Medicare billing errors are expensive, stressful, and far too easy to make. This Medicare item numbers list gives you a scannable reference you can pull up between clients, covering physiotherapy, psychology, occupational therapy, speech pathology, and related disciplines. You'll find the referral pathways that decide eligibility, the session caps that catch people out, the telehealth items that differ from their face-to-face versions, and the recent MBS changes worth knowing about. With a reference grounded in current MBS rules, billing with confidence is genuinely doable and a lot simpler than it sounds.
What is the Medicare benefits schedule and why does it matter for Allied Health?
The Medicare Benefits Schedule (MBS) is the list of medical services the Australian Government subsidises [5]. Each service carries an item number that sets the rebate and the rules for claiming it. For Allied Health practitioners, the MBS decides when your clients can access a rebate for the care you provide, and under what conditions.
Most Allied Health services aren't directly claimable. A client can't just book a physiotherapy or psychology session and claim it against Medicare the way they would a GP consultation. Access runs through specific referral pathways instead. The two you'll see most are the Chronic Disease Management (CDM) plan, prepared by a GP for clients with a chronic or terminal condition, and the Mental Health Treatment Plan, which opens the door to Better Access psychology and mental health items.
Without the correct plan and referral in place, there's no rebate. The claim gets rejected, or it gets clawed back later. That's why the referral pathway matters just as much as the item number itself. The sections below break this down discipline by discipline. This should help you find the items relevant to your practice, the caps that apply, and the referral conditions that make a claim valid.
CDM Plans, session caps, and key items for Physiotherapy
The main physiotherapy MBS item you'll bill is 10960, the standard Allied Health service delivered to a client on a Chronic Disease Management plan. This covers a face-to-face session of at least 20 minutes for a client whose GP has referred them under a CDM pathway.
How many physio sessions are available on Medicare?
Five per calendar year. However, the five Allied Health sessions under a CDM plan are shared across all eligible Allied Health disciplines, not five per discipline. So if a client has already burned through three sessions with an exercise physiologist, they've got only two sessions left for physiotherapy that year. The count resets on 1 January, not twelve months from their first visit.
The GP referral requirement
For any rebate to apply, the client needs a valid referral from their GP under a CDM plan (previously the GP Management Plan and Team Care Arrangements, now consolidated). The referral has to be current, and it has to specify the number of services. A lapsed or missing referral is the single most common reason a physiotherapy Medicare claim gets rejected on audit.
The conditions that qualify are chronic or terminal medical conditions managed over at least six months, such as arthritis, diabetes, or musculoskeletal conditions needing ongoing management.
CDM-funded versus privately billed sessions
CDM-funded sessions attract a Medicare rebate. Once the five are used, or if the client has no CDM plan at all, sessions get billed privately at your own fee. Being upfront with clients about which sessions carry a rebate heads off billing disputes down the track.
Telehealth physiotherapy items
Telehealth equivalents exist for physiotherapy CDM items, with item 91181 covering phone consultations while item 91166 covers video consultations. Both phone and video consultations must last between 30 and 50 minutes.
Better Access and item 10910 for Psychology
Psychology billing sits under the Better Access to Mental Health Care scheme, with items running through the 80000 to 80170 range depending on session type and provider category. Access begins with a Mental Health Treatment Plan prepared by the client's GP.
The Better Access session limit
Better Access offers clients up to 10 individual sessions and up to 10 group therapy sessions per calendar year. A client accesses an initial course of sessions, then goes back to their GP for a review before continuing. Re-referral is required after that initial course, and once again, the count resets on 1 January rather than rolling twelve months from the first appointment.
What is Medicare item 10910?
Item 10910 covers focused psychological strategies delivered by a GP or an eligible provider, rather than a session with a registered psychologist. It's a GP-delivered mental health service, so you'll usually run into it as context when coordinating care rather than as an item you bill yourself. Knowing it exists helps when a client is baffled about which sessions turned up on their Medicare statement.
Clinical versus registered psychologists
Billing differs by provider category. Clinical psychologists bill under a separate set of items (the 80010 to 80020 range for standard consultations) that attract a higher rebate than the items available to registered psychologists (80100 onward). Both are valid. The distinction reflects endorsement, and it changes the rebate amount your client gets back.
The November 2025 changes
On 1 November 2025, twelve MBS items were removed, including GP mental health items 2712 and 2713 [9]. Reviews and re-referrals that previously used these items are now billed by GPs using standard time-tiered attendance items such as 23, 36, 44, and 123 [9]. If a referral you receive still references a removed item, flag it. A plan built on outdated coding creates billing problems down the line.
Occupational Therapy, Speech Pathology, and Podiatry item numbers
Each of these disciplines attracts a Medicare rebate only when the client has a GP referral under a CDM or, where relevant, a mental health plan. The same five-session annual cap applies across the allied health disciplines sharing a CDM plan.
Occupational Therapy
The core Occupational Therapy item under a CDM plan is 10958, covering a face-to-face service of at least 20 minutes [3]. The common confusion here is the line between Medicare and the National Disability Insurance Scheme (NDIS). These are separate funding streams. A client can't claim the same session against both. Also worth noting, NDIS-funded Occupational Therapy sits entirely outside the MBS. When a client asks why their session wasn't rebated, it's often because their OT is funded through their NDIS plan rather than a CDM referral.
Speech Pathology
Speech pathology bills under item 10970 for CDM-referred clients. Paediatric work throws up frequent questions, because plenty of families assume childhood speech services are automatically Medicare-funded. They're rebated only when the child has a qualifying chronic condition and a current CDM referral. Without that, sessions are privately billed or funded through other schemes such as the NDIS.
Podiatry
Podiatry uses item 10962 under the CDM pathway, again requiring a valid GP referral and drawing on the same shared five-session allocation. Diabetic foot management is a common qualifying scenario.
The consistent thread across all of these stays the same - without a GP referral under a valid plan, there is no rebate. Confirming the referral before the first appointment saves everyone a difficult conversation later.
Mental Health Medicare items by profession
The relevant item numbers depend on both the provider category and the program area, so the service type and who delivers it matter as much as the discipline name. Below is a structured reference you can return to when a mental health billing query lands on your desk.
GP
GPs prepare the Mental Health Treatment Plan, the assessment document that establishes a client's eligibility for Better Access services. Worth getting straight: the plan itself is an assessment document, not a referral. The GP writes a separate referral to the psychologist or eligible allied health provider.
After the 1 November 2025 changes, items 2712 and 2713 were removed [9]. GP reviews and re-referrals now use standard time-tiered general attendance items: 23 (at least 6 minutes), 36 (at least 20 minutes), 44 (at least 40 minutes), and 123 [3]. The Better Access preparation items GPs use to create the plan remain in place.
Psychologist
These break down by session type and provider category:
- Clinical psychologists: items in the 80010 to 80020 range for standard individual consultations, attracting the higher rebate tier
- Registered psychologists: items in the **80100 to 80120** range for individual consultations
- Group therapy and telehealth: These variants have their own items within the 80000 to 80170 span
Allied Health
Occupational therapists and accredited mental health social workers that deliver focused psychological strategies under Better Access bill within the 80150 to 80170 range, again split by provider category and session length.
Let’s look at how this works in practice. For our example, we begin with a client with a Mental Health Treatment Plan who is referred for six sessions with a registered psychologist. In that case, the sequence looks like this:
1. GP prepares the Mental Health Treatment Plan and writes a referral for an initial course of sessions.
2. Sessions one through six are each billed under the registered psychologist individual consultation item (80110 for a standard session of at least 50 minutes, face to face).
3. Because the client has reached the initial course limit, they return to the GP for a review before any further sessions can be billed.
4. On re-referral, remaining sessions up to the annual cap of ten continue under the same item.
Getting the sequence right, and confirming the referral covers the sessions being delivered, is what keeps each claim clean. In practice, the tricky bit isn't the item number. It's spotting the moment a client hits their initial course limit before you've booked them in for a seventh session that won't rebate.
Health assessments and Allied Health implications for items 132 and 133
Items 132 and 133 cover specialized consultant physician assessments and management plans for patients with at least two morbidities (chronic or complex conditions, which can include congenital, developmental, and behavioural disorders).
Item 132 is a comprehensive health assessment for a client with complex, chronic, or multiple medical conditions requiring an ongoing management plan. Item 133 is the follow-up review of that assessment. These are longer, more detailed than a standard consultation, and only a GP can perform and bill them.
Why should this concern your practice? A health assessment under item 132 often triggers referrals into a CDM plan and onward to allied health services. When a GP identifies chronic conditions during a 132 assessment, that's frequently the moment a client gets referred for physiotherapy, occupational therapy, or podiatry under the CDM pathway. Understanding that these assessments sit upstream of your referrals helps you see where your CDM-funded clients come from, and why the care plan they arrive with is structured the way it is.
What is item 63001 and when does it apply?
Item 63001 relates to procedures billed under specific MBS categories, and it is not an Allied Health item. It sits within the diagnostic imaging and procedural areas of the schedule, well away from the allied health items you bill under CDM or Better Access.
Item 63001 covers a diagnostic Magnetic Resonance Imaging (MRI) scan of the head (including a contrast agent and an Magnetic Resonance Angiography [MRA] if performed) to investigate a known or suspected tumour of the brain or meninges (the protective covering of the brain).
You might come across it when a client asks about a number on their Medicare statement, or during a multidisciplinary billing query where several providers are involved in someone's care. In those cases, the honest answer is that 63001 falls outside Allied Health billing. For your own claims, stay with the discipline-specific items covered above: 10960 for physiotherapy, 10958 for occupational therapy, 10970 for speech pathology, and the Better Access range for psychology.
Can chiropractors claim Medicare?
Medicare does not cover standard chiropractic visits. Chiropractic isn't listed as an eligible Allied Health discipline under Chronic Disease Management plans or the Better Access schemeHowever, eligible patients with a chronic condition can access up to 5 subsidised chiropractic sessions per year through a GP Chronic Condition Management Plan (GPCCMP), with a Medicare rebate of approximately $60–$62 per session. A GP referral is required.
There are pathways, just not through standard MBS items. The Department of Veterans' Affairs (DVA) funds chiropractic care for eligible veterans, and many private health funds offer chiropractic cover under their extras policies. When a client asks whether they can claim chiropractic on Medicare, the accurate response is no, followed by a redirect to DVA eligibility or their private health extras. That way they leave with a genuine option rather than confusion.
What procedures are no longer covered by Medicare?
Medicare items change regularly, and billing a removed item lands you a rejected claim and possible compliance issues. The most relevant example for Allied Health and related disciplines is the 1 November 2025 removal of twelve MBS items, including the Better Access GP items 2712 and 2713 [9]. GPs now bill the associated reviews using standard attendance items such as 23, 36, 44, and 123.
These changes come through the MBS Review process, an ongoing program that assesses items for clinical value and appropriate use, then adds, amends, or removes them. Items get retired when they're superseded or consolidated, as happened when the GP Management Plan and Team Care Arrangements items were folded into the current CDM structure.
The practical upshot is blunt: bill a removed or amended item and the claim bounces. To stay current, check MBS Online [7] for the latest item numbers before you adopt any new codes, and treat any referral that references an old item as a prompt to confirm the current equivalent.
Telehealth item numbers for Allied Health
Telehealth items generally mirror their face-to-face equivalents, but with specific eligibility rules attached to patient location, provider registration, and the technology used. Video items are the standard for most allied health telehealth. Phone-only items are far more limited.
For physiotherapy under a CDM plan, item 91181 covers phone consultations while item 91166 covers video consultations.. Psychology telehealth items sit within the Better Access 80000 to 80170 range with their own video variants. In each case, the client still needs the same underlying referral and plan a face-to-face session would require. Telehealth doesn't create a separate access pathway. It's an alternative delivery mode for the same service.
Several telehealth items became permanent after the pandemic-era temporary arrangements ended, so they're a settled part of the schedule now rather than a stopgap. Discipline-specific restrictions still apply, particularly around established clinical relationships and whether phone consultations are permitted for a given service. Confirm the telehealth eligibility conditions before you bill, because they differ from the face-to-face item even when the number looks nearly identical.
Compliance risks of incorrect Medicare billing and how to reduce them
Wrong item numbers, billing without a valid referral, and exceeding session caps each create real audit risk and can lead to rejected claims. A single lapsed CDM referral can turn into a clawback plus the admin time to unwind it, which is exactly the scenario every practitioner wants to dodge.
The common failure points are predictable. A referral that expired mid-course. A client who'd already used their five Allied Health sessions elsewhere before they ever walked in. A plan referencing an item that was removed in the last MBS update. Each one is avoidable with the right checks at the point of booking rather than the point of audit.
This is where practice management software with built-in MBS logic earns its place. splose validates claims against current item numbers, tracks referral expiry and session counts against a client's plan, and flags issues before a claim is submitted rather than months later. That means fewer rejections, less clawback exposure, and confidence that the item you're billing is the right one for the service delivered. It backs up the careful billing you already aim for, with a lot less manual checking to get there.
Keep this reference close and bill with confidence
A well-organised, compliant practice isn't built on perfect memory. It's built on good reference points and reliable systems working quietly in the background. That's what splose was designed to do for Australian Allied Health practices, so the item you bill is the right one, every time. Bookmark this reference and come back to it between clients. Better still, spend a few minutes this week checking your current claims against the referral expiry dates and session counts on your active plans. When it comes to claims, all it takes is fixing a few small habits today to prevent big clawbacks down the track.
