Is ACC Physio Free? The Surcharge, the Session Limit and the Numbers
ACC-funded physiotherapy is not free. ACC pays the clinic a fixed contribution and the clinic decides what to charge you on top, and in a market review ACC jointly commissioned and published, the median surcharge for a follow-up appointment was $40 including GST, with a range across surveyed practices from $0 to $150 (Sapere, *Physiotherapy Market Review*, 10 December 2025, Table 9, retrieved 20 August 2026).
ACC says the same thing on its own front door, without the number: "If the injury is covered, we pay part of the health provider appointment fees. You'll need to pay the rest" (ACC, last published 13 February 2026, retrieved 20 August 2026).
What ACC actually pays a physiotherapist
There are two funding routes, and which one your clinic is on changes both the money and the session count. Neither is visible from the waiting room.
Clinics on ACC's Allied Health Services contract, sometimes called accredited providers, are paid per consultation at prices set in the published service schedule: $65.97 excluding GST for an initial consultation and $49.47 excluding GST for a follow-up (ACC, Service Schedule for Allied Health Services, service items PT01 and PT02, schedule dated 1 November 2026, retrieved 20 August 2026).
Clinics working under the Cost of Treatment Regulations are paid the rates set in regulation. For physiotherapy, billing code PHY3, ACC can pay either a flat rate of $27.42 excluding GST, $31.53 including GST, for each consultation, or an hourly rate of $68.99 excluding GST, $79.34 including GST, for the time the client receives direct treatment, apportioned in five-minute steps (ACC, Specified treatment provider costs, ACC1523, effective 1 June 2024, retrieved 20 August 2026). Over 95% of providers on this route use the hourly rate rather than the flat rate (Sapere, citing ACC data, retrieved 20 August 2026).
| Funding route | ACC pays for an initial appointment | ACC pays for a follow-up |
|---|---|---|
| Allied Health Services contract | $65.97 excl GST | $49.47 excl GST |
| Cost of Treatment Regulations, flat rate per consultation | $27.42 excl GST | $27.42 excl GST |
| Cost of Treatment Regulations, hourly rate | $68.99 excl GST an hour, apportioned | $68.99 excl GST an hour, apportioned |
Contract prices from the ACC Allied Health Services service schedule; regulation rates from ACC1523 (effective 1 June 2024), both retrieved 20 August 2026. ACC publishes the contract prices excluding GST and the regulation rates both ways.
So what does one appointment actually cost you?
Put ACC's contribution and the median surcharge side by side and the split moves a long way depending on which route your clinic is on.
ACC's published contribution for one follow-up appointment against the median patient surcharge of $40 including GST. Contribution figures from the ACC Allied Health Services service schedule and ACC1523; surcharge from the Sapere market review Table 9 (all retrieved 20 August 2026). The contract figure is our gross-up of $49.47 at the standard 15% GST rate, and the 30-minute hourly figure is ACC's own published part-hour amount. The median appointment length for a follow-up in the same survey was 30 minutes.
| Funding route | ACC pays, incl GST | Median surcharge, incl GST | Total | ACC's share |
|---|---|---|---|---|
| Allied Health Services contract | $56.89 | $40.00 | $96.89 | 59% |
| Regulations, hourly rate, 30 minutes | $39.68 | $40.00 | $79.68 | 50% |
| Regulations, flat rate per consultation | $31.53 | $40.00 | $71.53 | 44% |
The bottom row is the one worth noticing. On the flat regulation rate, the patient pays more for the appointment than ACC does. The percentages and the $56.89 are our arithmetic on the published rates; the rest is as published.
Surcharges are not capped, and ACC's contract says so directly: physiotherapy and podiatry suppliers "may set and charge a Client a co-payment for Services provided", and charges "must be clearly displayed, and the Client must be made aware of the charges prior to receiving the Services" (ACC Allied Health Services service schedule, clauses 19.2 and 19.3, retrieved 20 August 2026). The same clause allows a clinic to charge you for materials such as strapping or orthoses, for travel, and a did-not-attend fee for a missed appointment, provided you were told first.
What you pay also depends on where you live. Average follow-up fees ran from $47.60 in large cities down to $30.70 in remote areas in the same survey.
| Practice location | Average initial fee, incl GST | Average follow-up fee, incl GST |
|---|---|---|
| Urban, large city or metropolitan area | $55.70 | $47.60 |
| Provincial town or small city | $51.10 | $41.90 |
| Rural, small town or community | $48.50 | $40.50 |
| Remote or isolated area | $34.00 | $30.70 |
From the Sapere physiotherapy market review, Table 10, survey of physiotherapy suppliers (10 December 2025, retrieved 20 August 2026).
How many physio sessions does ACC cover?
There is no hard cap. There is a trigger number, after which your physiotherapist has to ask ACC before it will keep paying, and the trigger depends on the funding route.
For providers working under the regulations, prior approval is needed when the treatment trigger number of 16 has been or is about to be reached, when more than a year has passed since an allied health provider first treated you, or when a diagnosis is being added or changed. For contracted providers, the trigger number is 50 (ACC, getting prior approval for further treatment, last published 16 June 2026, retrieved 20 August 2026). Acupuncture sits separately, with a trigger of 12 treatments or 12 weeks from the first treatment.
Two things follow. Passing the trigger is not a decline, it is a request, and ACC says most requests are standard ones that need no medical evidence and can get an immediate decision by phone. But ACC will not pay for treatment provided beyond the trigger without prior approval, and it can recover the money from the clinic if it does (ACC Allied Health Services service schedule, clauses 13.1 to 13.4, retrieved 20 August 2026). That is why a clinic will sometimes pause your treatment for a few days rather than book you in again.
The trigger number is also injury-specific rather than universal. ACC tells providers that each Read code, the code used to record your injury on the claim, carries a trigger number telling them how many treatments ACC will pay for (same page, retrieved 20 August 2026).
How to check before you book
Four questions, in the order that gets you an answer fastest.
Ask the clinic what its surcharge is for an initial appointment and for a follow-up, as two separate numbers. The gap between them is real: the median initial fee in the survey was $49 against $40 for a follow-up, and the maximum in both cases was $150.
Ask whether the clinic holds ACC's Allied Health Services contract or works under the Cost of Treatment Regulations. That single answer tells you whether your treatment trigger is 50 or 16.
Ask whether the surcharge changes if the appointment runs longer, and whether there are separate charges for strapping, orthoses or a missed appointment. All three are permitted, and all three have to be disclosed to you in advance.
Ask whether your claim is already accepted. ACC only contributes once your injury is covered, and it confirms cover by text, usually with a letter within a week (ACC, last published 13 February 2026, retrieved 20 August 2026). Your physiotherapist can lodge the claim for you if nobody has yet.
Why there is a surcharge at all
Because ACC's funding model assumes one. The market review ACC commissioned found that "cost modelling shows ACC's contribution is reasonable, enabling practices to cover their costs when combined with sufficient service utilisation and a suitable copayment" (ACC, 30 March 2026, retrieved 20 August 2026). The copayment is not a clinic taking liberties. It is part of how the sums are meant to work.
The same review found significant inequities in access by socioeconomic deprivation, ethnicity and rurality, and reported that surcharges of $20 to $25 were common in low socioeconomic areas and were not always collected (same review and Sapere report, retrieved 20 August 2026).
The one scheme that made ACC physio genuinely free is no longer running. From 2022 ACC piloted fully funded physiotherapy for clients in Ōtara and Māngere who held a Community Services Card or faced financial barriers. ACC decided not to extend it, citing limited data and the predicted size of the investment needed to expand it, and the pilot ran only until its budget cap or its contract expiry on 31 December 2024 (ACC, 31 July 2024, retrieved 20 August 2026).
The limits on these figures
The surcharge numbers are survey figures, not a price list. They come from Sapere's survey of physiotherapy suppliers for a review dated 10 December 2025 and describe what practices reported charging, so an individual clinic can sit anywhere in the range and nothing obliges it to be near the median.
The rates ACC pays are current published rates, but they carry different effective dates. ACC1523 is effective 1 June 2024 and the Allied Health Services service schedule at ACC's contract URL is dated 1 November 2026. The two figures the review quoted for contract consultations in December 2025, $65.97 and $49.47, are unchanged in the schedule published now.
ACC does not publish the trigger number attached to each Read code, so we cannot tell you how many sessions your specific injury carries before the first approval request. It publishes only the 16 and 50 thresholds and the fact that Read codes carry their own numbers.
Where this sits against private cover
Physiotherapy surcharges are small money. The reason people end up reading ACC pages in the first place is usually the larger question underneath: what happens to the income if the injury keeps you off work, and what happens if the problem turns out to be an illness rather than an accident, which ACC does not cover at all. Those are set out in what ACC does not cover and the ACC gap explained.
QuoteHub is operated by Craig Smith Business Services Limited, trading as Smiths Insurance and KiwiSaver, a licensed Financial Advice Provider (FSP712931). Our panel is listed on our disclosure page.
References
- ACC, Specified treatment provider costs (ACC1523) (effective 1 June 2024, retrieved 20 August 2026): the PHY3 physiotherapy flat and hourly rates, GST inclusive and exclusive, and the part-hour table
- ACC, Service Schedule for Allied Health Services (schedule dated 1 November 2026, retrieved 20 August 2026): PT01 and PT02 consultation prices, clause 13 prior approval, clause 19 co-payments and additional charges
- ACC, Getting prior approval for further treatment for allied health providers (last published 16 June 2026, retrieved 20 August 2026): the treatment trigger numbers of 16, 50 and 12, and the standard and non-standard request criteria
- Sapere, Physiotherapy Market Review, final report (10 December 2025, retrieved 20 August 2026): Table 9 fee range, Table 10 fees by location, Table 12 appointment times, and the funding model description
- ACC, Physiotherapy Market Review, findings and next steps (30 March 2026, retrieved 20 August 2026): ACC's summary of the review's key findings
- ACC, What to do if you're injured (last published 13 February 2026, retrieved 20 August 2026): ACC pays part of the appointment fee and you pay the rest
- ACC, Treatment we can help pay for (last published 18 March 2025, retrieved 20 August 2026): what to ask your provider, and refunds if you paid the full cost
- ACC, Community Services Card Physiotherapy pilot ending soon (31 July 2024, retrieved 20 August 2026)
Disclaimer: This article is general information only and does not constitute personalised financial advice. ACC contribution rates are reproduced from ACC's published rate documents as at the effective dates stated beside them, and surcharge figures are survey results from the named report rather than prices any clinic is bound by. Ask your own provider what it charges before you book. QuoteHub is operated by Craig Smith Business Services Limited, trading as Smiths Insurance and KiwiSaver, a licensed Financial Advice Provider (FSP712931), Christchurch.
Read the full insurance guides
Compare your cover with a licensed NZ adviser · free, no obligation.
Explore related pages: Life Insurance, Income Protection, Health Insurance, Trauma Insurance, Free Will.