No gap physiotherapy in Miranda
On an accepted workers compensation or CTP claim there is nothing for you to pay. We bill your insurer directly for reasonably necessary treatment, so you can focus on getting better, not on the bill.
Nothing to pay when your claim is accepted
No gap means exactly that. On an accepted workers compensation claim, reasonably necessary treatment is billed directly to your insurer, so you have nothing to pay at the time of your appointment and no gap fee. We invoice the insurer on your behalf for all approved sessions.
The same applies to accepted CTP motor accident claims. We bill the insurer for approved treatment, so the cost does not land on you. It is worth knowing that no gap billing applies to accepted claims and approved or reasonably necessary treatment only, not to a claim that is still pending or has been declined. Every claim is a little different, so we confirm your exact arrangement with your insurer or case manager before we begin.
- Accepted workers compensation claim with icare NSW or its scheme agents
- Accepted CTP claim with NRMA, QBE, GIO or Allianz
- WorkCover Queensland claims
- Treatment that is reasonably necessary and approved for your injury
Often you can start straight away
If you have an accepted NSW workers compensation claim, we can usually start your physiotherapy without waiting for further approval. Where your injury has not been treated by a physiotherapist before and treatment begins within three months of your injury, SIRA allows up to eight sessions before any further approval is needed.
That number is not universal. If treatment starts more than three months after the injury, up to three consultations may be provided without pre approval, and a practitioner returning to an injury treated more than three months ago gets one. Treatment must always be reasonably necessary and delivered by a SIRA approved practitioner, which we are. We confirm the exact arrangement with your insurer or case manager for your individual claim.
We handle the paperwork to keep your care going
If you need treatment beyond the initial pre approved sessions, we submit an Allied Health Treatment Request, or AHTR, to your insurer. This is the SIRA form physiotherapists use to ask for approval for further treatment. It sets out your current presentation, your progress, any barriers to recovery and the proposed plan, including the number of further sessions and the expected timeframe.
The insurer decides on the request, so we cannot promise approval, but we prepare it thoroughly and follow it up. Once it is approved, treatment continues with no cost to you. We work alongside your nominated treating doctor so our treatment supports the plan in your Certificate of Capacity, and we handle this paperwork for you so there is no gap in your care.
Private fees, Medicare and private health
If you do not have a claim, our private fees are simple and upfront. An initial physiotherapy appointment is $165 for 60 minutes and a follow up is $142 for 40 minutes. You can see the full breakdown on our fees page.
Where you are eligible, a Medicare Chronic Disease Management plan from your GP can contribute toward a set number of physiotherapy sessions each year, and if you hold extras cover that includes physiotherapy you can claim a private health rebate. We provide a receipt with everything your fund needs. These reduce what you pay out of pocket rather than removing it entirely the way an accepted claim does.
Experienced in workers compensation and occupational rehabilitation
Andrew Ellis is the founder and principal physiotherapist at PACT, with extensive experience in workers compensation and occupational rehabilitation. He holds a Bachelor of Science in Exercise Science, a Master of Physiotherapy, is completing an Executive MBA, and brings 16 years of experience across the SIRA NSW scheme.
Drawing on his background as a Senior Rehabilitation Consultant and Workplace Health and Safety Advisor, and having delivered injury prevention training to thousands of workers, he works closely with insurers, case managers and employers to support a safe and sustainable return to work. PACT Physio and Rehab is an approved provider under SIRA (icare NSW) and is AHPRA registered.
Booking your first no gap appointment
Have your claim details handy when you get in touch. The insurer, your claim number and your case manager if you have one all help us confirm your arrangement quickly. If your claim is not yet accepted, we can still book you privately and switch to direct billing once it is approved.
Book online or call our Miranda clinic and we will take it from there. We are at Unit 1/196 Sylvania Road, Miranda, open Monday to Friday 7:30am to 9pm and weekends 8:30am to 6pm, and we also offer telehealth Australia wide through PACT Virtual Care.
No out of pocket cost
On an accepted workers compensation or CTP claim, your treatment is billed directly to the insurer. There is no gap and nothing for you to pay at your appointment, and we handle the invoicing for you. If you are a private patient, see our fees.
Good to know
Is physio really no gap on a workers comp claim?
What if my claim has not been accepted yet?
Does no gap apply to CTP motor accident claims too?
How many sessions are covered before further approval?
What happens after those sessions?
What do I pay if I do not have a claim?
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Same day appointments often available at our Miranda clinic, or by telehealth across Australia.