — not the fee. Most clinics, including VIBE, charge above the rebate to cover the cost of a full consultation, which means there’s a gap payment on the day.
How do I ask my GP for a care plan?
This is genuinely one of the easier conversations to have with your GP, you’re not asking for anything unusual, and GPs write these regularly. A simple approach:
- Book a standard GP appointment (sometimes a slightly longer one, since the GP needs to document your condition and goals. Ask the reception staff when booking if a longer slot is needed).
- Say it plainly: “I’d like to talk about a GP Chronic Condition Management Plan for my [condition] — I’d like to use it for physiotherapy/exercise physiology at VIBE.”
- Bring relevant history — any existing diagnosis, scan reports, or specialist letters help your GP document the plan accurately, though they’re not always essential.
- The GP prepares the plan and referral, which names the allied health provider type (e.g. physiotherapy) and how many of your five sessions are allocated.
The referral itself typically takes one appointment. From there, you bring the referral to us (or your GP can send it directly), and we handle billing the Medicare rebate at your first visit.
What happens once you’re referred
Bring the referral to your first appointment, or have your GP’s practice send it through to us beforehand. On the day, we bill the Medicare rebate directly and you pay the gap. From there, this is real treatment with a plan behind it, not a punch card of five generic visits. We assess your condition, set goals, and report back to your GP at agreed points so your care stays coordinated.
Once your five sessions for the year are used, you’ve got three options: continue on private fees, claim through private health extras cover if you have it, or wait for a new referral in the next calendar year.
CDM sessions vs private health extras — using both
A common point of confusion:
can you use both Medicare and your private health extras cover?
Yes, but not on the same session — Medicare and extras don’t stack on a single visit. What you can do is use your five CDM-funded sessions first, then switch to extras cover (if you have it) for anything beyond that.
Someone managing knee osteoarthritis across a year of physio and gym-based exercise therapy:
- Sessions 1–5: billed under the CDM plan, Medicare rebate applied each time, gap paid on the day.
- Session 6 onward: billed privately, then claimed back through private health extras (subject to your fund’s annual limits and waiting periods).
- Following January: a new GPCCMP referral can be arranged if ongoing management is still needed, giving another five subsidised sessions.
This is exactly the kind of long-term management our knee osteoarthritis article]and exercise for diabetes article go into in more depth, and it’s just as relevant for conditions like osteoporosis.
Common questions, quick answers
Do care plans renew every year? The five-session allocation resets every calendar year, but you generally need a new or reviewed plan from your GP to keep accessing it. Referrals issued from mid-2025 onward are valid for 18 months, so you may not need a brand-new plan every single year — your GP will guide you.
Can I split sessions between physio and exercise physiology? Yes — within the total of five, your GP can allocate sessions across whichever allied health disciplines suit your condition.
Does telehealth count? Some allied health services can be delivered via telehealth under a GPCCMP, but rules vary by service type and eligibility — check with your GP or with us before assuming a telehealth session will attract the rebate.
What about DVA or NDIS? These are separate funding pathways with their own rules and aren’t part of the Medicare CDM system. If NDIS applies to you, our NDIS article covers that pathway in detail.
The bottom line
If you’ve got a condition that’s hung around for six months or more, there’s a decent chance you qualify for subsidised physio or EP sessions. Most people simply don’t know to ask. It’s a five-minute conversation at your next GP visit, and we’re happy to talk you through exactly what to say and how the referral works.
Give us a call or book online at either of our clinics, and we’ll help you make the most of your five sessions.