Chronic pain management plans: Medicare, GP referrals and physio

What is a management plan?

A GP Management Plan (GPMP) is a written plan from your doctor for a chronic condition or complex care needs. It sets out your health goals, the services you need and what each person involved will do. If you need care from several providers, your doctor can add Team Care Arrangements (TCA), which allow a referral to allied health services such as physio.

Who may be eligible

Medicare generally defines a chronic condition as one that has been, or is likely to be, present for six months or longer. This can include long-term pain related to conditions such as arthritis, osteoarthritis or fibromyalgia. Your GP decides whether you are eligible and whether a plan is appropriate for you.

How Medicare and physio work together

If your GP sets up a plan with Team Care Arrangements and refers you, Medicare may provide a rebate for up to five allied health visits per calendar year. These visits are shared across all eligible allied health services, such as physio, podiatry and dietetics, not five for each. The rebate is a set amount, so the clinic may still charge a gap, and not every clinic bulk bills. Check the current rules on the Services Australia website or with your GP.

How to get one

• Book a longer appointment with your GP and say you would like to talk about a chronic disease management plan
• Describe how your pain affects your sleep, work and daily activities
• Ask if you are eligible, and if so, for a referral to a physio under the plan
• Take the referral to a clinic that accepts Medicare chronic disease management referrals, and ask about their fees and any gap before you book
• Ask your GP when the plan will be reviewed, as plans are usually reviewed after a few months

What a physio does under a plan

Your physio will assess you and agree goals with you, such as walking further, getting through a work day or sleeping better. Treatment is likely to include graded exercise, pacing and education, and many physios report back to your GP. See our guide to physio for chronic pain and fibromyalgia guide for what treatment can look like.

Other ways to fund care

Private health extras often pay a rebate for physio, so check your level of cover. If your pain follows a work injury, a veteran claim or comes with a disability, other schemes may apply, including WorkCover, DVA and the NDIS. For typical fees, see our physio cost guide.

When to see a doctor first

Persistent pain should have been assessed by a doctor, ideally before you start physio. See your doctor promptly if your pain is new, getting steadily worse, follows a fall or injury, or comes with fever, unexplained weight loss, numbness or weakness. For urgent symptoms such as chest pain, trouble breathing or loss of bladder or bowel control, call 000.

Common questions

This guide is general information, not medical advice. Talk to your doctor or physio about your own situation.