Enhanced Primary Care Plans 

2023


The Chronic Disease Management Plan (formerly called an Enhanced Primary Care Plan (EPC)) is a Federal Government initiative that allows eligible patients access to UP TO FIVE Allied Health Services (this includes Physiotherapy) per calendar year under Medicare, upon referral from a General Practitioner (GP).

The current rebate is $58.30 per appointment.

Is this for me?

  • Eligibility criteria?

    To be eligible you must either have:

    • A chronic medical condition that has been present (or is likely to be) for six months or longer;
    • Complex care needs that require ongoing care from a multidisciplinary team consisting of your GP and at least two other healthcare professionals.

  • How do I get a care plan?

    If your GP believes you would benefit from Allied Health Services such as physiotherapy, then a care plan needs to be initiated.

    To refer a patient for physiotherapy, a GP needs to provide the following Medicare Benefits Schedule - Chronic Disease Management Services:

    • A GP Management Plan (GPMP) - Item 721 (or review item 732)
    • A Team Care Arrangement (TCA) - Item 723 (or review item 732)

    You will need to obtain these from your GP before your appointment if you would like to access the Medicare rebate and bring them with you to your appointment.

  • Will I have an out of pocket expense?

    Due to the specialised area of care at Pelvic Health Melbourne, your plan does not cover the cost of your entire appointment. 

    It will allow you to access a rebate of $58.30 for each appointment for up to 5 treatments.

    You will still have an out- of pocket expense.

How do I use my plan?

  • How do I get the rebate?

    We require consultations to be paid in full on the day of your appointment.

    Our reception staff will submit your claim to Medicare on your behalf  (assuming you already have a bank account linked with Medicare). These claims are processed the same day and you should receive the funds directly into your nominated bank account.

  • Can I claim a rebate through Medicare and my Private Health Insurance for the same appointment?

    Unfortunately, no. You may only use the Care Plan  OR your Private Health Insurance, but not both to pay for each appointment. 

    We are happy to provide you with a Private Health Insurance quote so you can decide which option would be of better value for you.

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