Medicare
Medicare
A Chronic Disease Management Plan (CDM), also known as an Enhanced Primary Care Plan (EPC) or Team Care Arrangement (TCA) is a Medicare Government initiative to individuals to receive affordable and collaborative healthcare from an array of health professionals, such as physiotherapy, that provides funding for up to 5 sessions per calendar year.
Medicare benefits are available to people with chronic conditions and complex care needs who are being managed by a GP.
Claiming Medicare for physiotherapy is done through subsidized visits. Medicare is available to assist you in paying for physiotherapy; you still need to pay a gap fee of the consultation. The Medicare subsidy covers 20 minutes of the physio session, and being an evidence-based practice, our sessions are on average 30-45 minutes in length.
What does an EPC physio treatment involve?
All treatment sessions at The Physio Doctor are about an hour long, and consist of an Initial Assessment, physio diagnosis, treatment, prognosis, and treatment plan.
We also introduce ourselves and prepare letters for your GP and other medical/health specialists involved in your Care Team to ensure your overall chronic health recovery is aligned and collaborative.
How do I receive the rebate?
We take payment in full on the day of your consultation, then swipe your (same) debit card and deposit the Medicare rebate back into your bank account via our HICAPS machine.
You pay the full fee of the consultation.
We swipe your Medicare card to access the rebate.
You swipe your Debit or Cheque card. You immediately receive the rebate of $58 back to your card.
Please note the rebate cannot be returned to a credit card. Please ensure you have a debit card if you want to access an immediate rebate. If we cannot issue the rebate you can simply lodge your receipt through MyGov.
Medicare Expiry
EPC referrals have a 12 month expiry from the referral date and roll over into the next year. However, you are entitled to 5 sessions per calendar year.
Use all 5 sessions before the end of the year to receive an additional 5 sessions in the new calendar year. The sessions roll over into the next year, however become part of the new calendar years 5 sessions. Therefore, if you used 3 sessions in 2023 but have 2 sessions left on your referral that you use in 2024, your GP will only give you an additional 3 sessions for 2024.
We highly recommend using your sessions before the end of the year to ensure you maximise your Medicare benefits.