Can You Claim Myotherapy on Private Health Insurance?

Mick Breen

11 hours ago

4 min read

Yes, in most cases. If your extras cover includes remedial massage, you can claim your myotherapy session on the spot at my Thornbury clinic with HICAPS. How much you get back depends on your fund and your level of cover. I have seen anywhere from 5% to 100% of a session paid back. Medicare doesn't cover it, and you don't need a GP referral.

I'm Mick, the myotherapist at Melbourne Soft Tissue Therapy in Thornbury. Most of my clients use their health fund to help pay for treatment, because it really does take the sting off the price. Most people already know they have cover. Where they get stuck is how to actually claim it. So here's everything I tell my clients, in plain English.

How myotherapy shows up on your health fund

I'm a member of the Association of Massage Therapists (AMT). Myotherapy doesn't have its own provider number with the health funds, so every claim at my clinic goes through as remedial massage.

So when you check your cover, look for remedial massage on your extras. If it's on there, you can claim your sessions with me. (Not sure what the difference is? Here's what remedial massage actually is, and here's what myotherapy is.)

2 ways to claim

1. On the spot with HICAPS

This is the easiest way. Bring your physical health fund card, or have the digital card ready in your fund's app. If you're using the app, make sure you're signed in before you get to the clinic. We tap it at the end of your session, your rebate comes off straight away, and you only pay the gap. Done before you walk out the door.

2. Online, after your session

No card on you? No problem. I'll give you an invoice, and you claim it through your fund's app or website. It's quite easy to do these days.

How much will I get back?

The honest answer is it depends on your fund and your level of cover. Some of my clients get 100% back. Some get 80%, some 50%, and some only 5 or 10%. I haven't seen a common pattern between the funds, so I can't tell you what yours will pay.

The easiest way to find out is to call your fund (or check the app) before you book.

My prices, so you know what you're claiming against:

1 hour treatment: $124
30 minute treatment: $84
First visit (60 minutes): $134, or $124 with the new client offer

7 questions to ask your health fund before you book

Does my extras cover include remedial massage?
How much do I get back per visit? Is it a percentage, or a set dollar amount?
What's my annual limit, and how much have I already used?
When does my limit reset? Some funds reset mid-year, some at the end of the financial year.
Is there a waiting period before I can claim? This matters if you've just joined or changed your cover.
Does my provider need to be a member of a particular association? (I'm with AMT.)
Can I claim on the spot with my card or app, or do I claim online afterwards?

Some people use up their extras quickly because they need more treatment, so knowing your limit early saves a surprise later.

Your health fund shouldn't decide your treatment

I never suggest a 30 or 60 minute session based on what your fund covers. I don't even ask about it. If you've got cover, great. But it shouldn't change the treatment you get. It's all about what you need: body-wise, pain-wise, physically. It shouldn't be about the fund at all.

If you're wondering how many sessions you'll actually need, I wrote about that here: how often you should see a myotherapist.

What if I don't have private health insurance?

Whether you have insurance or not, I think it's still worth it. It's your health, it's your pain, it's your everyday life. It's great if you can get it covered, but it's still worth it if you can't. It really depends on the person and what they can afford.

What about Medicare, WorkSafe and TAC?

Medicare doesn't cover myotherapy or remedial massage.
No GP referral needed. You can book straight in.
WorkSafe and TAC: I'm not registered for these, so I can't process WorkSafe or TAC claims at the clinic.

Quick checklist for your first visit

Know what your fund covers (use the 7 questions above).
Bring your physical card, or have your digital card ready in the app. Make sure you're signed in.
That's it. We'll claim it on the spot.

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