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Physio Medicare EPC at bounceREHAB: Claim Your Medicare Rebate!

Updated: Jan 7

By Matthew Craig

Principal Physiotherapist

bounceREHAB est.2005

Matt: “Look, the short answer could be YES, but you have to meet specific criteria as far as your GP is concerned”.

There is no list of eligible conditions”

As we all know, Physiotherapy is a critical component of treatment for a wide range of on going musculoskeletal, cardiorespiratory and/or neurological conditions such as pregnancy & childbirth, osteoarthritis, cancer, asthma, diabetes, post surgical pain, chronic pain, neck pain and back pain.

For some patients there are ways to access a Medicare rebate for physiotherapy via the Chronic Disease Management (CDM) services.

You would think actually getting a GP referral for a Medicare rebate for physiotherapy should be a fairly simple process, however, this is not always the case and the power for your access to a Medicare rebate for physiotherapy lies is in the hands of your GP Doctor.

What is the eligibility?

The CDM (or previously known as EPC plan) requires eligible patients to be under the care of 3 health practitioners (often the GP, Physiotherapist and another practitioner (which could be a specialist, surgeon, obstetrician, cardiologist, urologist, oncologist or other allied health practitioners such as podiatrist ).

It also requires patients to have a complex and chronic condition- meaning that the condition must have been present for, or likely to be present for, more than 6 months. The aim of this program is to provide assisted care for patients who require a structured approach and require ongoing care from a multi-disciplinary team.

Matt (again): “So if you just sprained your ankle, you probably shouldn’t be seeing your GP for a Medicare referral. But if you do have a condition that requires you to see a specialist such as an orthopedic surgeon, neurosurgeon, oncologist, obstetrician, gyneacologist, sports doctor, cardiologist, or significant other you should consider seeing your GP for a Medicare referral to us at bounceREHAB for physio.

How many sessions do I get?

You can access up to 5 consultations under this program per calendar year, to any allied health practitioner your GP nominates. This is a great start for many people, however chronic and complex conditions require more than 5 sessions to treat properly - which is important in planning what the best course of action is with your physiotherapist. You are eligible to have a new referral each calendar year, subject to review with your GP.

How much does the Medicare rebate cover?

Currently the rebate is $58.95 per treatment for a physiotherapy consultation. This rebate is at times much more per visit than private health insurance rebates and if you have hit the annual medicare threshold you may receive a much larger rebate per physio session.

We do not bulk bill for Medicare services, so there will always be a gap payment. This amount varies by practitioner and service. If you call the clinic, we would be happy to talk through your condition, how we can help and exactly what your out of pocket expenses will be – no surprises!

Do I have to go to Medicare to get my rebate?

No! We have Medicare Online Claiming here at bounceREHAB and can process your claim on the spot if our frontdesk is attended to, saving you time, effort and hassle.

Here’s how it works:

  1. You pay us for the full consultation cost at the time of each treatment (card or cash)

  2. We process the payment through our system, which links into Medicare (bring your physical medicare card and a physical debit card - you need to know your debit PIN)

  3. Your rebate is paid direct into your bank account within 1-3 days

If you have any further questions about this program - or if you have an EPC/CDM plan, please give us a call on (02) 95717606 or make a booking by clicking on this link

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