Is Shockwave Therapy Covered by Private Health Insurance in Australia?
WRITTEN BY DR RUSSELL JENSEN Principal Chiropractor
Southside Spine and Sport, Bicton WA
Practising chiropractor since 2015.
Trained in Integrative Diagnosis (USA).
Special interest in nerve entrapment conditions including cluneal nerve pain, sciatica, and piriformis syndrome.
Full profile: southsidespinesport.com.au/meet-our-chiro
It is one of the most common questions I get from patients who are considering shockwave therapy. They have done the research, they understand the treatment, and then they stop and ask: will my health fund cover any of this?
The short answer is yes, in most cases it will. But the way it works is not quite what most people expect. In this post, I would like to explain how private health insurance applies to shockwave therapy in Australia, what you need to check before your appointment, and how we handle it here at Southside Spine and Sport.
How Private Health Insurance Works for Allied Health in Australia
In Australia, private health insurance splits into two types of cover: hospital cover and extras cover, sometimes called ancillary cover. Shockwave therapy falls under extras cover, not hospital cover.
Extras cover pays a rebate towards out-of-hospital health services that Medicare does not cover. These include chiropractic, physiotherapy, podiatry, remedial massage, dental, and optical. If you have an extras policy that includes chiropractic or physiotherapy, you will be able to claim through those respective providers.
The key point is this: shockwave therapy in Australia is not listed as a standalone item by health funds. It is delivered as part of a consultation, and your rebate applies to the consultation itself.
So Can I Actually Claim a Rebate?
Yes, if your extras cover includes the relevant discipline (chiropractic or physiotherapy, depending on who delivers the treatment) your fund will pay a rebate on the consultation.
At Southside Spine and Sport, shockwave therapy is delivered by me as your chiropractor. The claim goes through under chiropractic extras, using your standard chiropractic item number. There is no separate shockwave item number and no separate surcharge.
At Southside Spine and Sport, focused shockwave therapy is included as part of your standard consultation. You pay one fee. There is no surcharge, no separate item to claim, and no hidden extras. Your health fund rebate applies to the whole visit in the same way it would for any chiropractic appointment.
The typical chiropractic rebate through major Australian health funds ranges from around $30 to $60 per visit, depending on your level of cover and your specific fund.
What to Check With Your Fund Before Your First Appointment
Before your first appointment, it is worth spending five minutes confirming the following with your health fund.
Your policy includes chiropractic in its extras cover. Not all extras policies include every discipline. Basic or entry-level policies sometimes exclude chiropractic or have very low annual limits.
Your waiting period is served. Most extras policies have a two-month waiting period for new members or for members who have recently upgraded to a higher level of cover.
You have remaining annual limit available. Extras benefits come with an annual limit, which is the maximum amount your fund will pay towards that service category in a calendar year.
The quickest way to check all of this is to log into your health fund's app or member portal and look under your extras benefits. Major funds including HBF, Medibank, Bupa, and NIB all have this available. You can also call your fund directly and they will give you a benefit quote once they have your provider's item number.
Claiming on the Day: How HICAPS Works
Most chiropractic clinics in Australia, including Southside Spine and Sport, process health fund claims electronically on the spot using HICAPS (Health Industry Claims and Payments Service).
When you attend your appointment, we swipe your health fund card and it connects directly to your fund. You pay only the gap on the day.
If you forget your card or your fund is not on HICAPS, you can still pay the full amount on the day and then submit the receipt to your fund for reimbursement through their app or website. Reimbursement is usually processed within a few business days.
What About Medicare?
Medicare does not cover standard chiropractic consultations. However, your GP can refer you through a Chronic Disease Management Plan (formerly called an Enhanced Primary Care Plan) for up to five Medicare-subsidised sessions with an eligible allied health provider per calendar year. The current Medicare rebate for these sessions is $61.80 per visit.
If you have a relevant chronic condition and have not already used a Chronic Disease Management Plan this year, it is worth asking your GP whether you qualify. You cannot claim both Medicare and your private health fund rebate on the same visit, but the Medicare pathway can be a useful addition for the right patient.
A Note on Focused vs Radial Shockwave
Not all shockwave is the same, and this is worth understanding before you book anywhere.
Most clinics in Perth offering shockwave therapy are using radial shockwave, sometimes called radial pressure waves. These waves are strongest at the skin surface and only penetrate to roughly three centimetres deep, making them effective for superficial muscle and fascia problems. Different machines vary slightly, but that is the general picture. Most of these clinics also charge a separate surcharge on top of their standard consultation fee for this.
At Southside Spine and Sport, I use focused extracorporeal shockwave therapy (focused ESWT). Focused ESWT delivers high energy acoustic waves at a precise depth, which makes it more effective for deeper structures including tendons, calcifications, and certain nerve entrapment conditions. It is the more clinically specific tool, backed by stronger evidence for the conditions I use it to treat.
I have used both machines. When comparing them side by side for the same condition, focused shockwave is consistently more effective and produces superior results than radial.
There are obviously differences in how each can be applied, and there are situations where radial has its place, but on a like for like basis the results speak for themselves.
When it comes to claiming, there is no difference on your end. Shockwave is included in my standard consultation, and if your extras cover includes chiropractic, you will be covered.
Book an assessment online or call us: 08 6317 9897
Frequently asked questions
Does my health fund cover shockwave therapy if it is delivered by a physiotherapist instead of a chiropractor?
Yes. If you have physiotherapy cover and a physiotherapist is delivering your shockwave therapy, you will be covered. Keep in mind that some funds use separate annual limits for physiotherapy and chiropractic, so it is worth checking which one applies to your remaining balance.
Is there a specific shockwave item number I need to give my health fund?
No. In Australia, shockwave therapy delivered within a chiropractic or physiotherapy consultation does not have its own item number. Your provider bills using their standard consultation item number.
Can I claim shockwave therapy if I am covered by WorkCover or DVA?
WorkCover and DVA coverage depends on whether your condition is accepted and whether chiropractic treatment is approved for your case. Contact your claims manager or the relevant authority to confirm.
What if my plan has very low chiropractic benefits?
If your annual chiropractic limit is low, you may exhaust it before completing a full course of treatment. A typical course of focused shockwave therapy at Southside Spine and Sport involves up to six sessions. If your annual limit covers two or three of those, your out-of-pocket cost for the remaining visits will be the full consultation fee.
Ready to Book?
If you have a chronic tendon, nerve, or soft tissue condition that has not responded to standard treatment, focused shockwave therapy may be the next step. I am happy to talk through whether it is appropriate for your situation before you book.
Call us on 08 6317 9897 or book online. Bring your health fund card to your first appointment and we will process your rebate on the spot through HICAPS. No paperwork, no waiting.
Or call us on 08 6317 9897 if you would prefer to talk first.
Written by Dr Russell Jensen, Principal Chiropractor (AHPRA: CHI0001927257), Southside Spine and Sport. Published June 2026.
This article is for general information only and does not constitute medical advice. Always consult a qualified health professional for diagnosis and treatment.
