Disclaimer: This article provides general information about Medicare and chiropractic coverage in Australia. It is not financial or medical advice. Medicare rebates, item numbers, and policy details change regularly. Always confirm current details with Services Australia, your GP, or your health fund before making decisions about your care.
The question everyone asks at reception
If you work in a chiropractic clinic long enough, you hear this question multiple times a week: “Does Medicare cover this?” It usually comes right after the first appointment, when the patient realises they want to keep coming back but is doing the mental maths on what that looks like over a few months.
The honest answer is a bit more complicated than yes or no. And the number of people who walk in expecting Medicare to cover everything, only to find out they needed a GP referral first and can only get five visits a year, is genuinely surprising. So let’s clear it all up properly.
The short answer
Medicare does not directly cover standard chiropractic visits in Australia. You cannot just book in with a chiropractor, show your Medicare card, and get a rebate. That is not how it works, and it has never worked that way.
However, there is a pathway. If you have a chronic musculoskeletal condition, your GP can set up what is called a Chronic Disease Management (CDM) plan, which opens the door to Medicare rebates for up to five allied health visits per calendar year. Chiropractic is one of the allied health services covered under this arrangement.
So the real answer is: Medicare can partially cover chiropractic, but only through a GP referral under a specific care plan, and only for chronic conditions. If you just tweaked your back playing weekend sport, this pathway is not designed for you.
How CDM plans actually work
The CDM plan (sometimes still called an EPC plan, after its old name, Enhanced Primary Care) is a structured arrangement between your GP and allied health providers. As of July 2025, the government updated and renamed these arrangements under the Chronic Condition Management (CCM) framework, but most people and clinics still refer to them as CDM or EPC plans out of habit.
Here is how the process works in practice.
Step 1: See your GP. You need to have a chronic condition that has lasted, or is expected to last, six months or more. This could be chronic low back pain, neck pain, osteoarthritis, or other ongoing musculoskeletal issues. Your GP needs to agree that your condition qualifies and that allied health input would benefit your management.
Step 2: Your GP prepares the plan. The GP creates a care plan that identifies which allied health services you need. They will specify chiropractic if that is what you are being referred for. The plan outlines your condition, your treatment goals, and the providers involved.
Step 3: You get a referral. Your GP gives you a referral to a specific chiropractor (or you can ask for a referral to the one you already see). This referral is what allows the chiropractor to bill Medicare on your behalf.
Step 4: Book your chiropractic appointments. You take the referral to your chiropractor and book in. The chiropractor will process your Medicare rebate at the time of your visit, usually through HICAPS or online claiming.
Step 5: You get up to five visits per calendar year. This is important. The five visits are shared across all allied health services on your plan. So if your GP refers you to both a chiropractor and a physiotherapist, those five visits are split between them. You do not get five of each. You get five total.
One thing worth knowing: the plan needs to be reviewed by your GP at least once during the year. If your plan lapses or is not reviewed within the required timeframe (currently 18 months from preparation or last review), your referrals may no longer be valid. Stay on top of this, because clinics cannot always chase it up for you.
What the rebate actually covers (and the gap you will pay)
Here is where expectations often crash into reality. The Medicare rebate for allied health services under a CDM plan is currently around $56 to $62 per session, depending on the specific item number and the most recent indexation. As of mid-2025, the rebate sits at approximately $60 to $62 for a standard chiropractic consultation under the updated CCM items.
Most chiropractors charge somewhere between $60 and $100 for a standard adjustment. That means even with the Medicare rebate, you will likely have a gap payment of anywhere from nothing to $40 per visit. Some chiropractors choose to bulk bill CDM patients, meaning they accept the Medicare rebate as full payment with no out-of-pocket cost to you. But that is becoming less common, especially in metro areas where overheads are higher.
Let’s put some numbers to this. Say your chiropractor charges $85 per visit and the Medicare rebate is $61. Your gap is $24. Over five visits, you are paying $120 out of pocket for the year, and Medicare is covering $305. That is not bad at all. But if your chiropractor charges $100 and does not bulk bill, your gap is $39 per visit, or $195 for the year.
The key point: CDM plans reduce the cost significantly, but they do not eliminate it entirely, and five visits is the ceiling. If you need ongoing weekly care, you will be paying full price for everything beyond those five sessions.
Private health insurance for chiropractic
Private health insurance is the other common way Australians offset chiropractic costs. Chiropractic is classified as an “extras” benefit, meaning it is covered under extras or ancillary cover, not under hospital cover.
How much you get back depends entirely on your policy. Most mid-range extras policies will cover somewhere between $300 and $600 per year for chiropractic, with per-visit limits that typically range from $30 to $60. Some higher-tier policies go up to $800 or more annually. But you need to read the fine print, because the per-visit cap can be surprisingly low even on policies with decent annual limits.
A few things to watch out for:
Waiting periods are standard. Most funds impose a two-month waiting period on extras cover before you can claim for chiropractic. If you are signing up specifically because you need chiropractic care right now, you will be out of pocket for those first two months.
Annual limits reset on a set date, not when you joined. Most funds reset on 1 January or 1 April. If you join in November, your annual limit might only cover you for a month or two before it resets. That can work in your favour or against you, depending on timing.
Combined limits are common. Many policies lump chiropractic in with other therapies like physiotherapy, osteopathy, and remedial massage under a single “musculoskeletal” or “bodywork” limit. So if you are claiming physiotherapy and chiropractic from the same pool, you will hit the cap faster.
Can you use both Medicare CDM rebates and private health insurance? Yes, but not for the same visit. You cannot double-dip. For your five CDM visits, you claim through Medicare. For any additional visits beyond those five, you claim through your private health fund. This is actually a smart strategy if you need regular care throughout the year.
DVA, WorkCover, and CTP
If you are a veteran with a DVA Gold Card, chiropractic care is covered at no cost to you, provided you have a referral from a GP or specialist. The referral is valid for 12 sessions or one year, whichever comes first. After that cycle, you need a new referral to continue. Gold Card holders cannot be charged any gap fee by the chiropractor. It is worth noting that you cannot receive chiropractic and physiotherapy (or osteopathy) for the same condition at the same time under DVA, so you will need to choose one pathway.
White Card holders can also access chiropractic care, but only for conditions accepted as related to their service.
For workplace injuries, WorkCover (or its state equivalent, like Return to Work SA in South Australia, or WorkSafe in Victoria) typically covers chiropractic treatment as part of an approved rehabilitation plan. Your employer’s insurer needs to approve the treatment, and there is usually a process involving your treating doctor and the insurer’s case manager. The paperwork can be a headache, but the upside is that approved treatment is generally covered in full.
If you have been injured in a motor vehicle accident, CTP (Compulsory Third Party) insurance in most states, or TAC (Transport Accident Commission) in Victoria, can cover chiropractic treatment related to the accident. Again, you will need documentation linking your treatment to the accident, and the insurer will typically need to approve ongoing care. These claims can be slow to process, but they do cover chiropractic in most cases.
Common mistakes and misconceptions
After years of navigating this system, these are the misunderstandings that come up over and over again.
“Medicare covers chiropractic.” Not directly. Only through a CDM plan, only for chronic conditions, and only up to five allied health visits per year. Walk-in visits without a care plan get zero Medicare rebate.
“I can get unlimited visits under my CDM plan.” No. Five is the maximum per calendar year, shared across all allied health providers on your plan. Some people assume they get five for chiro, five for physio, and five for psychology. They do not. It is five total.
“Any GP will set up a CDM plan for me.” In theory, yes. In practice, some GPs are reluctant. A few do not fully understand how CDM plans work for chiropractic specifically, and others are hesitant to refer to chiropractors for various reasons. If your regular GP is not on board, it is worth having a direct conversation about why you think chiropractic would benefit your chronic condition management. If that does not work, you may need to find a GP who is more familiar with allied health referral pathways.
“The Medicare rebate covers the whole visit.” For some bulk-billing chiropractors, it does. But for the majority, there will be a gap. Always ask your chiropractor what their CDM fees are before your first appointment so you are not caught off guard.
“My CDM plan lasts forever.” Plans need to be reviewed by your GP. Under the updated CCM framework, the plan must be reviewed within 18 months. If it lapses, your referrals become invalid. Set a reminder in your phone.
“I can use my private health extras and Medicare for the same appointment.” No. You can use one or the other per visit, not both. But you can use Medicare for your five CDM visits and then switch to private health claiming for the rest of the year.
A practical cost breakdown
Let’s compare the three main scenarios for someone who visits a chiropractor fortnightly (roughly 26 visits per year) at a clinic that charges $85 per standard visit.
Paying fully out of pocket: 26 visits at $85 = $2,210 per year. Simple, no paperwork, but expensive.
Using a CDM plan only: 5 visits with a Medicare rebate of approximately $61 each = $305 covered by Medicare. Your gap on those 5 visits (at $24 each) = $120. The remaining 21 visits at full price = $1,785. Total out of pocket: $1,905. You save about $305 compared to paying cash for everything.
CDM plan plus mid-range private health extras: Same 5 CDM visits with $120 gap. Then 21 remaining visits, with private extras covering (say) $40 per visit up to an annual limit of $500. That is roughly 12 visits partially covered before you hit the cap. Out of pocket on those 12 visits: $540 (12 x $45 gap). Remaining 9 visits at full price: $765. Total out of pocket: $1,425, plus whatever your extras premium costs. A typical extras policy runs $800 to $1,500 per year, so the maths only stacks up if you are also claiming other extras like dental, optical, or remedial massage.
The honest truth? If chiropractic is the only reason you are considering private health extras, it probably is not worth it unless you are on a very high-frequency treatment plan or your policy has a generous chiropractic limit. Where extras cover really pays off is when you are using multiple services across the year.
When does it all make sense?
The CDM pathway is a no-brainer if you have a genuine chronic condition. Even if you only get five visits at a reduced rate, that is real money saved with relatively minimal hassle. The main barrier is getting the GP referral sorted, and keeping the plan current.
Private health extras make sense if you are already using them for dental, optical, or other allied health, and chiropractic is an added bonus. Signing up for extras purely to cover chiro visits rarely works out financially unless you are a very frequent patient.
For veterans, the DVA pathway is excellent and underutilised. If you have a Gold Card, there is no reason not to access chiropractic care when you need it.
And for anyone dealing with a workplace injury or car accident, make sure your chiropractic care is included in your approved treatment plan from the start. Adding it later can involve more paperwork and delays.
Finding a chiropractor near you
Whatever pathway you use to fund your care, the most important thing is finding a chiropractor who is a good fit for your needs and your condition. If you are looking for a registered chiropractor in your area, you can search our Australia-wide chiropractor directory to find practitioners by location, technique, and the services they offer.