How To Pay For Podiatry?

Here at The Feet People, we’re committed to getting you back on your feet so you can live and move without pain. No matter your podiatry needs, we accept a range of payment options to ensure everyone has a range of options to see and be treated by one of our experienced podiatrists. Here’s what you need to know about paying for your podiatry services with us.

Ways To Pay For A Podiatrist in Australia — Updated

Below is a refined description of each payment method based on the latest Medicare, NDIS, DVA, home care, and allied-health funding rules as of July 2025.

1. Out-of-Pocket Payments

Paying out of pocket means you cover the full cost of the appointment or service at the time of visit. This method remains valid and is often used when:

• Your treatment is not covered by any insurance or government rebate
  
• You prefer to avoid delays with claims or approvals
  
• The service is cosmetic, elective, or outside the scope of rebateable care
  

You will receive a receipt/invoice for your payment, which you may later use to submit claims (if applicable) to insurers, Medicare (where relevant), or funding programs.

2. Private Health Insurance (Allied Health/Podiatry Cover)

Many private health insurance policies include allied health or podiatry benefits. However:

• Coverage depends on your insurer, the specific policy, and level of cover
  
• Not all podiatry services (e.g. orthotics, custom footwear, etc.) may be included
  
• The insurer may require you to submit claims or may offer a “gap” arrangement
  

Best practice: When booking your appointment, request the item codes for the treatments you expect (e.g. orthotic fitting, biomechanical assessment). You can call your insurer in advance to confirm:

• Whether the codes are covered
  
• The rebate amount you can expect
  
• Whether you need to pay upfront and claim later or whether the clinic can submit on your behalf

3. Medicare (Chronic Condition / Allied Health Rebates)

Recent Changes (Effective from 1 July 2025)

• The prior system of GP Management Plans (GPMPs) and Team Care Arrangements (TCAs) has been replaced by a GP Chronic Condition Management Plan (GPCCMP).
• A single referral letter (rather than a prescribed referral form) is required for allied health services under chronic condition arrangements.
• The referral letter must contain certain minimum information (referrer name, practice address or provider number, date, explanation of condition, etc.).
• Referrals to allied health under the chronic conditions framework are valid for 18 months, unless otherwise specified.
• You must have your GP’s plan prepared or reviewed within the past 18 months to maintain eligibility.
• Transition arrangements: Patients under older GPMP/TCA arrangements (in force prior to 1 July 2025) can continue to access allied health under those until 30 June 2027.

How Medicare Works for Podiatry

• If your GP includes podiatry under your GPCCMP (or under older valid care plans until transition ends), you may access up to five Medicare-subsidised allied health services per calendar year, including podiatry.
• Each service must be at least 20 minutes in duration.
• The Medicare rebate is typically 85% of the scheduled benefit (for eligible services) — e.g. item 10962 for podiatry.
• Clinics may require you to pay in full up front and then claim the rebate from Medicare (or via HICAPS) on the day.
  
• The receipt must clearly state the MBS item code claimed.
  
• If you do not have a GPCCMP or equivalent valid care plan, Medicare will not provide a rebate for podiatry.
  

Note: Treating podiatry services as “medical” in nature does not guarantee Medicare coverage outside of this framework.

4. National Disability Insurance Scheme (NDIS)

How Podiatry Fits into NDIS

• Podiatry and foot care supports are classified under “disability-related health supports.” NDIS+1
  
• The service must be directly related to your disability and help you pursue your goals (e.g. mobility, independence).
• The NDIS will not fund supports more appropriately funded by Medicare or the health system. (I.e., if a service is already covered by Medicare, it usually is not duplicatively funded by NDIS).

Payment Options

There are two common methods for NDIS participants to pay:

1. Provider claims the funding directly

• The podiatry provider submits a claim via the myplace provider portal, using the NDIS support item codes.
• Payment is typically processed within 2–3 business days.

     2. Self-fund then reimbursement

• Participant pays the provider at time of service, obtains a detailed receipt/invoice
• Participant or their nominee submits a payment request via the myplace portal to have the funds reimbursed into their nominated account (usually within 48 hours).

When booking, the podiatrist may ask for your NDIS number, plan start date, and your funding arrangements to ensure correct billing. You may fill out our NDIS Referral Form.

Because NDIS reforms are ongoing, providers need to closely align services with what is defined as “reasonable and necessary” and substantiate the disability link.

5. Home Care Package / My Aged Care (for older Australians)

If you are a Home Care Package (HCP) recipient or under My Aged Care, allied health services like podiatry may be included if they are assessed and approved in your care plan.

• The Home Care Package Program includes allied health and specialist services in its allowable services under the inclusions/exclusions framework.
• Services must align with your assessed care needs and be documented in your care plan.
• You will typically need referral or approval from your Home Care provider (or care manager) prior to the appointment.
• The provider may coordinate the payment directly from your HCP funds on your behalf.

Not every podiatry service (especially high-cost devices or elective items) may be eligible under HCP — it depends on the classification under the inclusion/exclusion guidelines.

6. WorkCover / Workers’ Compensation

If your foot, ankle, or lower-limb injury is work-related and covered under WorkCover / workers’ compensation, the cost of podiatry treatment may be covered, subject to:

• Prior approval from the relevant WorkSafe or compensation authority
  
• Having the injury accepted under compensation claims
  
• The podiatry provider may need to liaise with the insurer or case manager
  
• Referral is usually not required from a GP, but prior approval / acceptance is critical
  

Important: All non-routine treatments or devices (e.g. orthotics) should be cleared with the insurer beforehand to avoid disputes.

7. Department of Veterans’ Affairs (DVA)

If you hold a DVA Gold Card or White Card, you may receive podiatry services at no out-of-pocket cost, subject to:

• A DVA D904 referral from your GP prior to attending the appointment (this referral is valid for 12 months or up to 12 visits, whichever comes first).
• The podiatry services must fall under the Schedule of Fees for Podiatrists.
• For orthotic devices or more specialized items, prior approval from DVA may be required.
• A DVA claim must be made using the correct item numbers and within the allowable annual limits.
• If you receive a service not in the fee schedule, that portion may not be claimable unless pre-approved.

Be sure to bring your card, referral, and any supporting documentation to your appointment.

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