Medicare Physiotherapy in Logan QLD: What Your GP Care Plan Referral Covers in 2026

The short answer: With a GP Chronic Condition Management Plan, Medicare pays $63.40 towards each physiotherapy visit (item 10960), for five allied health visits a year. There is a gap to pay, and we tell you what it is before you book.

People arrive at reception holding a referral letter and ask us the same thing: “so this means it is free, right?” Fair assumption — nobody explains the numbers at the GP surgery. Here is the plain version.

Do I qualify?

There is no official list of conditions. Medicare asks two things: that you have a condition which has lasted, or is likely to last, six months or more, and that your GP thinks a structured plan would help you manage it.

In our clinic that usually means knee or hip osteoarthritis, long-standing back or neck pain, a chronic respiratory condition, type 2 diabetes, Parkinson’s or post-stroke recovery. The six-month rule and your GP’s judgement decide it, not the label.

Worth saying to your GP: not “can I get a physio referral”, but “this has been going on eight months and it is limiting me — is a chronic condition management plan worth considering?”

What does Medicare actually pay?

The item number is 10960. Medicare pays 85% of the schedule fee, which comes to $63.40 a visit from 1 July 2026. Our fee sits above that, so a gap applies. We claim the benefit on the spot through HICAPS, so you are not chasing a refund.

You also cannot claim Medicare and your private health extras for the same visit. That is why it often pays to save your plan visits for when your extras run out, rather than using both in January.

How many visits do I get?

Five per calendar year, January to December. The part people get wrong: those five are pooled across every allied health profession on your plan. Three physio and two podiatry uses the lot. They reset on 1 January and do not roll over.

Being honest about it: five visits is a start, not a full course of rehab for something you have had for years. What it buys is a proper assessment and a programme you can keep running — many people then continue in gym-based rehab or clinical Pilates, or carry on at home with a review now and then.

What does the referral need to say?

Since 1 July 2025 it is simpler. A letter is fine — signed, dated, with your GP’s name and practice details and the reason for referring you. It no longer has to state how many sessions.

It runs for 18 months from your first appointment under it, not from the date it was written. Your plan itself needs to have been written or reviewed in the last 18 months. Plans written before July 2025 still work until 30 June 2027.

If your referral looks odd, bring it anyway. Older-style forms stay valid until their sessions are used, and even a lost referral is not a dead end. Ring us on 07 3209 2000 and we will tell you where you stand before you book something you cannot claim.

Do I have to see the physio my GP named?

No. A physiotherapy referral can go to any physiotherapist you choose — though it cannot be used for chiropractic or podiatry. Afterwards your physio writes back to your GP, which is the part that turns five appointments into something your doctor can build on.

What if I am not eligible?

A care plan is only one route, and often not the best one. DVA Gold and White Card holders have a more generous pathway. NDIS participants are not capped at five visits. For someone in residential aged care, we work on-site under contract. If none of those fit, private physio with extras cover is usually simpler than chasing a plan you may not qualify for.

Where does this apply?

These are national Medicare rules. We are in Logan City, Queensland — south of Brisbane, not Logan in Utah or Ohio — at U4 11–13 Allamanda Dr, Daisy Hill QLD 4127, seeing care-plan patients from Springwood, Slacks Creek, Shailer Park, Underwood and across Logan since 1987. More on our Medicare physiotherapy page and our Logan physiotherapy page.

Bring your referral and your Medicare card. You can book an appointment online any time, or call 07 3209 2000 and tell reception what you are trying to get back to doing. No referral yet? Book anyway — if a care plan looks right we will write to your GP with what we found.

This explains how the funding works. It is not a diagnosis, and whether a care plan suits you is a question for your GP. If symptoms are new, severe or getting worse quickly, contact your doctor rather than waiting for an appointment.

Reviewed by Joshua Hopton, Principal Physiotherapist at Daisy Hill Physio, U4 11–13 Allamanda Dr, Daisy Hill QLD 4127. Reviewed 14 August 2026.

Sources: MBS Online item 10960 (schedule fee $74.55, benefit 85% = $63.40), accessed 14 August 2026; MBS explanatory notes AN.15.3, AN.15.5, AN.15.6 and MN.3.1 (published 1 November 2025); GP chronic condition management plan items 965, 392, 92029 and 92060, which replaced items 721 and 723 on 1 July 2025.